The first day in a new life
In Bihar, a state with one of the lowest rates of hospital births in India, you will hear repeatedly that a new mother has come back home from the hospital within a few hours of delivery. The time may vary depending on when the family gets the government incentive of Rs 1,400 (about $28) that a new mother is entitled to. Occasionally, a family may spend the night if it’s too dark to travel back to the village. Most people aren’t aware of just how crucial those first forty-eight hours are for both the mother and the baby.
The reasons for hurrying back are manifold. Some don’t want to waste time in the alien atmosphere of a hospital and want to get back to celebrate the new arrival. Others say they fear being asked to pay money if they stay back. They are unaware that most complications occur during this forty-eight hour period and that staying in the hospital over night could potentially save the mother’s and the baby’s lives.
What will the family do back in the village if there is a complication in the mother’s or baby’s health?
Mistake 1: Some might go to one of the ‘jhol tanga’ doctors – quacks who roam villages on bicycles with a side-bag, or ‘jhola’, carrying supplies.
Mistake 2: Others may scramble to borrow money from neighbours and arrange a taxi back to the hospital. The question is will they make it in time and how will they pay back the money they borrowed?
Mistake 3: And others may even rush to the traditional midwife in the village and drag her home to attend to the mother or baby. But can she deal with postnatal complications?
Unfortunately, too often these measures aren’t enough.
Families are often eager to take their newborns home immediately after birth. The Government of Bihar provides free services to families to encourage them to spend at least 24 hours at the primary health centre after delivery, ensuring better care for the new mother and her infant. The incentives cover transport, food and accommodation.
Community Health Workers are incentivised by the Government of Bihar to visit women and newborns at home within three days of the birth. If the baby is low weight at birth, then the Community Health Worker should make seven visits within the first week to closely monitor the newborn’s health.
Out of every 1,000 live births in Bihar, 35 children die within 28 days of delivery. It is critical to be able to identify and take immediate action if there are signs of illness.
Families are encouraged to visit primary health centres at least three times during the baby’s first six weeks to measure its growth and progress.