Chennai: Virudhunagar health unit district, which excludes Sivakasi, registered no maternal deaths in 2023-24 – a drop from 15 deaths in 2021-22 and 6 in 2022-23, the state health department announced on Monday. The maternal mortality ratio (MMR) for Virudhunagar district, which includes deaths in Sivakasi, was 27 in 2023-24.
Between April 2023 and March 2024, the MMR for the state was 45.5 per one lakh live births, a decline of seven points from 52.3 in 2022-2023. When the COVID-19 pandemic hit Tamil Nadu in 2020, MMR increased for the first time in a decade. In 2020-21, maternal mortality went by 38 per cent from 53.4 to 73 per lakh live births.
The next year, it rose by another 24 per cent to 90.6. In the post COVID period in 2022-23, the MMR returned to 52.3. “We have seen the biggest decline after that in 2023-24 when MMR dropped to 45.5. It is the results of efforts taken by the government,” health minister Ma Subramanian said at a workshop on bringing down maternal mortality rate – connecting the missing dots. While districts such as Kanyakumari (14.5), Vellore (20.5) and Coimbatore (23.3) were among the lowest, Tirunelveli (77), Tirupattur (72.1) and Tirupur (69.9) were among the highest. “We must ensure there are no maternal deaths,” the minister told senior health officials and doctors at the conference. “When Kerala can have an MMR below 18 why can’t we ensure it for our women,” he asked.However, C-sections in the state continue to remain high. Although life-saving when done at the time of need, needless C-sections can increase risk of deaths in mothers, they said. Experts said increasing C-section rates were worrying and needed policy revision. “We must ensure blood sugar and blood pressure are under control, monitor high-risk women and ensure timely referrals to appropriate levels of care,” said a senior gynaecologist. One out of every two women underwent a C-section in the state. Of the 8.7 lakh women, 4.3 lakh, 50 per cent delivered through C-section. In 2016, C-sections were below 40 per cent in TN.On Monday, data released by health department showed the private sector recorded 58 per cent compared to 43 per cent in government hospitals. In Virudhunagar, 57 per cent of overall deliveries were C-Section – 52 per cent in government and 71 per cent in private. In Kanyakumari, which had the lowest MMR C-sections were recorded at 62 per cent . “We may not be able to keep MMR at zero, but bringing down C-sections will be difficult. Perambalur, which reported one death, brought MMR to 10 in 2015.
C-sections rose to 50 per cent . Now, MMR in the district is more than 24 and doctors have not been able to bring down C-sections,” she added. Data showed that C-section deliveries were higher in GHs at Villupuram and Nilgiris. For instance, 52 per cent of deliveries in GHs were C-sections compared to 37 per cent in private. Nearly 52 per cent of deliveries in this district were in GHs. In Nilgiris, 48 per cent of deliveries in GH were C-sections compared to 42 per cent in private hospitals.
Health secretary advocated for documenting outcomes of maternal audits in all districts, reducing preventable death in private hospitals, learning from other states and coordinating with other department to help women improve nutrition and follow health protocols.
