India is becoming a major threat in high-risk pregnancies where around 500 women per thousand die annually. The Union government's one-year old programme titled 'Avoiding maternal deaths' in the rural areas is creating an awareness on the availability of antenatal facilities in the primary health centres to prevent such deaths.

The government has started the Auxiliary Mid-wives Programme where training is imparted by doctors on the abnormal and normal symptoms of labour. But the Federation of Obstetrics and Gynaecologists of India (FOGSI) is of the view that unless the awareness drive on ante natal facilities is organised by the government on similar lines of the Pulse Polio campaign, the number of deaths would not come down.

The majority of maternal deaths in India are due to lack of ante natal care which can be prevented if the right medical attention is given from the start of pregnancy. The main causes of high-risk pregnancies are poor nutrition, anaemia and lack of neonatal care centres in the rural areas. A common problem in high risk pregnancy is the gynaecologist needs take care of two lives-mother and foetus. “It is crucial to ensure that every pregnant woman in the rural areas comes in for antenatal check-ups regularly. The pregnancy and labour need to be supervised to prevent problems,” Dr. Mandakini Parihar, head, Safe Motherhood Committee, FOGSI, who also runs a IVF centre and Fertility Clinic in Mumbai told Pharmabiz.com

The full-fledged neonatal clinics are only in the metros and not in the towns and villages where women in advanced stage of pregnancy comes in late to save the foetus. FOGSI has also set up a committee to take care of the rural obstetrics where an awareness drive is on to bring down the maternal mortality.

The developed counties have around 15 percent of women in high risk pregnancies and about 20 per cent in the developing countries. India does not fare well in maternal mortality which is around 500 per 1,000 women. Sri Lanka had similar maternal mortality rates until a few years ago which has been brought down to 89 per 1000 with massive awareness programmes. Maternal mortality in the West is about 25 per 1 lakh women.

Another major problem in India is the infertility population, which account for around 15 per cent of the total Indian population. The main reasons for infertility in India's urban population is due to stress and in the rural areas the cause is mostly infection and the most common being tuberculosis of the reproductive tract.

The government of India will announce in June 2003 the guidelines for infertility clinics to prevent malpractices in dispensing infertility treatment. FOGSI through its infertility committee is being consulted by the government of India to provide the rules for setting up of infertility clinics for ART (assisted reproductive techniques) in association with the Indian Council of Medical Research (ICMR).