Nagaland doctors say antenatal care matters

DIMAPUR: To reduce the health risks for mothers and their babies during pregnancy, the World Health Organisation has recommended at least four antenatal care (ANC) visits, but a survey undertaken by the government of India has placed Nagaland at the bottom of the table among 22 states and Union Territories analysed.

According to National Family Health Survey 2019-20 (NFHS-5), the proportion of mothers who had at least four ANC visits during their last pregnancy is lowest in Nagaland (20.7%), followed by Bihar at 25%, which is way below the national average of 59% and chart topper Goa at 93%.

The survey showed an increasing trend from 15% in NFHS-4 (2015-16) to 20.7% but the urban-rural divide is palpable with the proportion of mothers who underwent at least four ANC visits in the urban areas of Nagaland standing at 39.9% compared to 13.1% in rural areas.

It also showed that 49% (64.5% urban, 43.6% rural) of mothers in the state had an antenatal check-up in the first trimester during the surveying period, as against the national average of 70%.

What doctors have to say

Underlining the importance of antenatal care, medical practitioners from Nagaland have advised pregnant women to visit a doctor at least three to four times during their pregnancy period, or even more than once a month as per the advice of health experts, in cases of complications.

Sharing with Eastern Mirror about the importance of antenatal checkups, a senior obstetrician and gynaecologist working at a private hospital in Dimapur, said that during this period, doctors check the baby position, detect complications if any, see if the foetus is growing, check if placenta is placed right, look for malformations, and other associated diseases such as human immunodeficiency virus (HIV), hepatitis and others.

He said that majority of the women who come for antenatal checkups at the health facility he works are from urban areas.

Hopefully, women in rural areas go to government hospitals in their areas, or get checkup from ASHA and other health centres, he said.

The senior doctor said that if a pregnant woman does not go for medical checkup, she will not know if she has any complications, which can put her life as well as the child’s life at risk.

Informing that most women suffer from anaemia during pregnancy, which can also lead to maternal death, he said doctors can treat them and ensure that the haemoglobin is well maintained.

Speaking about maternal death, he said that such cases have reduced to a great extent as compared to the past. There are various causes of maternal fatality like hypertensive disorders, bleeding after delivery and others but anemia is one of the main causes, he added.

Dr. Yetovi Tuccu, gynaecologist at District Hospital Dimapur, said that health experts not only examine the mother’s health but also give counselling during an antenatal checkup.

Doctors can confirm the estimate duration of pregnancy, check the weight of baby, see if the baby is developing and if there are any underlying problems only after a checkup. And accordingly, screening is done and medications like iron and calcium are prescribed to boost the baby’s immunity.

The doctor also shared that if a child is delivered in a hospital, the government gives incentives like Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK) for mother and child.

Conceiving

Dr. Tuccu said there is no specific data or research done for Nagaland state on the odds of conceiving but opined that cases of women having difficulty to conceive a child have probably increased over the years.

One probable reason for this trend is women get married in their twenties earlier, but today most of them get married late, he said, adding that there are other various factors which may cause infertility like multiple sex partners, medical or surgical abortions, and many more.

‘With age, conceiving becomes harder because the quality of eggs decreases as women get older. Prime time is before 35 years but the most productive years are from 20 to 30 years,’ he said.

Dr. Tuccu also opined that there may be various factors in both men and women or infections that can cause infertility, but in recent times Polycystic Ovary Syndrome (PCOS) is contributing to anovulatory cycles, where ovulation does not occur, often due to hormonal imbalances.