Motherhood, Malnutrition and National Health

The mothers, are they well ?

Amartya Sen once expressed the concern that while conducting study on the health status of women, the respondents cannot answer most the questions asked related to their health and well-being. Several researches have concluded that one of the reasons for the poor health of women in India is the discriminatory treatment of girl child and married women receive compared to boys and married men. A frightening proof of this is the 63 million of “vanished” girls and women who have apparently died for no explicit reasons (The 2017-18 estimate, released as part of the country’s annual economic survey).

Discriminating feeding practices of girls and boys and access to health care services is among the factors responsible for higher female mortality and poor health when these girls grow into mothers. Discrimination is in the distribution of household resources including food. To our extreme disgust, baby boys are breast-fed longer than their female counterparts and boys are more often taken for medical treatment than girls when sick.

Girls suffer neglect, malnutrition, due to deficiencies of calories, protein, vitamins that affects women and adolescent girls. Malnutrition i.e. lack of protein and carbs threatens the survival of Indian mothers and their children, not to speak of the micro-nutrient deficiency. Infant born to under-nourished mother faces various problems, including cognition impairment, lower tolerance to infections, and a higher risk of falling sick and even death all along their lives. Women tend to suffer from nutritional deficiencies more than men due to their reproductive system, second class social status, poverty, and less or no education.

80% of the Indian pregnant women suffer from iron and iodine deficiencies. Nutrient deficiency leads to low birth-weight of the baby, birth defects and even fear of having a stillborn. Malnutrition from the girls’ childhood causes stunted growth, which later leads to problems during and following childbirth. Women are underweight due to protein energy malnutrition during their childhood in developing countries.

Maternal mortality is 57 fold higher in Indian women than in the USA. Severe anemia accounts for one fifth of all maternal deaths in India. It is believed that higher literacy leads to greater maternal health and lower infant mortality. Cardiovascular disease is the major reason to the high female mortality in India.

Maternal malnutrition in pregnancy and newborn

Under-nourished women lack the nutritional stock needed to support the embryo. Malnutrition has harmful effect on the division and replication of cells in the embryo at early stage, hindering its development. Impaired embryo development eventually affects the making of the foetus in the later stages of pregnancy. When the embryo is set into the wall of the mother’s uterus, it develops two types of cells, those that will create the foetus and those which will shape the placenta, the structure. In poorly nourished women, a smaller number of cells form the foetus than the placenta, meaning that the foetus starts its life smaller. This can result in stunned foetal growth and enhances the risk of the baby being born at a Low birth weight, which in turn is connected with a range of negative outcomes in childhood and later in life.

Malnutrition before Pregnancy

Foetal development is also affected by maternal nutritional status before pregnancy. It is during the first five weeks of pregnancy when the foetus creates most of its organs, heart, brain, lungs and the foetus is most vulnerable to the host body’s malnutrition. Food value deficiencies at this time may restrict the growth of the foetus’s organs.

Health risks for the child in the long term

When a foetus is malnourished in pregnancy it may also have a lifelong programming effect. For example, the foetus may change its metabolism to adjust with the malnutrition by diminishing the amount of insulin and glucose. Such change has been proved to permanently configure the metabolic system and increase the risk of chronic health problems later in life such as type 2 diabetes.

The traditional sin of neglecting a woman’s mind

The social connections of women’s mental health problems are ignored due to gender insensitivity and increasing medicalization rather than behavioral therapy of mental health problems of women.

Women are more at risk of depression while they are pregnant, and during the weeks and months after having a baby. During pregnancy, hormone changes can affect brain chemicals and cause depression and anxiety. Apart from this natural depression, the social stress of perfection and other causes slow poison a woman’s mental well-being. Moreover, it’s a normal practice to ignore this.

The domestic work is undervalued, and women find it hard to progress in a career keeping the domestic endeavors undisturbed. They have to struggle playing multiple profiles and are burdened with images. The criticisms are targeted to lower the victim’s self-esteem, and diminishing self-esteem is a risk factor for psychological complications. We should also keep in mind that women are far more likely to experience abuse, which often ended at mental illness later on.

And when a pregnant woman is suffering from these complications, rarely they get treated or at least handled with compassion the effects of which is a disturbed fetus in the womb.

Woman’s Right to Health in India

Violation of women’s sexual and reproductive health rights is a daily practice nowadays. This can include denial of access to health services, making women’s access to services depend on third party approval, forced sterilization, forced virginity examinations, and forced abortion against their consent, female genital mutilation and early marriage. Patriarchal interpretation of women’s roles within the family are still denoted by their ability to reproduce. Early marriage, repeated pregnancies as trying to produce male offspring is quite common. These I’ll practices devastate the health of women, even death is not rare.

The right to health includes both freedoms and entitlements, Freedoms include the right to control one’s health and body, e.g., sexual and reproductive rights, and to be free from interference e.g. free from torture and from medical intervention without consent and entitlements include the right to an equal opportunity of health. Health policies and programs have the potential to either construct or destroy human rights, including the right to health. Most of the times discriminatory traditions and power relations are at the centre of unjust health practices that should be fought with the weapons of human rights.

And it’s not about poverty

A huge proportion of women suffering from malnutrition are living in Indian cities. Same socioeconomic differentials are seen in maternal malnutrition. Marital status, social groups, religious groups, education level, wealth index and standard of living and type of cities have direct or indirect connection with degree of malnutrition.

Some researchers claim that the ongoing culture and traditional practices in India immensely affect the health and nutritional status of women. It also severely affects the future generations. Moreover, it reduces the quality of life of the population.

As a country we continue to demand to males in the family to be the main bread winners and eventually they get priority in almost all resources available. A study conducted by Apollo Munich Health Insurance in collaboration with Nielsen India Pvt. Ltd. in 19 cities revealed that inspite of an increase in health insurance claims filed by women, very few women are prompted to do health insurance for themselves.

The study also explored that 61% Indian women agreed that they skip their breakfast and compensate it with a heavier lunch in big cities. Women are still responsible for the well-being of their family and continue to neglect their own.

Shouldn’t we keep in mind that the children born of those neglected mothers grow into this country’s population, the greater part of which are repeating the same mistake as their ancestors, resulting in a traditionally weak race trapped in a vicious cycle?