Mumbai: A ‘tale of two mortality trends’ is unfolding in the city. The latest RTI data from the health department shows that while annual deaths among neonates and infants are on the decline (1,846 in 2022 to 1,687 in 2024), maternal mortality numbers continue to fluctuate. Over the last four years, the city has recorded 325 maternal deaths, with the annual numbers ranging between 70 and 93 since 2022.
Health officials said that half of these deaths involve patients referred from neighbouring districts, such as Thane and Palghar, or other parts of Maharashtra. “When looking strictly at Mumbai residents, our maternal mortality ratio (MMR) stands below 70 per 1,00,000 live births, meeting Sustainable Development Goals,” said a senior doctor from the BMC health department.
However, when including patients arriving from peripheral areas, the city’s maternal mortality ratio remains over 80. Dr Rahul Mayekar, a gynaecologist at Sion Hospital, which manages one of the highest volumes of referral cases in the city, said hospitals in the periphery often send patients in severely critical condition. He said these are often high-risk patients, many with pre-existing heart disease or placenta-related complications that result in hypovolemic shock (severe loss of blood) and death.
On top of that, the city’s monsoon-related illnesses, such as leptospirosis, malaria, dengue, and even hepatitis, add to the burden of maternal mortality. Dr Mayekar noted that every monsoon, patients contract these illnesses, leading to severe complications.
Dr Nikhil Datar, a city-based gynaecologist, said the city faces a heavy burden of non-communicable diseases like diabetes and hypertension, which increase pregnancy risks. Even smoking is now a factor making pregnancies high-risk unlike some years back as incidence of smoking among women has been increasing, he said.
However, he added that even with comorbidities, maternal mortality could be controlled far more effectively if a proper triaging system were in place.
“Low-risk pregnancies are often managed by tertiary hospitals, both public and private, while high-risk pregnancies are sometimes handled by smaller maternity or nursing homes. Referrals to tertiary care centres, where there are enough resources to manage complications, often do not happen early enough because of various reasons. By the time the referral is made, it is frequently too late,” said Dr Datar.
