According to the Reproductive and Child Health (RCH) program in India, what is the most common cause of maternal mortality in the country?

Explanation

## Most Common Cause of Maternal Mortality in India **Key Point:** Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality in India, accounting for approximately 27–28% of all maternal deaths, as per RCH program data and NFHS surveys. ### Epidemiological Context The RCH program tracks maternal mortality ratio (MMR) and cause-specific mortality. Among direct obstetric causes, PPH is the single largest preventable cause. ### Why PPH is Most Common 1. **Prevalence in resource-limited settings** — inadequate access to blood products, oxytocin, and skilled birth attendance 2. **Delayed recognition and intervention** — many deliveries occur at home or peripheral facilities without immediate management capability 3. **Uterine atony** — the most frequent cause of PPH in the Indian context ### RCH Program Response - **Active management of third stage of labour (AMTSL)** — advocated as standard of care - **PMTCT (Prevention of Mother-to-Child Transmission)** and **RMNCH+A** (Reproductive, Maternal, Newborn, Child Health + Adolescent) strategies include PPH prevention modules - **Skilled birth attendant (SBA) coverage** — target to reduce PPH-related deaths **High-Yield:** PPH accounts for ~27% of maternal deaths; hypertensive disorders ~12–15%; unsafe abortion ~8–10%; anemia as a direct cause ~5% (though it is a major contributor to maternal morbidity). ### Comparative Mortality Burden | Cause | % of Maternal Deaths | Preventability | |-------|----------------------|-----------------| | Postpartum hemorrhage | 27–28% | Highly preventable | | Hypertensive disorders | 12–15% | Preventable | | Unsafe abortion | 8–10% | Preventable | | Anemia (direct) | ~5% | Preventable | | Infection/sepsis | ~10% | Preventable | **Clinical Pearl:** The RCH program emphasizes that most maternal deaths are preventable through universal access to skilled birth attendance, emergency obstetric care (EmOC), and blood transfusion services.