India's Maternal Care Progress Marred by Postpartum Support Gaps
The landscape of maternal care in India has undeniably broadened over the last ten years, with increased access to services. However, a mother's journey through pregnancy and childbirth remains markedly uneven once she leaves the delivery room. The critical weeks and months following birth are often shaped by significant challenges, including breastfeeding difficulties, inadequate postnatal follow-up care, and severely limited mental health support systems.
Breastfeeding Struggles Highlight Systemic Failures
At the recent Times Future of Maternity 2026 conference, organized by Times Internet and Pregatips, clinicians and specialists gathered to address a frequently overlooked segment of India's maternity care ecosystem: the crucial periods before and, more importantly, after birth. The dialogue quickly centered on breastfeeding, an area where India continues to exhibit substantial disparities despite established global guidelines, with exclusive breastfeeding rates varying widely across different regions.
Dr. Deepti Arora, founder member of Everbliss Maternity and Family Wellbeing Leader, identified a recurring pattern in clinical practice. "Breastfeeding doesn't fail because a mother lacks knowledge about its importance," she explained. "The gaps in practical guidance are so profound that a mother often feels she doesn't know how to perform this fundamental act." Common initial hurdles include pain from incorrect latching, concerns over low milk supply, delayed initiation, and emotional overwhelm.
Dr. Arora emphasized that the core issue is not a lack of awareness but a deficiency in timely support and preparation. "Breastfeeding doesn't fail, but the systems do," she stated, advocating for early and continuous guidance rather than reactive interventions after problems arise.
Postpartum Recovery: An Under-Medicalized Phase
The concept of continuity in care resurfaced as discussions turned to postpartum recovery. Dr. Helai Gupta, Senior Consultant in Obstetrics & Gynaecology at Rosewalk Hospital, critiqued the healthcare system's tendency to view childbirth as an endpoint rather than the commencement of an extended recovery phase. "Postpartum care is the most under-medicalised phase in a woman's life cycle," she asserted.
This mindset has tangible consequences. Medical teams frequently concentrate on delivery and discharge protocols, while essential recovery aspects like sleep, hydration, mobility, and mental health receive scant attention. Dr. Gupta illustrated how even basic cultural practices can hinder recovery, noting that restricted water intake after delivery in some communities leads to dehydration, adversely affecting both recovery and lactation.
Mental Health: A Persistent Weak Link
Mental health support remains a fragile component throughout the care continuum. Dr. Juhi Rachel Baluja, Consultant Psychiatrist at St. Stephen's Hospital, acknowledged improved awareness but highlighted the enduring burden, with anxiety disorders being a primary concern during pregnancy and postpartum. "Around 15-20% of cases will have some sort of underlying anxiety," Dr. Baluja reported, noting that such issues are not confined to first-time mothers.
In more severe instances, symptoms may progress to depression or psychosis, often going unrecognized until they reach a critical stage. Dr. Baluja pointed out that many women fail to perceive these changes, underscoring the vital role of families. Early warning signs demanding immediate attention include diminished confidence, an inability to care for the newborn, and pervasive sadness.
Antenatal Education: An Underutilized Resource
The panel's conversation on preparedness shifted to antenatal education, which experts deemed significantly underutilized. Dr. Rashmi Bawa, Founding Director of the wellness platform WellMom for expectant mothers, described structured antenatal sessions as a low-cost, high-impact intervention. "Structured antenatal education is the most low-input but the most high-yielding resource that we have," she affirmed.
Dr. Bawa explained that when available information seems unreliable, these sessions equip families with knowledge on what to expect and how to respond. Furthermore, a communal space where parents can interact and learn from each other helps reduce anxiety and build confidence before delivery. Timing is crucial; as Dr. Arora noted, offering lactation guidance only after delivery is too late, as the mother is already grappling with physical recovery and emotional stress. Preparation during pregnancy enables mothers to distinguish between normal and abnormal situations, fostering a calm response instead of panic.
Extending Postnatal Support and Involving Families
The principle of care continuity also applies to how postnatal support systems are designed. Dr. Gupta observed that while current public health programs monitor mothers for up to six weeks post-delivery, follow-ups should be extended. Digital tools, periodic check-ins, and structured screening can facilitate early risk identification and enhance long-term outcomes.
Nevertheless, experts cautioned that systems alone are insufficient, especially in the Indian context where family involvement is paramount. "If the mother is supported, breast milk flows; if she is doubted, it slows," Dr. Arora remarked. Current support structures often disproportionately focus on the newborn, neglecting the mother's and family's holistic needs. Dr. Bawa highlighted that postpartum care, which should adopt a "parent-centric" approach, remains baby-centric in many households. Communication gaps between partners, a lack of practical assistance, and societal caregiving expectations can exacerbate pressure during this phase.
Experts also stressed the importance of including extended family members in care planning, as elders frequently influence decisions regarding nutrition, recovery, and infant care. Engaging them in the process can improve adherence and outcomes.
A Holistic Vision for Maternal Care
Throughout the panel, a unifying theme emerged: maternal care should encompass preparation, delivery, recovery, and adaptation to a new life stage, rather than commencing at labor and concluding at discharge. Strengthening prenatal, postnatal, lactation, and mental health frameworks requires coordination among healthcare providers, communities, and families, going beyond mere clinical protocols. This holistic approach is imperative because, for many women, the most critical care period begins after childbirth.
