From ward to home: The failings of maternal care in India

Access to maternal care has undoubtedly expanded in India over the past decade, although mothers’ experiences with pregnancy and childbirth after leaving the labor ward remain mixed. Impacting mothers’ outcomes in the weeks and months postpartum are breastfeeding-related struggles, weak postpartum follow-up, and limited mental health support. At Times Future of Motherhood 2026, organized by Times Internet and Pregatips, clinicians and experts came together to discuss a part of the Indian maternity care ecosystem that doesn’t often get much attention – what happens before birth and, more importantly, after birth.In the early days of discussions on how to strengthen prenatal, postnatal, lactation and mental support systems, the focus turned to breastfeeding and despite clear global guidelines, India still has gaps in this area. Exclusive breastfeeding rates still vary widely across regions. Dr. Deepti Arora, founder of Everbliss Maternity and Family Wellbeing Leaders, points to a pattern she sees over and over again in her practice. “Breastfeeding doesn’t fail because the mother doesn’t know it, but the gap in guidance is so great that she feels like I don’t know how to do simple things.”Known challenges in the first few days include pain from an incorrect latch, concern about insufficient milk supply, delayed initiation, and emotional agitation. However, what stands out most in Dr. Arora’s remarks is the lack of timely support and preparation, not the lack of awareness. “Breastfeeding doesn’t fail, the system fails,” she said, emphasizing the need for early and ongoing guidance rather than reactive intervention.When the discussion turned to postpartum recovery, the idea of ​​continuity came up again. Dr Helai Gupta, senior consultant in obstetrics and gynecology at Rosewalk Hospital, believes that the healthcare system often treats childbirth as an endpoint rather than the beginning of a longer recovery phase. “Postpartum care is the least medically intensive phase of a woman’s life,” she said.The consequences of this mentality are obvious. There are several aspects related to recovery that do not attract much attention from the medical team, while the focus remains on protocols related to delivery and discharge. For example, neglected areas include sleep, hydration, mobility and mental health. Dr. Gupta emphasized that even basic practices can have unintended consequences, noting that in some communities, postpartum water restriction can lead to dehydration, which can affect recovery and breastfeeding.Mental health, in particular, remains a weak link in the overall care continuum. Dr Juhi Rachel Baluja, consultant psychiatrist at St Stephen’s Hospital, said while awareness of mental health has increased, the burden remains, with anxiety disorders being one of the main areas of concern recorded during pregnancy and postpartum. “About 15-20 percent of cases … will have some underlying anxiety,” Dr. Baluja said, adding that the concern isn’t limited to first-time mothers.In more severe cases, symptoms may evolve into depression or psychosis and go unnoticed until they become severe. Dr. Baluja said many women do not see these changes, which fundamentally makes the role of the family important. Some early signs that require immediate attention include low confidence, inability to care for the baby, and sadness.Conversation around preparedness during the panel then turned to prenatal education, which experts say remains underutilized. Dr. Rashmi Bawa, founding director of maternal health platform WellMom, describes structured prenatal care as a low-cost, high-impact intervention. “Structured prenatal education … is the lowest-cost, highest-yield resource we have,” she said.Dr. Bawa said prenatal testing can help families understand what to expect and how to cope when available information is less reliable. Additionally, a shared space where parents can talk and learn from each other can help reduce anxiety and boost confidence before birth. Here, too, timing matters. For example, Dr. Arora said it’s too late to provide breastfeeding guidance after delivery because the mother is already facing emotional stress while her body recovers. Therefore, preparation during pregnancy allows mothers to know what is normal and what is not normal and to respond accordingly rather than panicking.This idea of ​​continuity of care extends to the way postpartum support systems are structured. Dr. Gupta said that while current public health plans follow mothers for six weeks postpartum, follow-up should be extended further. Digital tools, regular check-ups and structured screening can support early risk identification and improve long-term outcomes.At the same time, experts point out that the system itself is not enough as the role of the family remains central, especially in the Indian context. As Dr. Arora points out, “If the mother is supported, the milk will flow; if she is doubted, the milk will slow down.”However, current support structures tend to focus primarily on the newborn, often neglecting the needs of the mother and the entire family. Dr. Bawa noted that while postpartum care needs to shift to a more “parent-centered” approach, many families remain baby-centered. Additionally, communication gaps between partners, lack of practical support, and social expectations of care can also add to the stress of this phase.Experts also discussed the importance of involving extended family members in care planning. This is because older family members often have a say in decisions about nutrition, recovery, and infant care. Therefore, involving them in the process can help improve compliance and outcomes.Throughout the symposium, a theme discussed was that maternal care encompasses preparation, delivery, recovery and adjustment to the new phase of life, rather than beginning with delivery and ending with discharge. Therefore, in addition to clinical programs that strengthen prenatal, postnatal, lactation, and mental health structures, coordination among health care providers, communities, and families is critical. Why? Because for many women, the most important period of care begins after giving birth.