Tamil Nadu maternal health improved post-pandemic, finds IIT Madras study

Chennai: When India’s second Covid wave hit Tamil Nadu in 2021, pregnant women bore a disproportionate share of the damage. Hospitals overflowed, lockdowns kept expectant mothers away from clinics, and home deliveries surged by 66.3% compared to pre-pandemic levels. Maternal mortality rate — the number of deaths per 100,000 live births — nearly doubled.

But what happened after was unexpected. A study by IIT Madras, published in the peer-reviewed journal BMC Pregnancy and Childbirth, found that TN’s healthcare system did not merely recover from the pandemic, but emerged stronger. By 2023 and 2024, the state’s maternal and newborn health indicators surpassed even pre-pandemic levels, driven by years of sustained govt investment in emergency infrastructure.

“During the pandemic, the state witnessed severe disruptions in maternal healthcare access. The research sought to understand whether these disruptions had long-term effects,” said Prof P Kandaswamy who led the research, a retired IPS officer and professor of practice at IIT Madras’s departments of management studies and data science and AI. “The findings present a strong and encouraging counter-narrative,” he said.

The study is built on ambulance registry data — from 2017 to 2024 — drawn from 108 emergency medical services. Home deliveries fell by 36.1% below pre-pandemic baselines. Miscarriages dropped by 28% and complicated vaginal births by 19.2%. Neonatal mortality fell by 17% and infant mortality by 14%. The maternal mortality ratio fell to 37 deaths per 100,000 live births — a 19% drop from pre-pandemic levels and considerably lower than national average.

The emergency response system improved in parallel, the results showed. Ambulance response times for non-facility calls fell by up to 52.7% against pre-pandemic benchmarks. “Maternal and newborn health indicators showed substantial improvement in the post-pandemic resilient phase compared to pre-pandemic baselines,” said co-author Ashwin Prakash of Moody’s Analytics, Bengaluru.

The researchers traced these to a series of govt interventions that gained momentum after the first wave. With increased budgetary allocations, the state expanded its ambulance fleet, recruited more paramedics and obstetricians, and introduced risk-stratified antenatal care under schemes such as Pradhan Mantri Surakshit Matritva Abhiyan and TN’s Dr Muthulakshmi Reddy Maternity Benefit Scheme.

The researchers caution that better ambulances alone did not directly cause fewer deaths. What worked in TN, with its relatively strong health infra and administrative capacity, may not be easy to replicate in states where maternal mortality is higher and emergency systems weaker. Yet, the state’s experience shows that investing in emergency healthcare during a crisis can save lives long after it ends.