From wards to homes: Where India’s maternal care breaks down

The access to maternal care in India has certainly expanded over the past decade, even as a mother’s experience around pregnancy and childbirth continues to be uneven once she is out of the delivery room. What shapes the outcome for a mother in the weeks and months after delivery is breastfeeding-related struggles, weak postnatal follow-ups, and limited mental health support. At the Times Future of Maternity 2026, organised by Times Internet and Pregatips, clinicians and specialists convened for a discussion on a part of the maternity care ecosystem in India that doesn’t often get much attention – what happens before birth, and more importantly, after birth.

Early in the discussion on how to strengthen prenatal, postnatal, lactation and mental support systems, the focus turned to breastfeeding, an area where India continues to see gaps despite clear global guidelines. Exclusive breastfeeding rates still vary widely across regions. Dr Deepti Arora, founder member of Everbliss Maternity and Family Wellbeing Leader, pointed to a pattern she sees repeatedly in practice. “Breastfeeding doesn't fail because a mother doesn't know that, but the gaps in guidance are there so much that she feels that I don't know how to do the simple thing.”

Among the known challenges in the initial days are pain because of incorrect latch, concern around low supply of milk, delayed initiation, and emotional overwhelming. However, what stood out in Dr Arora’s remarks was the lack of timely support and preparation, instead of the lack of awareness. “Breastfeeding doesn't fail, but the systems do,” she said, underscoring the need for early and continuous guidance instead of reactive intervention.

That idea of continuity came up again when the discussion moved to postpartum recovery. Dr Helai Gupta, Senior Consultant, Obstetrics & Gynaecology, Rosewalk Hospital, argued that the healthcare system often treats childbirth as an endpoint rather than the beginning of a longer recovery phase. “Postpartum care is the most under-medicalised phase in a woman's life cycle,” she said.

The consequences of that mindset are visible. Several aspects related to recovery don’t get much attention from medical teams, while the focus remains on delivery and discharge-related protocols. For instance, areas overlooked are sleep, hydration, mobility, and mental health. Highlighting how even basic practices can have unintended consequences, Dr Gupta noted that restricted water intake after delivery, in some communities, causes dehydration, which impacts recovery and lactation.

Mental health, in particular, remains a weak link across the continuum of care. According to Dr Juhi Rachel Baluja, Consultant Psychiatrist, St. Stephen's Hospital, while the awareness around mental health has improved, the burden is still there, with anxiety disorders among the key areas of concern recorded during the pregnancy period and also post-delivery. “Around 15-20% of cases… will have some sort of underlying anxiety,” said Dr Baluja, adding that such concerns are not limited to only first-time mothers.

In more severe cases, symptoms can evolve into depression or psychosis and remain unnoticed before they turn critical. According to Dr Baluja, many women are not able to see these changes, which fundamentally makes the role of families important. Some of the early indications that require instant attention are low confidence, inability to care for the baby, and sadness.

The conversation during the panel discussion around preparedness then moved to antenatal education, which experts said remains underutilised. Dr Rashmi Bawa, Founding Director, WellMom, a wellness platform 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 said.

According to Dr Bawa, when available information is not considered to be reliable enough, the antenatal sessions help families in understanding what to expect and how to respond. Further, a shared space where parents can talk to and learn from each other can help reduce anxiety and gain confidence ahead of delivery.

Here, timing is also important. For instance, providing guidance around lactation after delivery is too late, according to Dr Arora, as the mother is already facing emotional stress while recovering physically. Hence, preparation during pregnancy lets mothers know what is normal and what is not, and accordingly respond instead of panicking.

This idea of continuity of care extended into how postnatal support systems are structured. According to Dr Gupta, while current public health programmes track mothers up to six weeks after delivery, the follow-ups should extend further. Digital tools, periodic check-ins, and structured screening can support early risk identification and boost outcomes over the long-term.

At the same time, the experts noted that systems themselves are not enough, as what remains central, particularly in the Indian context, is the role of the family. As Dr Arora noted, “if the mother is supported, breast milk flows, if she is doubted, it slows.”

Yet, current support structures tend to be heavily focused on the newborn, often overlooking the needs of the mother and the family as a whole. Dr Bawa noted that when postpartum care is required to move towards a more “parent-centric” approach, it remains baby-centric in many families. Moreover, communication gaps between partners, lack of practical support, and social expectations around caregiving can add to the pressure during this phase.

Experts also discussed the significance of involving extended family members in care planning. This is because older family members often have a say in decisions around nutrition, recovery, and infant care. Hence, engaging them in the process can help boost adherence and outcomes.

Across the panel, the one theme that held the conversation was that maternal care spans preparation, delivery, recovery, and adaptation to a new phase of life instead of starting at labour and ending at discharge. Hence, coordination between healthcare providers, communities and families is critical in addition to clinical protocols to strengthen prenatal, postnatal, lactation and mental health structures. Why? Because the most important period of care for several women begins after childbirth.

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