The rise of institutional births in India: are maternal and newborn risks adequately addressed?

The government has successfully increased facility-based childbirth over the last decade, but are these hard pressed services successfully recognizing women’s health risks in pregnancy, birth, and post-partum stages? Is there an understanding of women’s health behaviour and the risks they perceive and prioritize? This chapter explores the quality of health services in two studies conducted nearly ten years apart in rural Karnataka, during which time there was a 47 per cent increase in institution-based births. This chapter shows that the healthcare system narrowly perceives risks within a biomedical framework as opposed to women’s more multidimensional view of risk. Furthermore, the process of identifying, assessing, and managing these health risks has not been located in an institutional framework of accountability that prioritizes its patients. This chapter proposes that the government must adopt a more culturally attuned approach that strengthens the quality and not simply the coverage of health services