The Petitioner, a health activist based in the State of Madhya Pradesh, alleged that the state’s programs to reduce maternal mortality had not been properly and effectively implemented in Madhya Pradesh, and particularly within the Bhind district, where there was an acute shortage of trained healthcare providers, services, and equipment for pregnant women seeking care. One facility had women sharing beds, while another was sending women in need of blood transfusions to a health center that was two hours away. Basic infrastructure and sanitation were absent in many instances. The petitioner highlighted that Madhya Pradesh had the third highest maternal mortality rate out of all Indian States, to indicate the program’s failure. This case sought to address the high costs of healthcare and the failure of Madhya Pradesh’s public health system.
The High Court of Madhya Pradesh issued a landmark judgment, recognizing that a woman’s right to survive pregnancy and childbirth is a fundamental right protected under Article 21 (protection of life and personal liberty) of the Constitution of India. In the decision, the Court declared that “shortage not only of the infrastructure but of the manpower” has led to the “inability of a woman to survive pregnancy and childbirth [which] violates her fundamental right to live as guaranteed under Article 21 of the Constitution of India.” Relying upon extensive government research and reports, the Court documented the failure of the government to implement the National Rural Health Mission (NRHM), a public health scheme devised by the Central Government to address India’s high rates of maternal and infant mortality. The Court rejected the government’s claim that financial constraints served as a barrier to implementation, noting that a significant amount of the budget remained unspent at the end of 2009. The Court ordered the immediate implementation of the NRHM, with a focus on strengthening infrastructure and providing access to timely maternal health services, skilled personnel, and effective referral and grievance mechanisms.
The Court emphasized the direct relationship between delayed antenatal care and maternal mortality, and issued specific orders to guarantee women’s access to timely maternal health services. It ordered the State of Madhya Pradesh to improve conditions in health facilities by guaranteeing the availability of 24-hour delivery and other maternal health services provided by trained professionals. The Court also ordered the state to make basic infrastructure improvements, such as fully functioning electricity and water systems; to ensure that an emergency vehicle is available 24-hours a day under the Janani Express Yojna government scheme, that in all 227 community health centers in the district 24 hours delivery services are available; to provide for the vaccination of pregnant women and their newborns; and to establish a monitoring system to track patient records.