Jarita Jamkar is a 23-year old tribal housewife, who lives in a remote village in Maharashtra. She was married at the age of 18 and became pregnant soon after. Her pelvis was too small for a natural delivery; so she delivered her daughter by Cesarean Section. During her second pregnancy, she visited the Auxiliary Nurse Midwife (ANM) for antenatal care, who found that Jarita was anemic with a blood hemoglobin concentration of only 7 percent. The ANM began treatment for deworming, followed by the administration of iron folic acid tablets. The medical officer of the Primary Health Center also advised a supplementary diet and a regular dose of calcium tablets. The supplementary diet was provided daily by an Anganwadi worker, and this was financed by the Village Health Nutrition and Sanitation Committee under the National Rural Health Mission. The ANM also conducted regular follow-up home visits.
Due to these efforts, Jarita’s hemoglobin concentration rose from 7 percent during her first antenatal visit to 9.8 percent in the seventh month of pregnancy. Her husband and family members supported and motivated her to continue her treatments. Keeping in mind her previous Cesarean Section, the Medical Officer of the Primary Health Center referred Jarita to the District Women’s Hospital for the purpose of safe delivery.
On the evening of September 7, 2009, Jarita started feeling labor pains. The Village Health Nutrition and Sanitation Committee provided transportation to the hospital, which was 35 kilometers away. There, she delivered a girl by Cesarean Section.