Building Resilience from Birth: Prioritising Maternal and Newborn Care

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This essay is part of the series: World Health Day 2025: Healthy Beginnings, Hopeful Futures

Ensuring maternal and newborn health is fundamental to establishing a robust foundation for lifelong well-being. The maternal health continuum, encompassing preconception, pregnancy, childbirth, and postpartum care, significantly influences both immediate survival and long-term health outcomes for both the mother and child. The first 1,000 days of life, from conception to a child's second birthday, represent a critical developmental window that shapes cognitive potential, metabolic health, and disease susceptibility. While advancements in healthcare have led to notable declines in maternal and neonatal mortality, disparities persist, particularly in Low and Middle-Income Countries (LMICs). Factors such as maternal malnutrition, inadequate healthcare access, and socio-economic inequities exacerbate risks, leading to suboptimal outcomes. A holistic, evidence-based approach integrating maternal nutrition, antenatal care, safe delivery, and postnatal health interventions is imperative to ensuring a trajectory of health and resilience across the lifespan.

The maternal health continuum, encompassing preconception, pregnancy, childbirth, and postpartum care, significantly influences both immediate survival and long-term health outcomes for both the mother and child.

Maternal and Newborn Survival: Foundations for Survival and Lifelong Development

Maternal health constitutes the bedrock of neonatal survival and long-term developmental outcomes. The mother’s physiological and psychosocial well-being during preconception, pregnancy, and the postpartum period, directly influences both immediate and lifelong health trajectories of their offspring. Adverse maternal health conditions—such as malnutrition, hypertensive disorders, gestational diabetes, and anaemia—are strongly associated with increased risks of preterm birth, Intra-Uterine Growth Restriction (IUGR), low birth weight, and neonatal morbidity. Beyond the perinatal period, maternal health exerts enduring influence on neurodevelopment, immune system maturation, and metabolic programming of the child, ultimately shaping susceptibility to chronic diseases in adulthood. This intergenerational dimension of maternal well-being underscores its pivotal role in public health planning.

Maternal nutrition plays a critical role in determining pregnancy outcomes and foetal development. Adequate intake of essential macronutrients and micronutrients such as iron, folic acid, calcium, and vitamin D is indispensable for preventing neural tube defects, anaemia, and compromised skeletal development. Furthermore, a growing body of evidence supports the concept of foetal programming, wherein maternal nutritional status modulates gene expression and metabolic pathways, thereby influencing the offspring’s risk of developing non-communicable diseases such as cardiovascular conditions and type-2 diabetes later in life.

Antenatal care (ANC) provides a strategic entry point for the early identification and management of pregnancy-related complications. Regular ANC visits enable systematic monitoring of maternal blood pressure, blood glucose, and foetal growth parameters, facilitating timely intervention for conditions such as pre-eclampsia and gestational diabetes. In addition, immunisations against tetanus and rubella enhance both maternal and neonatal immunity. Beyond clinical surveillance, ANC is a critical platform for maternal health education, empowering women with knowledge on optimal nutrition, safe delivery practices, and newborn care—contributing to improved health outcomes across the life course.

Adequate intake of essential macronutrients and micronutrients such as iron, folic acid, calcium, and vitamin D is indispensable for preventing neural tube defects, anaemia, and compromised skeletal development.

Maternal health and access to timely, high-quality interventions profoundly influence neonatal health, particularly in the first 28 days of life.  The leading causes of neonatal mortality—preterm birth complications, neonatal sepsis, and birth asphyxia—necessitate integrated strategies that include skilled birth attendance, emergency obstetric care, and neonatal resuscitation. Institutional deliveries under the care of trained health professionals are vital for promptly managing labour complications such as obstructed delivery or postpartum haemorrhage. Exclusive breastfeeding during the first six months is a cornerstone of neonatal survival and development. It offers immunological protection, supports optimal neurodevelopment, and establishes a healthy gut microbiome with long-term benefits for immune and metabolic function. However, socio-cultural stigmas, workplace barriers, and lack of lactation support frequently hinder breastfeeding continuity.

Infection prevention through evidence-based practices such as Kangaroo Mother Care (KMC), timely antibiotic administration, and strict hygiene measures have demonstrated significant reductions in neonatal morbidity and mortality. KMC also promotes maternal-infant bonding and psychological resilience, especially in preterm infants.

Socio-Economic Barriers in Maternal and Child Health

Despite significant strides in maternal and newborn healthcare, persistent socio-economic disparities and environmental challenges impede progress. Poverty, food insecurity, and inadequate healthcare infrastructure remain formidable barriers to optimal maternal and child health. Climate change further exacerbates these challenges by disrupting food systems, contributing to nutritional deficiencies, and increasing exposure to vector-borne diseases that disproportionately affect pregnant women and neonates.

In addition, gender norms, systemic discrimination, and deeply embedded societal expectations significantly shape maternal health access and outcomes. Predominantly patriarchal frameworks often place reproductive decision-making authority in the hands of men, thereby limiting women's autonomy in seeking timely antenatal care, skilled birth attendance, and postnatal services. These constraints are further magnified by intersecting social determinants such as low educational attainment, ethnic marginalisation, and geographic isolation, leading to compound health inequities among vulnerable populations.

Predominantly patriarchal frameworks often place reproductive decision-making authority in the hands of men, thereby limiting women's autonomy in seeking timely antenatal care, skilled birth attendance, and postnatal services.

Male involvement, though critical, remains inconsistently conceptualised and underutilised. Sociocultural norms and narrowly defined gender roles often limit men’s participation in financial support, neglecting essential aspects such as emotional engagement, shared decision-making, and support during clinical encounters. However, evidence suggests that active male and family involvement enhances maternal health service utilisation, birth preparedness, and psychosocial well-being.

Policy Recommendations for Enhancing Maternal and Newborn Survival and Addressing Socio-Economic Barriers

Maternal and newborn health implications extend beyond infancy, shaping an individual’s lifelong health trajectory. Early-life adversities, including prenatal malnutrition and perinatal complications, are increasingly recognised as key determinants of adult-onset chronic diseases.

Driving meaningful change, the following policy recommendations focus on integrating maternal and newborn care into broader health and socio-economic strategies:

• Integrate maternal and neonatal services—including antenatal care, skilled birth attendance, emergency obstetrics, and neonatal intensive care—into essential health benefit packages under Universal Health Coverage (UHC).
• Strengthen community health systems by expanding the role of trained midwives and community health workers for early risk identification and culturally appropriate care.
• Invest in health infrastructure and functioning referral and transport systems, particularly in rural and underserved regions.
• Mitigate economic barriers through financial incentives, maternity entitlements, and targeted nutritional support for low-income families.
• Implement gender-responsive policies that enhance women’s autonomy, promote male engagement, and address discriminatory norms.
• Mainstream early-life interventions such as breastfeeding promotion, neonatal immunisation, and parenting support national health strategies.
• Develop climate-resilient healthcare systems to ensure maternal and newborn services continue during environmental disruptions.
• Strengthen health communication strategies to increase awareness of maternal and newborn care practices.
• Establish disaggregated data systems and foster multi-sectoral collaboration to address socio-economic determinants of health.

Prioritising maternal nutrition, ensuring skilled birth attendance, promoting breastfeeding, and strengthening neonatal care are essential strategies to reduce maternal and newborn mortality while fostering long-term health resilience.

Conclusion

A healthy beginning is not merely a short-term goal but also a foundational pillar for a hopeful future. Prioritising maternal nutrition, ensuring skilled birth attendance, promoting breastfeeding, and strengthening neonatal care are essential strategies to reduce maternal and newborn mortality while fostering long-term health resilience. Multisectoral collaboration, integrating healthcare, education, social protection, and climate resilience, is pivotal in achieving sustainable improvements in maternal and child health outcomes. Investing in maternal and newborn health is both an ethical imperative and an economic and social necessity, contributing to healthier generations, more productive societies, and global sustainable development.

Subhasree Ray  is the Section Head - Wellness at TVS Motor Company's Sustainability Department.

• Healthcare
• India
• lmic countries
• low and middle income countries
• maternal health care in India
• maternal health conditions
• maternal health in india
• maternal nutrition
• neonatal health in india
• newborn health in india
• newborn healthcare in india

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