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Every year, as millions of women marry, they dream of starting a family, of having their homes filled with tiny cries and the happy laughter of gurgling babies. In India however, pregnancy is too often followed by the question of
whether the unborn child is a girl or a boy.

A confidential system of enquiry into maternal mortality, based on that used in England and Wales, was introduced in Malaysia in 1991 with a view to identifying deficiencies in care and recommending remedial measures.

Despite its many advantages, the employment of women in economic activity in India has been associated with increased mortality for infants and young children. Simultaneously, narrower gender differentials in child mortality among employed women have been noted.

The high female infant mortality rates (Miller, 1985), the practice of female infanticide (Krishnaswamy, 1988), the neglect of female children with regard to access to health services, nutrition (Sen and Sengupta 1983) and education (Mankekar, 1985), and the sexual abuse of girls (Bhalerao, 1985)

Every minute of every day a woman dies as a result of pregnancy or childbirth. The loss per annum of 500,000 women is mind boggling. A maternal death is the outcome of a chain of events and disadvantages throughout a woman's life.

Maternal death has been recognized as an area of maternity care that requires urgent attention. The most striking feature about maternal health today is the extraordinary difference in maternal death rates between developed and developing countries.

In 1991, an article on the Maternity Care Program in Matlab, Bangladesh, reported a substantial decline in direct obstetric deaths in the intervention area, but not in the control area. The decline was attributed primarily to the posting of midwives at the village level.