A week ago, in Kerala — a state that takes pride in its near 100 per cent institutional delivery rate and globally acclaimed maternal health achievements — a young mother lost her life while attempting childbirth at home. In a state where maternal deaths have become increasingly rare, this tragedy stands out as it could have been easily prevented.
Kerala’s maternal mortality rate is among the lowest in India. Yet, experts warn that a small but worrying rise in unassisted home births, often driven by misinformation, mistrust, or misguided beliefs, poses a serious threat to this success story. Her death is not just a personal loss — it is a public health warning.
Certain sections of society continue to perceive institutional delivery with suspicion. The romanticisation of unassisted “natural” childbirth, often fuelled by non-expert narratives, has led to avoidable maternal and neonatal morbidity and mortality.
In this case, the health system had no opportunity to intervene. There were no antenatal visits, no risk assessments, no opportunities for counselling or early identification of complications. The family had excluded themselves from the formal healthcare safety net — with fatal consequences.
As a palliative care physician, I frequently encounter the far-reaching impact of health misinformation — extending well beyond the context of childbirth.
Patients with advanced illnesses, particularly cancer, are often targeted by unscientific and exploitative practices. These range from naturopathic “detox therapies” to conspiracy-driven discouragement of diagnostic scans such as CT or MRI, citing baseless claims of harm or radiation “toxicity”. Tragically, these delays in seeking evidence-based care lead to disease progression, increased suffering, and financial exploitation.
Religious objections to scientifically proven treatments — such as refusal of blood transfusions — add another layer of complexity, especially in critical care scenarios. In parallel, the resurgence of anti-vaccine rhetoric, amplified through social media platforms, poses risks not only to individuals but to broader public health.
These phenomena are no longer isolated or anecdotal. The World Health Organisation (WHO) has identified misinformation as a leading threat to global health, capable of undermining decades of progress in healthcare delivery and disease prevention.
Kerala’s public health achievements and emerging challenges
Kerala has earned national and international recognition for its healthcare indicators. The state’s maternal mortality rate (MMR) stands at an impressive 19 per 1 lakh live births — a fraction of the national average of 97. This progress is the result of sustained investment in public health infrastructure, community engagement, and trust in science-based interventions.
Yet, incidents such as the recent maternal death raise troubling questions about the resilience of these achievements. Are sections of the population slipping through the cracks of the health system due to mistrust, misinformation, or socio-cultural isolation?
Kerala’s success story rests not merely on infrastructure, but on continued public engagement, health literacy, and proactive policy measures.
Preventing such tragedies requires action at multiple levels, including strengthening community-level health education to counter myths and misconceptions; enhancing the visibility and accessibility of public health services; regulating and, where necessary, legally addressing the deliberate spread of harmful misinformation; and building social trust through transparent communication and respectful engagement.
Healthcare systems alone cannot address this challenge. Civil society, religious leaders, educators, media, and social influencers all have a critical role in promoting accurate health information.
Maternal deaths arising from preventable causes are not merely medical failures — they reflect collective social failure. In an era where Kerala has achieved world-class health indicators, no woman should die in isolation from care, misled by myths, or trapped by misinformation.
This is a wake-up call not only for health systems but for society at large.
The fight against health misinformation cannot be left solely to doctors or health workers. It requires a collective cultural shift — one that upholds science, values evidence, and prioritises the dignity and safety of every human life.
We must build stronger partnerships between healthcare providers, community leaders, educators, and the media. Digital platforms must take responsibility for curbing the spread of harmful health content. Legislators should explore appropriate regulatory frameworks to prevent the exploitation of vulnerable patients.
Above all, as citizens, neighbours, friends, and family members, we must foster an environment where seeking timely medical care is seen not as a weakness or failure — but as an act of courage, wisdom, and love.
Every preventable death is a question we must answer. Let us ensure that no more mothers, no more families, and no more communities pay the price of silence, ignorance, or misplaced faith. Kerala’s healthcare success is not inevitable. It must be defended — fiercely, collectively, and compassionately.
(The writer is a senior consultant surgeon and palliative care specialist and co-founder, Global Palliative Doctors Network)
While the country has successfully brought down maternal mortality numbers from 1.19 lakh in 1990 to 36,900 in 2015 and 24,700 in 2023, the progress has slowed. (File Photo) 
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