Prof. Tamorish Kole
Chair, IFEM Clinical Practice Committee
Past President, Asian Society for Emergency Medicine
Society for Emergency Medicine, India

World Health Day 2025 marks the beginning of the "Healthy Beginnings, Hopeful Futures" World Health Organization campaign, calling for urgent action to reduce preventable maternal and newborn deaths. The statistics are alarming—nearly 300,000 maternal deaths and over 4 million newborn deaths or stillbirths occur annually. This equates to one preventable death every seven seconds. The emergency medicine (EM) community, with its expertise in rapid assessment, critical interventions, and coordinated response, is uniquely positioned to support this mission globally.

One of the most significant challenges in maternal and newborn health is delayed access to care. Many deaths result from delays in recognizing complications, reaching appropriate facilities, and receiving timely interventions. In several regions, emergency obstetric and newborn care remains insufficient, with hospitals lacking essential equipment and skilled personnel. Additionally, workforce shortages in emergency medicine, especially in low-resource settings, limit the ability to provide immediate, life-saving care for pregnant women and newborns.

India accounts for a significant share of global maternal and newborn deaths, highlighting the urgent need for improved emergency care. According to the latest data, India reports approximately 28,000 maternal deaths annually, with a Maternal Mortality Ratio (MMR) of 103 per 100,000 live births (2020) —higher in rural areas and among marginalized communities. Newborn mortality remains a major concern, with over 500,000 neonatal deaths each year, making India one of the highest contributors to global newborn mortality. The leading causes include postpartum hemorrhage, hypertensive disorders, sepsis, and birth asphyxia, many of which are preventable with timely emergency interventions. While initiatives like the Janani Suraksha Yojana (JSY), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), and emergency referral transport services (e.g., 108 ambulance services) have improved access to maternal and neonatal care, gaps persist in emergency obstetric care, trained personnel, and prehospital stabilization. Strengthening India’s emergency medicine infrastructure, training frontline responders, and integrating telemedicine solutions can play a transformative role in reducing preventable maternal and newborn deaths, aligning with the goals of World Health Day 2025.

To address these gaps, the emergency medicine community can enhance emergency obstetric and neonatal care. Training EM physicians, nurses, and paramedics in managing maternal hemorrhage, eclampsia, obstructed labor, and neonatal resuscitation is critical. Emergency departments must ensure 24/7 access to life-saving interventions and incorporate Point-of-Care Ultrasound (POCUS) for rapid diagnosis of pregnancy-related complications. These improvements will allow for earlier detection and faster treatment, significantly improving outcomes.

Another key area for improvement is prehospital and transport systems. A well-organized maternal and neonatal rapid response team (nRRT) can provide immediate stabilization and expedite referrals. Additionally, integrating telemedicine support in emergency settings can enable real-time consultations for managing high-risk cases in remote areas. Emergency ambulances must also be equipped with essential maternal and neonatal care tools, including fetal monitoring and medications to prevent postpartum hemorrhage.

Capacity building through simulation-based training programs is essential for equipping EM professionals with the skills to handle maternal and newborn emergencies. Introducing Basic and Advanced Life Support in Obstetrics (BLSO & ALSO) courses into emergency medicine training can improve preparedness. Collaborations between emergency physicians, obstetricians, and neonatologists can foster a multidisciplinary approach, ensuring that emergency responders are well-trained in childbirth-related crises.

Strengthening hospital preparedness and referral systems is another crucial step. Emergency departments must implement standardized triage protocols to prioritize obstetric and neonatal emergencies. Establishing regionalized referral networks between primary health centers, emergency facilities, and tertiary hospitals can ensure that high-risk cases receive specialized care without unnecessary delays. Hospitals must also maintain adequate stocks of critical medications, such as oxytocin to prevent hemorrhage and magnesium sulfate to manage eclampsia, alongside essential neonatal interventions.

Beyond hospital settings, community engagement and public awareness play a pivotal role in preventing maternal and newborn deaths. Emergency medicine professionals can lead maternal health first-aid programs, educating communities on danger signs during pregnancy and newborn care. Partnering with community health workers and advocacy groups can enhance grassroots-level awareness and ensure that expectant mothers seek timely care. Additionally, the EM community must advocate for government policies that prioritize emergency obstetric and neonatal care as a public health priority.

The "Healthy Beginnings, Hopeful Futures" campaign provides a crucial opportunity for the emergency medicine community to reaffirm its commitment to saving maternal and newborn lives. By strengthening emergency response systems, improving training, enhancing hospital preparedness, and engaging communities, EM professionals can make a profound impact. On World Health Day 2025, it is imperative to recognize that every second counts in an obstetric or neonatal emergency. The EM community’s swift, skilled interventions can transform these critical moments into lifesaving victories, ensuring that more mothers and babies not only survive—but thrive.