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Table 3 Causes of maternal deaths in India

From: How do accountability problems lead to maternal health inequities? A review of qualitative literature from Indian public sector

First delay - Lack of awareness (obstetric risk factors, danger signs, or value of institutional delivery)
- Lack of antenatal care (opportunity to provide information on obstetric risk factors and maternal health care)
- Cost constraints—related to poverty (treatment and indirect costs, travel, perceived affordability, corruption and informal payments at health facilities)
- Social norms considering pregnancy and childbirth as a normal phenomenon
- Gender or women’s low status
- Perceived and/or experienced quality of care
- Fear of cesarean section, surgery, disrespectful behavior, and unfamiliar environment at health facilities
Second delay - Cost constraints (to arrange money)
- Lack of roads
- Lack of transport, including difficulty in arranging transport at night
- Lack of information (regarding availability of services)
- Geographic location (e.g., tribal settlement in remote areas)
- Difficult terrain (steep hill and water-logged road during rain)
- Referral(s)
Third delay - Non-availability of services (designated obstetric services at different levels of health system, abortion, and postnatal care)
- Lack of health professionals, including lack of competency or skills among health professionals
- Lack of drugs and supplies, including blood
- Cost constraints (to pay for drugs, blood, and treatment)