Weak Care, Dirty air: Twin Threats to Newborns in Madhya Pradesh

Too many newborns in Madhya Pradesh are either underweight or premature. According to a Lok Sabha response, 24% of children under six in Madhya Pradesh were underweight, 39% were stunted, and 6% were wasted. That is to say, more than one in five are underweight. Nearly 15% arrive before the full term of nine months. A crisis this big affects millions.

New research from IIT Delhi, IIPS Mumbai, and teams from the Asian Institute of Technology (AIT), Thailand, University College Dublin, and the University of St Andrews, Scotland, links rising air pollution to these poor birth outcomes. In areas with higher levels of PM2.5, tiny air particles smaller than 2.5 microns, babies are more likely to be born underweight or premature. North Indian states, including MP, show some of the worst data.

“Every eighth child in the country is being born prematurely,” the study said. 

The study identified PM2.5, particles coming from burning coal, wood, and other fuels. “Every 10 microgram increase in PM2.5 raises the chance of low birth weight by 5% and premature birth by 12%,” the report said.

It used data from the National Family Health Survey, a nationwide survey done in multiple rounds with a sample of households across India, and satellite-based pollution maps to study how air quality affects pregnancy outcomes. The goal was to help target health programs where they’re needed most.

Researchers in the report say the solution needs to go beyond hospitals. Heat waves, erratic rainfall, and dirty air are already impacting pregnancies by disrupting fetal growth, causing dehydration and stress, spreading infections, and limiting access to timely care.

How Inadequate Nutrition Threatens Childbirth

Madhya Pradesh struggles with some of the worst maternal and infant health indicators in India. According to the Sample Registration System (SRS) 2022 report, the state recorded 159 maternal deaths per 100,000 live births and 40 infant deaths per 1,000 live births. This infant mortality rate is over 50% higher than the national average of 26.

Rural areas report even worse outcomes. The infant mortality rate in rural MP is 43, compared to 28 in urban areas. Female infants in rural regions are more likely to die than males, with a mortality rate of 44 versus 42.

Dr. Amita Singh is a Bhopal-based nutritionist and dietitian. She links the underweight or premature trend to poor adolescent nutrition. She told Ground Report, "Some issues start from poor nutrition in girls aged 10 to 19. If they don’t get proper food during their teenage years, they don’t reach their full height or growth potential. They should be at least 140 cm tall by the age of 19. But almost 60% of adolescent girls don’t reach that height."

She runs a Food Sense clinic by Dietitian AmitaSingh and works as a consultant dietitian at Nutrisense and National Hospital in Bhopal. Her concerns about weak mothers match what researchers found: polluted air adds more stress to already risky pregnancies.

“These children are born to mothers who often lack the strength to carry healthy pregnancies. When these girls get married and become pregnant, they’re often not strong enough to maintain their health or the baby’s,” Dr. Singh said.

People tell women not to drink much milk or eat sour foods, even those rich in vitamin C. In many families, girls eat last after serving everyone else, and often there isn’t enough food left for them.

How Air Pollution Threatens Childbirth

Ground Report spoke to Dr. Ujjwal Das, assistant professor at Fakir Mohan University and an independent researcher on urban health and child nutrition. “Many homes lack proper kitchens or ventilation. Women cook indoors for hours, often near infants, which increases exposure risks,” he said.

“These pollutants can impair oxygen and nutrient flow to the fetus, cause inflammation and oxidative stress, and disrupt hormonal balance. Evidence shows that exposure during the third trimester is particularly associated with lower birth weight, while high levels of PM2.5, nitrogen dioxide, and ozone are consistently linked to premature birth before 37 weeks,” said Dr. Neha Abhijit Pawar, Consultant, Gynaecology, Kokilaben Dhirubhai Ambani Hospital, Mumbai.

She added that toxic air pollutants like benzene and polycyclic aromatic hydrocarbons (PAHs) may interfere with fetal organ development, increasing the risk of congenital anomalies such as heart defects, neural tube defects, and cleft palate.

Though not involved in the IIT-IIPS study, Das’s research in eastern India found similar trends: underweight children were more common where pollution and poor housing coexisted. “Young mothers often lack support or knowledge, making things worse,” he added.

Surge in Premature Deliveries & Caesarean Crisis

How a baby is born also affects their long-term health. For instance, babies with premature and low birth weight are at a higher risk of infant death and long-term health issues, including diabetes and heart disease.

New research shows that C-section deliveries, which involve surgery to deliver a baby, especially when not medically necessary, are linked to poor nutrition and slower development in children. These babies face higher risks of asthma, allergies, and obesity; have weaker gut health; and are less likely to breastfeed early. Some studies also associate C-section births with lower academic performance later in life.

In rural Madhya Pradesh, where healthcare infrastructure is weak, unnecessary C-sections can lead to even worse results. Many facilities lack trained staff or equipment to manage surgical deliveries safely. The overuse of C-sections also increases financial pressure on public hospitals, limiting care for those who need it most.

Need  for Clean Air and Care

Public health experts warn that the poorest families face the greatest risk. Many live in highly polluted areas, use biomass fuels, and have limited access to medical care during pregnancy. 

The researchers called for stronger action under the National Clean Air Programme, launched in 2019. To reduce risk, the researchers recommend simple steps for pregnant women: avoiding outdoor exposure on polluted days, using clean cooking fuels, wearing N95 masks, and seeking regular checkups.

To support maternal and child health, Madhya Pradesh is covered under Mission Poshan 2.0. A government scheme that provides nutrition for 300 days a year through nearly 14 lakh Anganwadi Centers. It includes fortified rice, millet-based meals, and targets pregnant women, lactating mothers, and children under six.

One can’t separate air quality from maternal care and nutrition. When mothers are unsupported, children suffer, especially with polluted air. Das also noted a key data gap: “Air quality data is mostly urban. We need household-level tracking in rural areas for real solutions.”

Poshan 2.0 supports nutrition for mothers and children through Anganwadi centers, but it falls short in many areas. Many centers lack trained staff, clean kitchens, and regular supplies. The scheme often overlooks teenage girls, whose poor health affects future pregnancies. Food distribution is uneven, and follow-up is weak. Fortified meals help, but they can’t fix problems like dirty air, unsafe cooking fuels, or gender bias in food access. Without clean air, early care, and better outreach, Poshan 2.0 cannot protect newborns in Madhya Pradesh. The program needs stronger delivery, local monitoring, and a focus on girls before they become mothers. 

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