Assam: India’s state with the highest maternal mortality

On a rainy afternoon in Dibrugarh, also known as India’s Tea City, pregnant women are crammed into the maternity ward at Assam Medical College. At least two or three women share each bed, and dozens more sit on the floor outside. The hospital is chaotic: the walls are mouldy and the corridor is stained with blood.

Angela Dungdin, aged 28, is seven months pregnant and works in one of Assam’s 800 tea plantations or “gardens,” which altogether employ more than 800 000 workers.

She was brought to the hospital with placental abruption, resulting in the placental lining separating from her uterus.

She is grateful that she made it to the hospital in time to stop the internal bleeding, she told The BMJ, unlike many of her peers. Her concern, though, is for the week’s wages that she’ll miss while in hospital.

“I’ll be discharged soon. I was working until the minute I came here and I’ll have to work the minute after I give birth,” she said. “I have no option.”