Maternal healthcare in India has made encouraging progress. According to NFHS-6, antenatal care indicators have improved significantly across the country. The proportion of women receiving four or more antenatal care (ANC) visits increased from 58.5 per cent in 2019-2021 to 65.2 per cent in 2023-2024, reflecting greater continuity of maternal healthcare. For the same periods, coverage of at least one ANC visit rose from 92.6 per cent to 95.9 per cent, while the proportion of women registering for antenatal care in the first trimester increased from 70.0 per cent to 76.2 per cent. Adherence to iron and folic acid (IFA) supplementation for 100 or more days also improved from 44.1 per cent to 54.9 per cent.
These gains demonstrate that more women are accessing pregnancy-related healthcare than ever before. However, improving the quality of antenatal care (ANC) is equally important and it should serve as an opportunity to discuss preventive interventions, particularly maternal vaccination.
Bridging the vulnerability gap before routine vaccination begins
A child’s health journey begins while it is still in the womb, which makes maternal vaccination an important component of pregnancy care.
Routine infant vaccination begins at six weeks of age. Until then, newborns rely largely on the protection they receive from their mothers. During pregnancy, antibodies produced by the mother naturally cross the placenta and are transferred to the developing foetus. Vaccination during pregnancy supports the mother’s antibody production, enabling the transfer of these protective antibodies to the foetus. These maternally derived antibodies help provide passive immunity when infants are particularly vulnerable and have not yet developed their own vaccine-induced immunity.
The benefits of maternal vaccination extend beyond birth. Protective antibodies continue to be transferred through breast milk for up to eight weeks after delivery, extending the window of passive immunity for the infant. Thus, antibodies passed through the placenta while pregnancy and through breastmilk after birth help bridge the vulnerability gap until routine childhood vaccination begins and the baby’s own immune system can start building protection.
Safe, evidence-based and cost-effective
Extensive global scientific evidence supports the use of recommended inactivated and toxoid vaccines during pregnancy, with no evidence of harm to the foetus. In contrast, live vaccines are generally avoided because of a theoretical risk to the developing foetus. Expectant mothers should consult their healthcare provider to understand which vaccines are recommended during pregnancy.
Maternal vaccination such as Tdap helps protect newborns against whooping cough (pertussis) during their earliest and most vulnerable weeks of life. Gynaecologists recommend taking Tdap vaccination as an important strategy for providing early protection to infants during the 27th to 36th week of pregnancy.
Beyond individual protection, maternal vaccination is also recognised as a cost-effective preventive healthcare strategy, particularly in countries like India, where reducing the burden of infectious diseases in mothers and newborns remains a public health priority.
Making maternal vaccination a routine conversation
Every antenatal visit presents an opportunity to educate and empower expectant parents. By making maternal vaccination a routine part of these conversations, we can help ensure that every child receives protection from the very beginning because safeguarding a baby’s health starts long before its birth.