By Sanavver Shafi
Bhopal, Madhya Pradesh: Samma Aadivasi (30), six months pregnant, sits on the terrace (otli) of her mud house in Kalotra village of Shivpuri district, her hand resting on her stomach as she sifts through the cold ashes of a stove. Outside, unseasonal rain and hailstorms on March 3-4 have flattened the remaining Rabi crop.
Inside, agents from microfinance companies come to her door every two to three days for debt installments.
“All night I stayed awake in the cold, holding my stomach afraid something might happen to my child,” Aadivasi told 101Reporters, recalling this January when severe frost hit. “We thought the wheat and mustard harvest would bring some money. Now the crop is gone, and the debt collectors are not letting us live.”
Across Shivpuri and Sheopur, tribal women, especially from the Sahariya community, are facing a convergence of erratic weather, crop loss, and mounting debt, creating a high-risk environment for pregnancy and childbirth.
Aadivasi’s situation is not isolated. Her neighbours, Ramo (30) and Sushila (27), describe similar conditions.
“There is no work left in the fields,” said Sushila. “When there isn’t a single rupee in hand, for pregnant women, even getting two meals a day becomes difficult.” With crops damaged, agricultural labour opportunities have declined sharply, affecting both income and access to food.
The vulnerability is reflected in data. More than 62 percent of Sahariya tribal families live in mud houses without permanent walls, exposing them to cold winds during winter. The literacy rate in the community is 23.2 percent. Among pregnant women, 90.1 percent are anaemic, and 59.1 percent of children are underweight.
See also: Trump Claims ‘No Downside’ to Avoiding Tylenol During Pregnancy. He’s Wrong.
Ramo said she remains fearful. “My previous child was born prematurely at eight months and died after two months. I am in my sixth month now. I feel scared again.”
According to the Ministry of Tribal Affairs’ annual report (2023–24), the Infant Mortality Rate (IMR) among Scheduled Tribes is 41.6 per 1,000 live births, and the Under-5 Mortality Rate is 50.3. The Registrar General of India (SRS 2022) reports Madhya Pradesh’s IMR at 40, the highest in the country.
To address maternal and child health, the state has implemented schemes such as Anemia Mukt Bharat, Nutrition Rehabilitation Centres, and Janani Shishu Suraksha Karyakram. The MP Economic Survey 2025-26 notes 62 Special Newborn Care Units and 65 Pediatric Intensive Care Units in operation.
In April 2025, Chief Minister Mohan Yadav launched ANMOL 2.0 and the Matru Shishu Sanjeevan Mission for digital tracking of pregnancies.
NHM Madhya Pradesh Mission Director Dr Saloni Sidana said, “Systematic use of the Anmol app will ensure 100 percent registration and better monitoring of high-risk pregnancies.”
District officials echo similar claims. Sheopur CMHO Dr Dilip Singh Sikarwar said, “We go door-to-door to register pregnant women and provide medicines.”
However, in settlements without smartphones or reliable internet, such digital systems have limited reach.
When asked about high anaemia rates, Sikarwar attributed it to lack of awareness among tribal women, saying they avoid supplements due to beliefs.
What has unfolded in the region is not a single event, but a sequence of weather shocks. November 2025 recorded the coldest temperatures in 84 years in Bhopal and Shivpuri. In January 2026, temperatures in Shivpuri and Sheopur dropped to around 4°C.
Between February 29 and March 4, a Western Disturbance brought heavy rain and hailstorms across more than 20 districts. Hailstones measuring 6-7 mm flattened standing mustard crops in the Gwalior-Chambal division, according to Agriwatch.
Further rain and hailstorms between March 18-20 and again in early April damaged both standing and harvested crops. In many fields, harvested produce remains waterlogged and is now rotting under subsequent heat. Palua Aadivasi (60), a farmer from Bhesora village, said, “When it was supposed to be cold, frost came. When the crop was ready, hail fell. Nothing is in our favour.”
Hailstorms having a severe impact on agriculture (Photo - Sanavver Shafi, 101Reporters)
Loan repayment deadlines for zero-interest cooperative loans ended on March 29, 2026, without extension despite crop losses. Farmers recall that such deadlines were extended in previous years following natural disasters.
For landless Sahariya families, pressure from microfinance institutions (MFIs) is more immediate.
According to an AIDWA report, over 60 percent of women have taken loans at interest rates between 22-26 percent, and nearly 30 percent report coercive recovery practices.
MFIs typically lend to groups of 20-25 women, starting with Rs 10,000-30,000 loans that increase with timely repayment.
Samma Bai had earlier taken a Rs 20,000 loan and repaid it. She later borrowed Rs 60,000, of which three recent instalments remain unpaid.
Her husband, Sahabsingh (32), said, “Every other day, recovery agents come to the house. Sometimes they use abusive language. We have no option but to listen.”
With no income, families are forced into distress measures. Some have mortgaged ration cards for Rs 1,000-2,000. Others sell subsidised grain to meet immediate needs.
ASHA workers are often the first point of contact in these conditions, but they face constraints themselves.
On March 9, 2026, ASHA and USHA workers protested in Bhopal demanding higher honorariums and employee status.
In Kalotra, ASHA worker Narayani Aadivasi (50) said, “During the cold, we found many pregnant women with dangerously high blood pressure due to stress and exposure.”
This irregular cold wave is not merely a matter of common cold. Medical science calls it Placental Dysfunction. Gynecologist Dr. Seema Joshi of Dr. Kailashnath Katju Government Hospital in Bhopal explained: "The difference of up to 21 degrees Celsius between day and night temperatures puts dangerous pressure on the body of pregnant women, causing constriction in blood vessels."
A Japanese study found that when a pregnant woman is exposed to extreme cold, the pulsatility index of the uterine artery increases from 1.14 to 1.52. Dr Kavita N Singh, Dean of Gandhi Medical College and gynecology expert, elaborated: "The body constricts blood vessels (vasoconstriction) to maintain temperature, severely obstructing blood and oxygen flow to the fetus."
She added: "The physical stress of cold and the mental stress of debt collectors together greatly increase cortisol levels in the woman's body." Research published in the Journal of Physiology (2024) confirms that approximately 80 percent of term stillbirths occur due to placental dysfunction and elevated maternal cortisol. A 2023 study in the Chinese Medical Journal found the risk of stillbirth increases up to 4.63 times in women exposed to extremely low temperatures. Research published on PubMed Central further shows that extreme weather exposure increases stillbirth risk by 36 to 83 percent.
See also: Shutdown Halts Some Health Services as Political Risks Test Parties’ Resolve
Despite this horrific ground and scientific reality, state administration policies appear limited to paper. The Madhya Pradesh government created the "State Action Plan on Climate Change and Human Health (SAPCCHH 2022-27)" under the Government of India's National Programme on Climate Change and Human Health. Its stated objective: reduce climate-related diseases, make health services climate-resilient, and protect vulnerable sections including women, children, and tribal communities.
The plan's own document admits high disease burden — waterborne diseases like diarrhea, typhoid, hepatitis; vector-borne diseases like malaria, dengue, chikungunya; respiratory and non-communicable diseases. At drafting time, IMR was 48 per 1000 live births and neonatal mortality was 35. The state had 10,189 sub-health centers, 1,199 PHCs, and 330 CHCs, high disease burden, limited infrastructure.
The budget tells its own story. The plan allocates only Rs 397.06 lakh for 2022-23 and Rs 420.1 lakh for 2023-24. In a state with more than 2,000 PHCs, an energy audit is proposed for only 10. Training is also minimal — 3 days for doctors, 2 days for health workers. Most critically, there is no separate strategy for the interconnected crises of the PVTG population, irregular cold, pregnant women's health, and debt pressure.
Dr RK Badve identifies a core flaw: "We are viewing climate only in relation to heat, whereas cold and rapid fluctuations in temperature are equally dangerous for pregnant women. There is no clear medical protocol for this in the policy. a major shortcoming."
The 2024 report by the Council of Energy, Environment and Water (CEEW) warns that more than 2 lakh health facilities in India are at risk from extreme weather, and that risks must be assessed at the district level.
Environmental activist Rashid Noor Khan said, "The plan has sentinel hospitals, surveillance systems, AQI monitoring, and awareness campaigns. But these are mostly limited to monitoring and reporting. In villages and tribal areas, this is not transforming into a system that directly saves lives."
CMHO Dr Sikarwar, when questioned about policy failure, again defaults to migration and tribal beliefs as explanations.
Samma Bai does not know about SAPCCHH 2022-27, the Anmol app, or the SNCU units. She knows only that her crop is gone, the debt collector will return tomorrow, and she is seven months pregnant in a mud house where the cold still finds its way through the walls.
This article was originally published in 101 Reporters under Creative Common license. Read the original article.
[KS]
Suggested reading:
Subscribe to our channels on YouTube and WhatsApp
Download our app on Play Store