Beed, Maharashtra: Four months pregnant, Archana Mali (name changed) stepped out for work in the rain.

The last week of September 2025 had brought relentless downpours to Marathwada. Fields lay waterlogged, streams had overflowed and villages across the region were struggling with flood-like conditions. In Saudana, a remote village in Beed district, Mali could not afford to stay home. A landless labourer, she had been promised Rs 100 for clearing sludge and doing odd jobs.

"There was no work in the field due to the excessive rainfall, but I was going to get 100 rupees for the day for removing the sludge and doing some minor tasks," she told 101Reporters. "It was still raining. Once the work was done, I was walking towards home, trudging through the mud, when my foot slipped and I fell directly onto my stomach."

"Initially, I didn't feel anything serious, but after a while, severe pain started in my abdomen. We thought the fetus would be fine, but the pain kept increasing. Finally, when we went to the block-level government hospital in Beed, they said the fetus could not be saved and had to be removed."

Like many women engaged in informal agricultural labour, Mali continued working during her pregnancy despite difficult weather conditions.

The rains that year came not as steady showers but as intense, short-duration downpours, particularly in August and September, triggering floods, damaging crops and cutting off villages across Marathwada. According to the India Meteorological Department, cumulative rainfall in the region by the end of September had reached between 826 mm and 977 mm — nearly 129% to 134% of the seasonal average. Between June and October, Marathwada received 1,046 mm of rainfall, equivalent to 139% of its expected seasonal total.

What do numbers show

Official health records indicate an increase in reported miscarriages in parts of Marathwada during the period of extreme rainfall.

In the five-month period from June to October 2024, 153 miscarriages were recorded in Beed district. In the same period of 2025, the figure rose to 225, according to data provided by the District Health Officer.

According to official health data cited in a report published by Divya Marathi, Chhatrapati Sambhajinagar district recorded a 43.49% increase in miscarriages during the eight-month period from April to November 2025 — from 1,959 in 2024 to 2,811 in 2025.

The figures were also cited in a written reply to a starred question raised in the Maharashtra Legislative Assembly by MLAs Santosh Danve and Dhananjay Munde. Public Health and Family Welfare Minister Prakash Avitkar stated that 2,811 miscarriages were recorded in Chhatrapati Sambhajinagar district and 6,136 across the Marathwada region, based on data from the Health Management Information System (HMIS).

The legislators had asked whether above-average rainfall, flooding and disruption to public services had affected maternal and infant health outcomes.

The minister rejected suggestions of a direct link between excessive rainfall and miscarriages.

"It is not appropriate to outright claim that excessive rainfall directly causes miscarriages," he said. "The state's health system is fully prepared during flood situations. We are taking all necessary measures to ensure no inconvenience occurs in delivery or other treatments."

What doctors say

Doctors and public health experts caution that miscarriages cannot be attributed to rainfall alone. However, they say extreme weather can create conditions that may increase risks for some pregnancies.

Chhatrapati Sambhajinagar-based gynaecologist Dr. Shubhangi Mande explained: "Although there is no direct link between excessive rainfall and miscarriage, the risks certainly increase due to the difficulties that arise during flood situations. Infectious diseases increase during the monsoon, causing high fever, which can directly affect the fetus. Due to the poor condition of roads, women cannot reach the hospital on time. Sometimes incidents of slipping and falling occur, while mental stress and physical exhaustion also increase significantly. The combined effect of all these factors increases the possibility of natural miscarriage."

Dr Shubhangi Mande (Photo - Vitthal Sable, 101Reporters)

Medical research has shown that infections and high fever during pregnancy can affect placental function and fetal development. Research published by the World Health Organization (WHO) and the National Institutes of Health (NIH) notes that maternal infections, inflammation, and sustained high body temperature during pregnancy may increase the risk of adverse fetal outcomes, including fetal distress and pregnancy loss in severe cases.

A major study published in Nature Communications in 2024, examining 90,465 pregnancies across 33 developing countries, found that women who experienced flooding during pregnancy faced an approximately 8% increased risk of miscarriage — and that if flood conditions persisted for more than 16 days, the risk could nearly double. According to the study, more than one lakh pregnancies worldwide are lost annually due to flood-related conditions, with South Asia among the highest-risk regions.

A 2023 review published in The Lancet Planetary Health further noted that pregnant women face heightened health risks during climate extremes, particularly in low-resource settings with limited healthcare access.

Health data infographics (Photo sources by - Vitthal Sable, 101Reporters)

Ambulances out of reach

According to the Beed District Health Department, the 102 and 108 ambulance services remained operational during the floods. However, officials said that in some areas vehicles were unable to reach pregnant women because bridges had been washed away or roads had become inaccessible.

When the BaiManus team visited flood-affected villages in Beed district, damaged roads, waterlogged settlements and long distances between villages and healthcare centres highlighted the challenges residents faced in accessing emergency healthcare during the heavy rains.

Officials shared records of reported cases but declined to comment on the condition of medical facilities or emergency healthcare access, stating that they did not have permission from the state government to speak on the matter.

In several villages affected by flooding and road damage, ASHA workers became an important link between pregnant women and the healthcare system.

Parvati Gaike, an ASHA worker from Saudana village, described the challenges she encountered during the heavy rainfall.

"In a natural disaster, it is not just houses that collapse; the entire health system in rural areas is disrupted. When roads are closed due to the onslaught of rain, ensuring the safety of a pregnant mother becomes our biggest challenge. At the administrative level, these miscarriage incidents might not be considered the wrath of nature — but due to constant running around, a fearful atmosphere at home, and mental stress, the buds in many mothers' lives wither before they can even bloom."

She added: "We don't just deliver medicines; we also try to heal these invisible wounds by counselling each family during those difficult times."

Accredited Social Health Activist (ASHA) worker Parvati Gayake (Photo - Vitthal Sable, 101Reporters)

Climate, disasters and maternal healthcare

Public health experts and healthcare workers in rural Maharashtra argue that the increase in miscarriages during periods of extreme weather warrants closer examination. They point out that the state's public health system does not currently have dedicated mechanisms focused specifically on health risks linked to climate-related disasters such as floods, heatwaves or extreme rainfall.

Field health workers suggest that PHCs in flood-prone talukas need to be made more disaster-resilient, equipped with emergency blood storage, better transport, and critical care support during the monsoon. They also argue that emergency planning in remote villages should not rely entirely on the 108 ambulance network — in areas where roads are frequently submerged, advance deployment of boats or alternative transport before the monsoon begins could be lifesaving. Some healthcare workers and activists further argue that women who suffer pregnancy complications during climate-related disasters should receive special assistance under disaster relief frameworks, particularly where access to healthcare was disrupted by floods.

District Health Department in Beed (Photo - Vitthal Sable, 101Reporters)

Health experts caution that miscarriages can occur for a variety of medical reasons and that it would be inaccurate to attribute all cases recorded in Marathwada during 2025 to extreme rainfall. However, doctors, ASHA workers and public health researchers interviewed for this story said that flooding, disrupted transport, delayed access to healthcare, infections, physical strain and mental stress can create additional challenges for pregnant women during climate-related disasters.

The increase in reported miscarriages during the period of heavy rainfall has raised questions about how prepared rural health systems are to protect maternal health during extreme weather events.

Cover Image - Archana Mali, a case study profile (Photo - Vitthal Sable, 101Reporters)