E-PMSMA means Extended Pradhan Mantri Surakshit Matritva Abhiyan. It was launched by the Ministry of Health and Family Welfare in January 2022 to strengthen the tracking and management of high-risk pregnancies.
It builds on the original Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), which provides assured antenatal care to pregnant women on the 9th day of every month. E-PMSMA goes one step further by focusing on continuous follow-up of women identified as high-risk.
Objective and Focus
The main objective of E-PMSMA is to ensure that high-risk pregnant women are not only identified, but also tracked until safe delivery.
Under the original PMSMA, pregnant women are screened during antenatal check-ups. If a risk factor is found, the woman is marked as a High-Risk Pregnancy (HRP).
E-PMSMA strengthens this process by creating an individual tracking mechanism for such women through the existing PMSMA portal. The Ministry has developed additional digital features for individual HRP tracking.
High-Risk Pregnancy Tracking
High-risk pregnancy includes cases where the mother or baby may face increased risk during pregnancy or childbirth.
Risk factors may include:
- severe anaemia
- high blood pressure
- diabetes in pregnancy
- low maternal weight
- previous caesarean section
- multiple pregnancy
- malpresentation
- bleeding during pregnancy
- history of stillbirth or pregnancy complications
- teenage pregnancy or advanced maternal age
In 2024, the Government expanded the list of high-risk pregnancy categories from 10 to 25 to improve early identification and timely management of complications.
How E-PMSMA Works
E-PMSMA is designed to move from one-time screening to continuous care.
The process broadly includes:
- identification of high-risk pregnant women during ANC check-ups
- registration and tracking on the PMSMA portal
- tagging with the nearest First Referral Unit
- follow-up by health workers
- referral to specialist care where required
- monitoring till institutional delivery
This is important because simply identifying a high-risk pregnancy is not enough. The woman must receive follow-up care, transport support, referral linkage and delivery at an appropriate health facility.
Significance
E-PMSMA is important because many maternal and neonatal deaths occur due to delayed detection or poor management of pregnancy complications.
It helps improve maternal health by:
- ensuring early identification of risk factors
- strengthening follow-up of high-risk pregnancies
- improving referral to higher facilities
- reducing preventable maternal deaths
- reducing newborn complications
- supporting institutional delivery
- improving digital tracking of pregnant women
Its importance is directly linked with reducing Maternal Mortality Ratio and Neonatal Mortality Rate.
Recent Implementation Examples
States have started using digital tools under PMSMA and E-PMSMA to track high-risk pregnancies.
In Uttar Pradesh, digital tools under PMSMA were used between April and November 2025 to track 25.29 lakh pregnant women, out of which 2.19 lakh were identified as high-risk and linked with specialised care.
Such examples show that digital tracking can help health systems move from passive registration to active monitoring of vulnerable pregnant women.
Key Challenges
The main challenge is converting digital tracking into actual care.
If a high-risk woman is identified but does not receive timely referral, transport, specialist care or safe delivery support, the purpose of E-PMSMA is weakened.
Major concerns include:
- shortage of gynaecologists and specialists
- weak referral transport in rural areas
- poor follow-up after high-risk identification
- lack of ultrasound and diagnostic facilities
- delayed antenatal registration
- anaemia and malnutrition among pregnant women
- uneven digital data quality across districts
- weak coordination between primary centres and referral hospitals
The scheme’s success depends on last-mile health system capacity, not only portal-based tracking.
Conclusion
E-PMSMA is the extended version of PMSMA, launched in January 2022 for individual tracking of high-risk pregnancies.
Its core purpose is to ensure that pregnant women with risk factors are identified early, monitored regularly, referred properly and supported until safe institutional delivery.
The programme is important because India’s maternal health challenge is no longer only about increasing check-ups or institutional deliveries. The bigger challenge is ensuring quality care for high-risk pregnancies through timely diagnosis, referral and follow-up.
