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Assisting Childbirth

the same frame as pyschoneuroimmunology, one certainly wants more than an allusion. Silences around Women

Assisting Childbirth

Birth and Birthgivers: The Power behind the Shame

edited by Janet Chawla; Shakti Books, Har-Anand Publications, New Delhi, 2006; pp 312, Rs 495.

PUNAM ZUTSHI

S
ubsequent to the publication of Dais as Traditional Birth Attendants (1980) by D N Kakar, and Labour Pains and Labour Power: Women and Childbearing in India (1988) by Patricia Jeffery, Roger Jeffery and Andrew Lyon, the role of ‘dais’ has certainly been attended to by Kalpana Ram in Maternities and Modernities: Colonial and Postcolonial Experiences in Asia and the Pacific (1998) and Santi Rozario and Geoffrey Samuel’s Daughters of Hariti: Childbirth and Female Healers in South and South-East Asia (2002). With the publication of this volume which lies at the intersection of anthropology, women’s studies and public health, childbirth and dais in India can truly be said to come centre stage.

This is the outcome of an initiative occurring at the threshold of the academe, when we consider Janet Chawla’s trajectory from natural childbirth educator to researcher. The encounter with the complete lack of reflexivity or resistance shown by educated modern Indians in the face of the “mutilations” of Caesareans and episiotomies, leads Chawla into the labyrinth of the dais’ world through that strand of the American feminist movement which has an abiding interest in the feminine body and in women’s spirituality. Two contributors to this volume – political scientist Deepti Priya Mehrotra and philosopher Anuradha Singh were Chawla’s interlocutors as research director and resource person respectively, on the Matrika project that spearheaded research on the subject.

The papers by Chawla and Mehrotra and Singh are all concerned with the knowledge system of the dais and its validity in different ways. Chawla wrestles with the silences that surround ‘sharam ki baat’, the acts of translation required to understand and explain the work of the dais to the world at large and issues of women’s reproductive health. In arriving at what lies behind the shame, it would have been fruitful to engage with the work of Veena Das and of Frederique Marglin. While Marglin’s significance to Chawla’s journey is duly attested, surprisingly her work, specifically the concept of ‘mangala’ is not looked at. Mehrotra explains the selection of methods by which the researchers gained access to the knowledge and practice of the dais. The resonance between the dais’ knowledge and Ayurveda leads Anuradha Singh to a systematic exposition of the subject of birthing in Ayurveda texts. All three are sensitive to the problems in the uncritical revival of tradition. Singh’s work is particularly sensitive to “traditional” practices that need to be re-examined. Singh’s epistemological activism builds theoretical bridges between the work of the dais and classical texts, which has historically not been undertaken, certainly on account of the divisions of labour in the knowledge system, that does not “learn from the midwives” as Paracelsus did. As Mehrotra succinctly puts it “Like every other body of knowledge – including modern medicine – traditional Indian knowledge of midwifery is imperfect, provisional and incomplete. It is, at the same time, contextfriendly, woman-friendly and sustainable” (p 198). Mehrotra is acutely aware that the best of the medical system is inaccessible, whereas the worst of it is fast spreading and causing considerable damage to women’s health. She advocates the reframing of universal rights to include amongst other rights, the dais’ right to be recognised as professionals considering that it is poverty and malnutrition that lead to high maternal mortality and morbidity. Dais, we are reminded, actually save lives in conditions a doctor would not be able to function. Just one minor quibble: when symbolic acts such as the untying of hair and the opening of locks are brought into the same frame as pyschoneuroimmunology, one certainly wants more than an allusion.

Silences around Women’s HealthSilences around Women’s HealthSilences around Women’s HealthSilences around Women’s HealthSilences around Women’s Health

The norms, if not taboos, that govern speech regarding questions of sexuality and pregnancy enjoin silence as these are sharam ki baat, it is important to recall that what is not spoken may often be sung. The singer-editor Vidya Rao’s paper attends to ‘sohars’ sung collectively by women to celebrate birth usually that of a son, to discover that the sohars not only sing of birth, but of women’s desire, the pleasures of sexual love, of pregnancy’s travail (and the need for a dai!) and the fears of infertility. In a poignant sohar where the bride speaks of leaving her home and making the journey to her husband’s, the person addressed in the song is the child, perhaps unborn, who as Rao points out, will mirror the journey between one world and the next. The understanding of the mother and foetus as ‘dvihridiya’ as Ayurveda terms it, finds aesthetic resonance here. In a rich and layered manner Rao explores a whole series of sohars against the backdrop of the ‘natyashastra’, other musical forms and bhakti poetry, to comprehend the way that the sohar subverts the many assumptions and injunctions that are contained in the classical and authoritative texts. And yet sohars encode the dominant voice even when they subvert, but allow a voice wherein one may find one’s own space. One does wonder whether in the printed sohars or those collected from midwives, bawdy songs directed at the male body like the one documented in Jeffery et al (p 123) appear.

The case for returning or retaining childbirth at home is made in two ways. One is an account of her own childbirth at home after three hospital deliveries by the novelist Manju Kapur. The other comes from Alpana Sagar’s incisive look at what militates against this. As a doctor trained in public health, Sagar’s research on childbirth in a New Delhi slum is juxtaposed with what can only be described as an archaeology of biomedical practices, a “history of the present” in Foucauldian terms. In a synoptic look at the rise of modern obstetrics and its diffusion to the Indian colony, Sagar allows us to understand the marginalisation of dais as part of the modern ideals about reproductive health, despite the fact that the majority of women have births at home and would prefer to do so.

While dais have symbolised a nation’s “backwardness”, they are trained as birth

Economic and Political Weekly June 10, 2006

attendants for government programmes, intermediaries in the process of modernisation. Subadhra Devi Rai from the field of population and health, looks at the case of Gujarat to make a case for assessing the hidden economic dimensions of maternal health programme that rely on the participation of dais. Her exercise makes one think of the realm of the non-economic even as it is being rethought by her through the monetary evaluation of dai’s work and providing us with a picture of the dai outside of her tasks of “birth attendant”. Rai forces us to see what the dai’s contribution to the fiscal savings of the Gujarat government in fact is, at a time when it aims at moving towards phasing out dais in the larger project of institutional births.

Caste and Pollution IssuesCaste and Pollution IssuesCaste and Pollution IssuesCaste and Pollution IssuesCaste and Pollution Issues

Anthropologist Sarah Pinto challenges the notion of the dai as midwife or “traditional birth attendant”. Drawing on her doctoral work in Sitapur district, Pinto outlines for us the division of labour involved in childbirth, making a distinction between the collective handling of delivery and the specialised nature of post partum work. This turns the focus on caste, pollution and ‘jajmani’ relationships in the picture of childbirth. The ‘dhanuk’ is responsible for cord cutting, washing the baby and rubbing it with “dirt” (sic), cleaning up, and the disposal of the placenta at the time the ‘jachcha’ and child are considered the most polluted; the ‘naoun’ comes to massage the new mother taking on the remaining phase of seclusion. With the multiplicity of women who provide advice, assistance or comfort in numbers at the time of delivery with no special emphasis on who catches the child

– and the internal differentiation in post partum work, it is difficult to speak of the dai as a unitary figure. It is also difficult to speak about a body of specialised knowledge as what is possessed is ‘jankari’, an integrated web of knowledge and experience accessible to all. The consequences of training are that post partum workers trained to be dais are seldom called for deliveries outside their own jati, while baby deliverers trained as dais refuse to cut the umbilical cord. When Pinto tells us that the idea of the midwife may relate to institutional efforts to create “modernity”, than to the shape of “tradition”, she can be viewed as calling into question the premises that are the basis for advocacy in the other papers in the volume.

An aside: Pinto’s use of trash-work to describe the work of the dhanuk and dirt found or earth may be treated as disconcerting American usage, but when disappear and progress become transitive verbs in “to disappear the dai” or “to ritually progress the child”, one is more than slightly startled.

I believe that Chawla’s work on the theology of Bemata and ‘narak’ partly embedded in the opening chapter of this book brings the cosmology of the dai squarely into the universe of anthropological discourse. The book would have benefited from the independent inclusion of this work. While we are familiar with the ‘purusha sukta’ hymn that underpins the hierarchical organisation of caste-based society, Bemata and narak are a reminder to look at “ground” realities as it were, making the dai as integral to the axis of purity and pollution as the ‘nai’ and the ‘dhobi’.

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Email: punam.zutshi@gmail.com

Economic and Political Weekly June 10, 2006

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