Indian Midwife - A Dying Breed?

In rural India, until a few decades ago, midwives were an integral part in the gynecology scene. Hospitals were few and far between and the nearest one with basic amenities was over an hour away. There were no doctor on call nor were there any vehicles on standby to rush you there. Enter midwife aka Dai, in Hindi, who lived in the vicinity and used indigenous methods based on an intimate knowledge of the female anatomy and years of experience.

She bustles into the room of the expectant mother, shoos away the others, opens her trusted bag of supplies after ensuring there is plenty of hot water, soap, cotton etc and keeps up a steady monologue aimed at soothing the expectant woman writhing in pain. Deftly, the midwife examines her, asks relevant questions and when the time is right, signals her to push. Outside, the husband's anxious face would break into a wide smile the moment he hears the shrill cry of the baby and waits impatiently to hear that all is well. The midwife is suitably rewarded and she continues to visit the new mother for months afterwards to ensure her and her baby's well being.

Until the early 1960s, in my native village in Kerala (South India), women belonging to a community called the 'valakkathrol' were called to handle childbirth. They were 'traditional' midwives and all they used to have, was a knife that was used to cut the umbilical cord. These women relied on their intimate knowledge of ancient folk medicine and experience. My grandmother delivered her ten children in her bed at home, with a valakkathrol in attendance. Going to a hospital was not an option in these remote villages. Farm work, running large households coupled with nutritious wholesome food, had conditioned pregnant women of those days and eased childbirth. They were not bogged down by stress or weakened by the rigors of living in a competitive world that exists today.

I was amazed when my mother had narrated her experience with the midwife, when she had given birth to my older brother. She had gone to her parents house (a beautiful quaint village) in Kerala for the delivery. When the time came, she was at home in bed. The midwife had instructed her to push. One hand was lightly placed on my mom's stomach and the other hand held a thick rolled piece of cloth that was pressed tightly to her anus!! My mother explained that it was to stop her from expelling her stools....which was likely when you had to push with all your might. Nowadays, enema is administered through the anus and your bowels are cleared before you get ready for the delivery.

Sadly, midwives are a dwindling lot now. It started during the British rule, when the English missionaries started spreading the western method of childbirth. They wanted to replace midwives with trained nurses. The midwife training centres that they built did not help our 'dai' as it required knowledge of English. However, after independence, dais benefited a lot from improvised training policies that equipped them to deal with delivery complications and reduce infant mortality.

In the villages, most dais have a loyal clientele and they prefer them over trained midwives, because in addition to assisting childbirth, she is on call to give you valuable advice, right from your first term of pregnancy until after postpartum, in the comfort of your home. As a consequence, the new mother is happy and relaxed which helps in smooth delivery.

It is interesting to note that midwifery originated in ancient India and is one of the oldest professions in the world. Charaka (200 BC) known the father of medicine and Sushruta(600 BC) known as father of surgery, refer to midwives in their writings as wet nurses from decent families.

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