Pangs of transition
BIRTH ON THE THRESHOLD — Childbirth And Modernity In South India: Cecilia Van Hollen; Zubaan, an associate of Kali for Women, K-92, I Floor, Hauz Kauz Enclave, New Delhi-110016. Rs. 350.
CARDIAC PAIN is said to be the king of all pains. And labour pain, the queen. And all unsung queens (read mothers) are supposed to know, feel, experience and understand that the fruit of birth is certainly worth the pain. Consolidating the viewpoint, Cecilia Van Hollen interestingly looks at how childbirth, reproductive rights and feminisation of poverty are inextricably linked. Her evocative detailing of Indian customs and the pangs of childbirth in a public hospital read like pathos with a punch.
She writes apologetically in the introduction that the book "may at times seem like a litany of complaints and an unsolicited condemnation of reproductive health services provided in Tamil Nadu which is usually viewed as a success story in Maternal Child Health (MCH)." However, this book is the fruit of her extensive research on men and women whom she encouraged to share their stories of joy and pain, frustration and accomplishments, about movement and change in the conceptualisation and experience of childbirth.
Case study
It is a study, conducted between 1995 and 1997, of poor women living in Nochikuppam (southern end of Chennai's Marina Beach) and in semi-rural pocket of Kaanathur-Reddikuppam, an hour from the city towards south of Chennai. It is a miniscule sample to look at the rapid transition in the availability and use of modern medicines but the author establishes how modernity has impacted childbirth while acknowledging the fact that India contains a plurality of medicine systems of knowledge and practice which become a part of the decision- making process for women. They are also aware of how their class and gender status constrains the choices they could make about their reproductive health.
So, what is at stake? Lives and the potential for suffering. In fact, Cecilia highlights this art of suffering in the wake of modern medicine's determination to kill pain. The book is permeated with the key theme of "medicalisation". She liberally cites instances where the wide range of social and cultural processes go into decisions like "where to go for pre-natal care and delivery, whose advice to seek during post-partum period."
Glorifying motherhood
Despite the presence of small and big government and public hospitals within the reach — unlike earlier times — class and caste-based forms of discrimination which women continue to face in delivery rooms and the "biomedicalisation" of births by administering allopathic labour-inducing medicines or analgesics to reduce pain and family planning pressures, forces themajority to invoke "Vali" (pain) in the house. It is the cultural notions about female power (Sakti), more so in Tamil Nadu, that asserts that hospital birth denies the women of a "full-bodied, spiritual woman-centered experience of natural birth."
Calling her work an "ethnographic take and not a cross-cultural book", the author states that "biomedicalisation" of childbirth throughout the globe cannot be viewed as a monolithic process. She observes that allopathy is not hegemonic even in Tamil Nadu, where a large percentage of births continue to take place in homes with the assistance of a "dai". Yet, this practice, in her opinion, cannot be viewed as a form of resistance but that ruling out MCH care is a "choice".
Traditional customs
Since a woman embodies Sakti by enduring all pain, she takes a very thought-provoking look at the pregnancy rituals in the State. The imperative performance of "Seemantam" ritual despite its growing economic burden is explored without mulling or glossing over it. At times albeit in a too simplistic an analysis, the researcher sets one thinking through the concept and arguments: what should indeed be sacrificed or compromised — allopathic care or ritual cost?
While at such ceremonies women are revered for their reproductive capacities, the best medical care — meaning allopathic care associated with modernity, efficacy and prestige — do not always come about as the first and only choice. One cannot say that the book was much needed or awaited, but for anyone following gender issues, it could offer both refreshing and hackneyed views. Without being overawed, the author delivers it all with an open mind and cerebral honesty.
SOMA BASU
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