Birth on the Threshold
Birth on the Threshold
Childbirth and Modernity in South India
Cecilia Van Hollen
University of California Press
Berkeley and Los Angeles, California
University of California Press, Ltd.
London, England
© 2003 by the Regents of the University of California
Chapter Four was published in different form as “Invoking Vali: Painful Technologies of Modern Birth in South India,” Medical Anthropology Quarterly 17, no. 1 (March 2003). Chapter Five was published in an earlier form as “Moving Targets: Routine IUD Insertion in Maternity Wards in Tamil Nadu, India,” Reproductive Health Matters 6, no. 11 (May 1997); and Chapter Six was published in different form in Santi Rozario and Geoffrey Samuel London, eds., The Daughters of Hariti: Birth and Female Healers in South and Southeast Asia (London: Routledge, 2002). All are reprinted here by permission.
Library of Congress Cataloging-in-Publication Data
Van Hollen, Cecilia Coale
Birth on the threshold : childbirth and modernity in South India / Cecilia Van Hollen.
p. cm.
Includes bibliographical references and index.
ISBN 0–520–22358–6 (cloth : alk. paper)—
ISBN 0–520–22359–4 (pbk. : alk. paper)
1. Childbirth—India, South. I. Title.
RG530.3.I42 I583 2003
618.2′00954—dc21
2003003890
Manufactured in the United States of America
12 11 10 09 08 07 06 05 04 03 10 9 8 7 6 5 4 3 2 1
The paper used in this publication is both acid-free and totally chlorine-free (TCF). It meets the minimum requirements of ANSI/NISO Z39.48–1992 (R 1997).
For Christopher and Eliza Van Hollen, who gave birth to my life in South Asia, and for Jeffrey and Lila Rodgers, who let me share that life with them. And in loving memory of baby Charlotte.
Contents
Maps appear on pages 17 and 30
Prologue: Birth on the Threshold
Introduction: Childbirth and Modernity in Tamil Nadu
2. Maternal and Child Health Services in the Postcolonial Era
3. Bangles of Neem, Bangles of Gold: Pregnant Women as Auspicious Burdens
4. Invoking Vali: Painful Technologies of Birth
5. Moving Targets: The Routinization of IUD Insertions in Public Maternity Wards
6. “Baby Friendly” Hospitals and Bad Mothers: Maneuvering Development during the Postpartum Period
Conclusion: Reproductive Rights, “Choices,” and Resistance
Appendix I. Sample Interview Questionnaires
Acknowledgments
Had my parents not taken me as a child to live in South Asia, this study and the book would, most likely, have never come to be. First and foremost, I thank them for teaching me the importance of embracing the world.
In India, so many have helped so graciously that I cannot mention them all. My deepest gratitude is to all the women and men who participated in this study, sharing their stories of joy and pain, of frustration and accomplishment, and including me in their celebrations. My research assistants—Annette Mathews and Haripriya Narasimhan—were true collaborators on this project; without their knowledge, sensitivity, and friendship none of this would have been possible. I am particularly indebted to Annette Mathews, who worked with me the entire year of 1995, assisting with interviews and with the painstaking work of translation and transcription, as well as with the collection of materials from numerous government offices. With a background in social work and a familiarity with medical establishments in Tamil Nadu, Annette was also an invaluable asset in the process of analyzing the underlying meanings and motives behind people’s comments in interviews, and she often suggested avenues of inquiry which would not have occurred to me. Perhaps most important, Annette’s lively and humorous personality helped to both put people at ease and inspire animated discussions. Haripriya Narasimhan’s assistance with the same kind of work toward the end of 1995 and again in 1997 also proved invaluable. I am particularly grateful that Haripriya was able and eager to travel with me on my visits to regions of Tamil Nadu beyond Madras and Kaanathur-Reddikuppam. Haripriya’s background in anthropology and, particularly, in different cultural ideologies and practices within Tamil Nadu led me to think about my research materials in a new light. Finally, Rajeswari Prabhakaran devoted much time and energy to helping with transcriptions and translations and made arrangements for me to witness an elaborate Brahmin cīmantam ritual. Much of this research was facilitated by my long-standing affiliation with the Working Women’s Forum in Madras. I am greatly indebted to the forum’s president, Jaya Aranachalam, and to all of the women involved in the Reproductive Health program for their insights and organizational skills. I am also appreciative of the staff at the IPP-V Santhome zonal hospital in Madras for facilitating my ongoing research in that hospital. And Padmini Swaminathan, my mentor at the Madras Institute for Development Studies, provided suggestions and encouragement throughout the project.
My