Human Rights Fellowship: Changing times for midwives in India

Lara Mitra believes access to a healthy life is a basic human right.  “This didn’t used to be an option for women in rural villages,” explains the Human Biology major and 2013 Human Rights Fellow. 

Over the summer months, Mitra spent eight weeks interviewing traditional midwives, called dais, in western India.  She worked on behalf of Self-employed Women’s Association (SEWA) to gather data on the roles dais play in a rapidly modernizing environment.  SEWA trains dais in basic cleanliness and the use of septic equipment--the only formal training these midwives undertake.  Mitra spoke with admiration of the highly experienced midwives noting, “her hands are her main tool, and her knowledge.”  

Wise, trusted, and often-elderly, dais play a central role in their communities. They they have participated in multiple generations of maternity as tender caregivers, experienced deliverers, and sources of wisdom.  However, due to new incentive systems in India, more women in rural areas are traveling to urban hospitals to give birth, lending the question: what is the role of the dai?

After arriving in Gujarat, a state in western India, and beginning to commute to rural areas by bus and rickshaw, Mitra was discouraged by rumors and her inability to connect with a dai.  And then, one day, her disillusionment was dispelled.  Mitra met a dai walking down a street with a woman that she had both delivered and been midwife to during the woman’s multiple pregnancies.  “Seeing the generational connection was powerful,” says Mitra.  She went on to interview the dai, and others like her.  Listening to the often funny, scary, and embarrassing stories of the women and their dais was one of Mitra’s favorite parts of her fellowship.  

She discovered that dais still play an important role in communities: they accompany women to the urban hospitals where male doctors and unfamiliar environments can intimidate mothers, they perform emergency, home deliveries for women who have waited too long to call the ambulance, and they check on the mothers throughout their pregnancy and post delivery.  Even so, dais are declining in numbers.  

With women’s increasing access to education, dais’ daughters often go on to join a profession where they can earn a living.  Dais are not paid for their service, but rather aresupported by the community out of respect for their important role in society.  Thus, as midwifing is a skill handed down from mother to daughter, there are not many replacements being trained to take over from the aging population of dais.  Yet, the role of the dai cannot be filled by an outsider, since a dai must be a trusted and integral member of the community.  “Identifying that person (to take on the role of dai) will be a challenge,” says Mitra.  

After learning the intricacies of the changing structure of rural communities in response to modernization of health care and education, Mitra hopes to stay in contact with SEWA.  Her fellowship has inspired deep interest in the topic, and she has declared her concentration in Human Biology as Human Rights and Maternal Health.  She hopes to learn more about “how traditional and modern medicine come together,” having discovered how “they are both really important.”

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Charlotte Brown is a senior undergraduate studying Contemplative Neuroscience through the Program for Indiviudally Designed Majors.  She enjoys studyng the brain in biology and the mind in poetry and other arts.