Pub Date : 2021-11-18DOI: 10.1093/oso/9780190130718.003.0002
Samiksha Sehrawat
This chapter provides important insights into why culturalist, technocratic, and neoliberal approaches to maternal and neonatal health have persisted in South Asia despite critiques by bringing together a historical analysis of the ‘problem of childbirth’ under colonialism with the interdisciplinary literature on the medicalization of childbirth. This chapter establishes the central role of British women doctors who fashioned themselves as colonial experts on maternal health in shaping developmental discourses regionally and internationally. British women doctors’ professional project drove their participation in a wider international epistemic community and the creation of infrastructure to improve maternal health in South Asia which emulated British maternalist discourses. Their interventions influenced anti-colonial nationalist attempts to reform reproduction and initiatives by middle-class South Asian women. These reformist discourses, which braided eugenicist concerns with communal polarization and marginalized subaltern medical auxiliaries, continue to pervade post-colonial interventions. The chapter also explores the emergence of international health organizations in the interwar period which produced a discourse linking health and governance to which critiques of conditions of maternity in South Asia responded.
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Pub Date : 2021-11-18DOI: 10.1093/oso/9780190130718.003.0009
N. Madhiwalla
Within the larger context of commodified medical practice and compromised standards in under-resourced government services, premier government medical colleges are reputed to be the enclaves where ‘scientific medicine’ is practised. In the past decade, these have begun to admit a significant proportion of less socially privileged students. This chapter examines the contribution to the production of knowledge of obstetricians graduating from two such institutions who have returned to the ‘periphery’. These students approach medical education without the cultural resources to engage with medicine as a knowledge system. The focus is on instilling discipline and imparting skill in technique, which students imbibe as protocols, without acquiring a broader understanding of the field, an affinity for research, or an exposure to evidence-based practice. Unable to visualize their practice as a conscious engagement with their context, they define their adaptations as violations of the ‘protocolic practice’, undermining their self-assessment as practitioners of science.
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Pub Date : 2021-11-18DOI: 10.1093/oso/9780190130718.003.0006
Deepra Dandekar
This chapter ethnographically explores childbirth practices at Taljai, a large urban slum on the southern outskirts of Pune city in India. Based on women’s recounting of their personal experiences and social relationships surrounding birth-giving at home, this chapter describes childbirth at Taljai as unstable, mirroring the migrant lives of women. Women’s migrant lives at Taljai are precarious and subject to material paucity and systemic violence, defined by strong internal negotiation and sociability surrounding their birth-giving practices at home. While homebirths are predicated on friendship networks among women, clinical births either indicate individual exclusion from women’s groups at Taljai or women’s active choice to avoid being controlled by other women. This chapter explores the tight gendered sociability surrounding homebirth at Taljai, demonstrating how women amalgamate experiences of self-birthing at home with home-birthing at the slum, instrumentalizing childbirth rituals as a means of social bonding.
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