Perinatal: Discussion Paper

Perinatal: Discussion Paper

3rd July 2009

Proposal for discussion to present at PERINATAL: Symposium on Birth Practices and Reproductive Rights
George Mason University, Fairfax, Virginia

Title:  Changing choices in childbirth in rural India – stories from Srikakulam District, Andhra Pradesh, India


Women’s options in childbirth are circumscribed by broader factors that determine their opportunities in life, whether and when to marry, to study, or work outside the home.   The limiting factors include ideas about women’s bodies, of  menstruation, fertility and reproductive cycles. Colluding with women’s sense of  inferiority and powerlessness are government policies pushing women towards  institutional childbirth and requiring women to report to the hospital at 9 months  3 days gestation. For women who do not go into labor at 9 months 3 days, this  policy increases the likelihood of hospital birth and related interventions,  including Cesarean birth. A generation is growing up that considers hospital birth  and Cesarean birth to be “normal” and home birth or vaginal birth to be  exceptional. In the process the tradition of midwifery is disappearing. This  pattern reflects a broader global pattern in which traditional living practices  such as natural birth, breastfeeding, sleepsharing, babywearing, and natural  hygiene (also called elimination communication) are being disparaged and  discontinued in societies where they have been in continuous practice up to the  present generation, while being revived among the elite in the first world. These  trends in turn impact attitudes towards learning, health, hygiene and natural resources in a way that creates a gap in the tradition so that the practices can no longer be handed down from elders but must be learned from books, classes or other  media. Meanwhile government policies and profit-driven advertising promote institutional birth, bottle feeding, diapers, cribs and timetables of vaccination, discipline and education that are not oriented to optimal health, growth and learning of the child. Ironically, people believe that following these trends will help them climb the social and economic ladder, but in the larger picture we see that this helps to transfer from the poor to the rich, practices respecting health of mind, body and environment.


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