Wednesday, 16 November 2011

#10 Birth in Bangladesh

FACT OF THE DAY: Childbirth is thought to be so ‘polluting’ in rural Bangladesh that the ‘dai’ who helps with the birth only bothers to wash her hands after she has finished dealing with the newborn and birth fluids, not before.

Right, today I am going to tackle one of the big ones – childbirth.

I have been slightly putting this off as it certainly doesn’t make for light reading. I guess we got a hint at this from the terrible birthing statistics around the world in post #2.

But today, I am going to describe the childbirth experiences in rural Bangladesh.

If you are hoping for descriptions of a lovely natural birth, with nurturing traditional birthing customs that ensure the safe delivery of the baby, then I’m afraid you’re going to be disappointed. If you are a fan of ‘natural birth’ you may find you’ve changed your mind after you’ve read this.

In fact, maybe this post should come with a health warning – not for the faint hearted, or anyone who is going to be giving birth soon.

People in rural Bangladesh, be they Christian, Muslim or Hindu, think of childbirth as an extremely ‘polluting’ event.  I don’t think we really have an equivalent to the idea of this sort of ‘pollution’. It has nothing to do with the physical mess created by labour (something that we could understand more easily) but describes the belief that women in childbirth and for some time afterwards are contaminated or impure. Any contact with the birthing mother, the bodily fluids of birth, or the newborn is thought to be polluting. 

Because of this their childbirth practices are all about avoiding pollution, rather than delivering the baby safely. Family members want to minimise their contact with the birthing process, which means that the labouring woman is not really supported in any way. 

It’s such a terrible thought that because of these superstitious beliefs, women are not supported by anyone in their time of need. And it really is a time of need, there is no pain relief, and it’s very likely the birthing mother is petrified by what’s about to happen. But instead, the other women in their household watch from a distance, possibly giving her a bit of sanctified water to drink if the pain gets really bad.

Women give birth either in a hut specially built away from the main house, or in a partitioned off part of the kitchen. 

A birth assistant called a ‘dai’ is employed, not to provide support or expertise, but to deal with the pollution of the birth, leaving everyone else unpolluted.  She has no training and normally does as instructed by the other elderly women who are looking on. The dai is usually a very low caste person who is "typically so poor that she is prepared to take on this most disgusting of tasks" which involves touching the woman’s genitals, cutting the cord, cleaning the baby, and tidying up the placenta and fluids of labour. 

But even the dai will not bother to wash her hands before assisting with a delivery, and will only do so afterwards, to try to wash away the pollution.

This obsession with ‘pollution’ contrasts with the total lack of concern or precautions to do with hygiene. The villagers blame evil spirits, rather than infection, for any death in childbirth. 

On reading about these poor women’s experiences, the bit that really touched me was that once the baby was delivered, the dai forced the labouring woman’s plait down her throat to make her wretch and expel the placenta.  How awful.

A Dai.     Photo credit IRIN

Here is a quote from a researcher called Blanchet doing fieldwork in northern Bangladesh. She was present at the first labour of a seventeen year old girl in the family kitchen. A dai had been called but had not arrived.

“As the delivery became imminent, it became evident that none of the other women present was prepared to tackle the birth. Instead they asked Blanchet herself to catch the baby. Blanchet asked for soap to wash her hands, but the women told her that it was before not after that she should use soap. The birth was without complication, but throughout the birthing process the other women refrained from coming in contact with the birth substances. For instance, when the baby was delivered by Blanchet, she was advised to place it on the cold earth of the floor, as none of the women was willing to hold it.”

I have read very similar accounts of childbirth in Uttar Pradesh, India so clearly these attitudes are found throughout that part of the world.

But I think that’s enough for today....

One consequence of these pollution beliefs that could be positive, is that women may be more willing to go to a health centre or hospital to give birth as it will keep the pollution out of the house. In many cultures women are very reluctant to go to hospitals and expose themselves to doctors, usually male doctors, as this is deeply shameful. Often hospitals are used as a very last resort for difficult deliveries, once it is too late.

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If you would like to read more yourself, have a look at:

Rozario, S ‘The Dai and the doctor: discourses on women’s reproductive health in rural Bangladesh’ in Ed Kalpana Ram and Margaret Jolly (1998) Maternities and Modernities; Colonial and postcolonial experiences in Asia and the Pacific  Cambridge University Press

Blanchet, T (1984) Women, Pollution and Marginality: Meanings and Rituals of Birth in Rural Bangladesh Dhaka: University Press

Interestingly, less damning accounts of the Bangladeshi Dais can be found. For example;

About India:

Patricia Jeffery, Roger Jeffery, Andrew Lyon (1989) Labour pains and labour power Zed Books : New Jersey USA