Contentious Practices In Childbirth And Their Resolution From Ayurvedic Perspective

Author

1Anuradha Singh, 2Dr.K.S.Krishnan, 1National Institute of Science, Technology & Development Studies, India, 2Marg, Pusa, New Delhi 110012, India.

Proceeding

1st International Conference & Exhibition on Women's Health & Asian Traditional (WHAT) Medicine

Date

23/8/2005

Keyword

Ayurveda, health practices, childbirth, specific diet, herbs , massage therapy

Abstract

Indian motherhood is caught between contentious prescripts issuing out of Ayurveda and modern science. I investigate practices related to childbirth that are prima facie contentious and articulate reasons for divergence. More than sixty percent of childbirths in India still occur in accordance with traditional wisdom of the dai-s, based by and large on the Ayurvedic theory. Blending of the resource base of dai-s and modern maternity-care structures is a developmental necessity for society. However, this blending implicates and requires a deeper understanding and a resolute articulation of ontological enigma of childbirth and epistemic hiatus between the traditional and the modern. Presently, there are no reliable facts and figures available indicating how many deliveries take place by traditional or modern medical methods. According to the Ministry of Health & Family Welfare (MOHFW), Government of India, the Maternal Mortality Ratio in India is 407 per 100,000 live births (SRS, RGI 1998).  The major causes of these deaths have been identified as anemia, hemorrhage toxemia, obstructed labor, puerperal sepsis and unsafe abortion. In India more than 60% of birth take place in rural settings under the surveillance of local midwives. Few women have access to skilled birth attendants and fewer still to qualitative emergency obstetric care. Since a majority of deliveries are done by birth attendants, to train them is one of the prime concerns  of the government and the nongovernmental bodies. However most of  these training programs do not take cognizance of the traditional knowledge base of the TBAs, instead, the  focus is on cleanliness, observance of any pathological symptoms in the pregnant women (so as to refer them to another health worker) or how to cut the cord while assisting the ANMs or the doctor. I propose Ayurvedic input into dai training programs so as to strengthen and complete  the dai-s knowledge base. This is in the light of the fact that Ayurveda has a special affinity to the larger worldview of the dai-s, and can provide the rationale and theory for health practices which modern medicine and government-training programs have rejected as redundant. The strong theoretical base gives Ayurveda a distinct advantage, which folk practices of the dais do not possess. For instance providing rationale for using specific substance as diet or medicine during pregnancy, pre and postpartum food restrictions, delay in the cord cutting etc. . Ayurveda is theoretically well founded and consistent medical system. It is experientially successful and relevant to the society, being closer to people, cost effective and a preventive, promotive and curative science of life.  Ayurvedic hospitals manage the birth phenomena and  restore the health of the mother through specific food, herbs and massage therapy. Non govt. effort in India to provide the benefits of Ayurveda to the mother and child through the  training of TBAs is laudable but insufficient.To mention a few ngo-s like  IKKYA in Karnataka, ADS in Maharashtra,  Jagran Samiti in Rajasthan, CHETNA in   Gujarat,  LSPSS Coimbatore  incorporate knowledge of Ayurveda in TBA training. FRLHT also gives inputs of  traditional Ayurvedic  & Siddha  practices  in its modules  for NGO's  (especially for village health workers) International bodies like WHO, UNICEF, and UNFPA have issued a joint statement on training traditional birth attendants (TBAs), advocating the need for such training in the context of local conditions. Given disproportionate investments for modern biomedical system, traditional health practices whether folk practices or the classical Ayurvedic ones, have suffered a certain amount of marginalisation. Only very determined coordinated efforts of the govt. and the non govt. agencies to assess and maximize the contribution of traditional knowledge in maternity care can address the issues of blending of the modern and the traditional practices for healthy reproduction.