The Village Midwife

Matt. 25:29 For to all those who have, more will be given, and they will have an abundance; but from those who have nothing, even what they have will be taken away.

In typical Indian fashion, our team of four entered a home, took a pillowed seat on the floor, and sipped hot chai. We traveled to a village to meet the local dai (midwife). Our team, four Indian men, and one elderly woman filled the small room. “She,” we were told, “is the dai, and her name is Raja.”

I looked at a small woman whose face and hands were engraved with deep lines. Raja sat crossed legged on the floor and listened to the men as they described to us who she is and what she does. “She has been the village dai for nearly sixteen years,” I was told definitively. But her age was something to be guessed. “Maybe around 70 years old.” Hand-written ledger books were spread out on the table in front of us. “This shows how many children were born in 2014,” said our guide as he moved his finger across a row of figures. As Raja sat silently, the men told the story of the village dai through the statistical information recorded in the journals.

<img src="https://images.squarespace-cdn.com/content/v1/514ce42ae4b0d2e6d866511c/1434832672603-RX0IUZ7QSBZ6OVN5XDPW/Dai+reviewing+birth+records.jpg" alt="Dai reviewing birth records.jpg" />

<img src="https://images.squarespace-cdn.com/content/v1/514ce42ae4b0d2e6d866511c/1434832671741-U5N5UE8P37L17BLTPANS/Meeting+with+Dr+an+Dai.jpg" alt="Meeting with Dr an Dai.jpg" />

<img src="https://images.squarespace-cdn.com/content/v1/514ce42ae4b0d2e6d866511c/1434832739365-F4HMZE0RB9R7UUDT4L3G/Dai+communicating+with+doctors.jpg" alt="Dai communicating with doctors.jpg" />

“Making observations” is a key component in ethnographic research. Even with the language barrier, I was able to observe Raja’s reactions to what the men were saying about her and her work. After an initial period of silence, Raja began to speak for herself. I watched this elderly woman become animated when something was stated without her consultation or, possibly, without her agreement. Several times, she silenced one of the younger men with a quick swat of her hand. As our translator tried to summarize her answer to a question before she was finished talking, she raised her voice until he was forced to hear her out. It was clear that the work of bringing children into the world was her business and she would have the last word. Her story could not be told through statistics.

As the men continued to focus on the journals, Raja stood up and left the room. Several minutes later she returned with one of her pregnant patients, a 25-year-old villager who is 4 months into her sixth pregnancy. Raja delivered all but one of the woman’s children, a daughter born at the government hospital who “expired after birth.” I was not able to understand exactly why she went to the government hospital or what happened, but I saw the interaction between midwife and patient as they talked about the incident. The presence of trust and intimacy between the two women was unmistakable.

In an effort to meet the United Nations Millennium Development Goal of reducing the maternal mortality rate, the Indian Government implemented the Janani Suraksha Yojana (JSY) program in 2005. Touted as a “safe motherhood intervention under the National Rural Health Mission,” the objective of JSY is to reduce “maternal and neonatal mortality by promoting institutional delivery among poor pregnant women.” (source) As the government intervention program escalates, the future of the village midwife is threatened.

Today, Raja can still raise her voice to make sure that the whole story is being told. She can strike an imperious young man who misrepresents what she does. She can call a young mother to testify of her midwifery experience, competency, and compassion. But the time is coming when India’s dais will not be able to tell their story—when the government will mandate the maternal health treatment of all of India’s poor population.

Privilege equals choice. For the poor, even the limited choices they have are being taken away. When powers take, they simultaneously erase or commandeer their stories. When we help to tell the stories of the poor, we acknowledge their right to choose. Raja makes the choice to value her role as a midwife. She takes pride in offering women childbirth services without the dangerous and expensive journey to cold and impersonal government hospitals. Her story needs to be shared for the sake of all who serve those so easily forgotten.