Traditional Birth Attendants

I feel some sort of kinship with these hard-working, village-born old ladies, wise in a way that only decades of living life can bestow. Their spirits, just like the tattered saris wrapped around their aging bodies, have retained their vibrancy and uniqueness despite years of field work, child rearing, & village life. Here, Praba, one of my co-workers, sits to interview one of these village midwives, known as a traditional birth attendants (TBA). We had originally set out to interview TBAs in all of the villages surrounding Mysore City to investigate rural birthing practices. The idea was to use these TBAs as community links to identify pregnant women in each community and ultimately help increase access to HIV testing and counseling in these hard-to-reach populations. While our strategy has shifted slightly, given the relative inactivity of traditional birth attendants in the past several years, through these interviews we have gleaned some very interesting and useful information. Take, for instance, this lady here. We sit in her house on a woven mat, and Praba begins the interview. As we cover issues regarding antenatal care visits, problem-solving during dangerous deliveries, and post-partum practices, I find myself enthralled with this woman. At first, she inspects me with inquisitive eyes. I can see the questions in her mind churning. But as the minutes pass, skepticism lends itself to warmth. There's a solidarity speaking woman to woman about these issues. Her deep creased lips open, exposing a mouthful of broken and expressive teeth. Glassy, yellow eyes meet mine. I didn't think it possible, but the creases on her dark brown skin deepen as she smiles. Around her eyes. On her forehead. And cheeks. Her earlobes droop down low from the gravity pull of golden earrings.

She tells us about 30 years of delivering babies in her village. She recounts many techniques we have heard before. Mucous in the eyes, nose, and mouth of the newborns are sucked out by mouth or wiped down with an index finger. After delivery, she places the baby on the mother's stomach. With a string and unsterile blade she then ties and cuts the umblical chord. Wrapping the other end of the umbilical chord around her big toe, she waits for the placenta. If the placenta does not come out, she shoves some of the mother's hair down her throat to induce vomiting and stomach heaving contractions, thereby expulsing the placenta. When an infant doesn't cry after delivery, he or she is layed down in cool cow dung to awaken the baby. After the interview, she pinches the shit out of my cheek and kisses her hand. The Indian way of saying: so much love. Really, the kind of love-pain only old ladies can get away with. Then to top it all off, Praba decided to buy a chicken. As I'm bracing myself to watch a chicken killing, she motions for me to follow her outside. But no killing ensues. Her grandson grabs a chicken and then she makes me assist in packaging up the goods (picture me holding a plastic bag and this woman shoving the live chicken into the baggy: I'm screaming, she's laughing).

At the end of each interview, we give the traditional birth attendants birthing kits. The same ones that came with me through airport customs. Each kit contains: a pair of gloves, soap, a string, and a blade. Above Selvi, PHRI's driver (fun fact: Selvi is the ONLY female professional driver/taxi driver in the State of Karnataka), places gloves on one of the TBAs. Usually, we end these village outreach trips around 5pm and, inevitably, the rain starts coming down. Time to head back to Mysore and wave goodbye to the kids: