Birth is Political

 

During my time at CMSK JCMB, the statement by Sheila Kitzinger in the foreword of the book Birth Reborn, “Birth is a political issue. It concerns every woman’s right to give birth in freedom and in a loving environment,” resonated with me. More than any other speciality, what happens during Antenatal Care, Intrapartum Period in a Labour Room, Postnatal Care, largely reflects how a community treats their women- how much freedom and autonomy the women have regarding their choice; to conceive, their diet, the so-called “need” for labour room violence (verbal and physical) for proper delivery, choice of place for checkups and delivery.

On Tuesdays, when the ANM visits for vaccination and the office is open to sanction Birth Certificates, the OPDs would usually be flooded with Postnatal Care mothers and neonates. Some mothers presented with a burning sensation on passing urine, fatigue. When asked about their diet, the majority replied that they don’t eat or drink anything past 4-5 pm as their mothers/ mothers-in-law restrict them. It is believed that the mother eating and drinking at night would make the newborn sick, even though they do breastfeed their newborn even during the night hours. Moreover, what they eat is severely restricted as the mother eating fish, egg, etc, would upset the baby’s stomach. This reminded me of my times at the Primary Health Care centres run by BHS, Udaipur, when expectant mothers would not be allowed to eat ghee/butter/curd as it was believed to cause miscarriages, but that was during the antenatal period. Moreover, such restrictive diets are imposed on mothers with an average BMI of 15-16. Often, the companion to the hospital would be the husband; hence, only the expectant parents would receive counselling regarding diet, rest, level of activity, etc. We also come across some caring husbands who want to get the best for their pregnant wives, but are stuck between what is counseled at the hospital and what their mothers’ or community say. However, the decision maker regarding the new mother's diet would be her Saas/Ma.  

Hence during our PNC home visits, apart from weighing the newborn and assessing the mother’s wellbeing, much time is spent on counselling their own mothers and mothers-in-law. Similarly, the prescription during that Tuesday OPD, along with their supplements and other medications, was to particularly eat and stay hydrated at night while feeding the baby, which would be written down big and bold. This is just one of the examples during the course of pregnancy, how in the postnatal period, woman are still restricted and do not have the right to take decisions regarding something as basic as what and when they can eat.