Thursday, March 20, 2008

Dai (TBA) Meetings

Meetings with traditional Indian midwives(TBA) called Dai are conducted at different Asha centers located in slums scattered throughout Delhi. These slums include: Ekta Vihar, Tigri, Mayapuri, Chandipuri, Zakhira and Kalka Ji.
After observing the success of Asha’s empowerment programs, I realized that it was vital for the Dai groups to maintain a similar structure. Asha and I tried to create an environment where the Dai’s traditions were not overshadowed or marginalized by biomedical knowledge but, instead, wedded with more recent information Asha and the Dai have designated as necessary and helpful.
Initial Dai meetings begin with stating that the purpose of the group is to create a resource pool of individual, cultural and scientific explainations the Dai find helpful. The Dai are then asked to give their names and introductions detailing their background with Asha and midwifery - some of the dai have attended to the births of more than 1,000 babies! A few days ago, when I was standing outside talking with a Dai named Bhimla, a group of about 70 children gathered around us and, while tousling their gleaning well-oiled hair, she said: “See all these children? I have delivered every single one of them as well as many of their parents!” Amazing.

Bhimla, a famous Dai working in Ekta Vihar!



After introductions, the dai are asked to share ethnomedical traditions(I find this part of our meeting to the most fascinating) Common traditions include:
1. Delyaing cord cutting until after the baby is delivered – this ensures that the baby received sufficient blood and oxygen from the mothers. The Dai believe it helps the baby to be eased, rather than jolted, into the outside world. There is actually no medical reason to support immediate cord cutting. A 2007 study in the Journal of the American Medical Association has found that delaying cord cutting for up to two minutes has been shown to have immediate and subsequent benefits for the baby. http://jama.ama-assn.org/cgi/content/full/297/11/1241
2. Having a women sit on clean smooth bricks to enhance her ability to squat. Dai from Zakhira have also said that applying pressure to mother’s coccyx, using a thick ball of cotton or cloth, decreases the women's pain and pushing time.
3. Ensuring that the a mother drinks warm nutritious liquids – milk with ghee or dhal water – throughout her labor.
4. Bathing the baby in warm water directly after birth. If baby does not take its first breathe immediately, the Dai use gentle massage rather than harsh slapping or thumping!
5. Unlocking all the locks, windows and doors and untying the mother’s hair when she begins labor. Unbinding the surrounding energy, represents the sacred opening that is occurring in the women’s body.
6. Women are often sent to live with their mother’s for 40 days, which is about the exact amount of time it takes for a women’s body to return to its prepregnancy state! This practice helps the women rest and avoid pressure from over eager husbands!
The Dai have expressed a need for a basic understanding of current obstetric practices to help them distinguish supportive medical advances from potentially detrimental concepts and practices. Such information also helps them work along side and understand the escalating number of interventions women have begun to encounter at hospitals.
For example, a question that usually arises in our meeting addresses the practice of Dais administering oxytocin (Dai under Asha have adopt the policy of never administering oxytocin). The Dai tell me that the number of dai using oxytocin, obtained from a local pharmacist, is escalating. Although not all the Dai know exactly how oxytocin functions in the body, most all agree that an injection of oxytocin usually increases a women’s pain and often causes the women to be rushed to the hospital. Before I share more scientific description of oxytocin, the Dai are always asked to share ethnomedical traditions that bring similar to that of an oxytocin injection. After discussing their experiences, a brief and contexualized scientific description of oxytocin is given: why oxytocin is usually given and its physiological effects - a picture which the Dai can usually color in themselves. I then share some information about natural ways to induce labor or increase the body’s natural oxytocin flow, along with how different positions can help labor progress. At the end of the discussion, the Dai evaluate the information I shared and identify what they would like to be translated and illustrated.
The role I play at the dai meetings is two fold. First, I am compiling a description of the Dai’s traditional practices to help Asha preserve and validate the Dai's ethnomedical knowledge. Second, I help the Dai access outside resources and information that may provide answers to their questions. Above all, every minute I spend with the Dai contributes the a hugely to what I am learning about childbirth through working in India. I am continually realizing how much I have yet to grasp about assisting women in the profound experience of birth!
I will cherish the time I spend with the Dai for the rest of my life. It is such an honor to steep in their incredible amount of experience, vivid stories and strength as well as large doses of milky-
sweet chai! These beautiful women represent a legacy of wisdom that is being buried under the proliferation of today's medical technology and concepts of birth and health.

2 comments:

Nathan said...

Grace, this is amazing, amazingly beautiful stuff. Heartbreaking, too. But you're in it, doing something to make lives better. All I can do is shake my head in admiration. Thank you so much for publishing. Happy Easter!

Sanju said...

Grace, I am currently living near Dibrugarh Assam and trying to locate a Daima nearby. What is the best way to find one.
Thanks
Sanju