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Birth on the Threshold

Birth on the Threshold: Childbirth and Modernity in South India

Cecilia Van Hollen
Copyright Date: 2003
Edition: 1
Pages: 310
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  • Book Info
    Birth on the Threshold
    Book Description:

    Even childbirth is affected by globalization-and in India, as elsewhere, the trend is away from home births, assisted by midwives, toward hospital births with increasing reliance on new technologies. And yet, as this work of critical feminist ethnography clearly demonstrates, the global spread of biomedical models of childbirth has not brought forth one monolithic form of "modern birth." Focusing on the birth experiences of lower-class women in the South Indian state of Tamil Nadu,Birth on the Thresholdreveals the complex and unique ways in which modernity emerges in local contexts. Through vivid description and animated dialogue, this book conveys the birth stories of the women of Tamil Nadu in their own voices, emphasizing their critiques of and aspirations for modern births today. In light of these stories, author Cecilia Van Hollen explores larger questions about how the structures of colonialism and postcolonial international and national development have helped to shape the form and meaning of birth for Indian women today. Ultimately, her book poses the question: How is gender-especially maternity-reconfigured as birth is transformed?

    eISBN: 978-0-520-93539-6
    Subjects: Anthropology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-xii)
  4. Note on Transliteration
    (pp. xiii-xvi)
  5. PROLOGUE: Birth on the Threshold
    (pp. 1-4)

    Mumtaz was nineteen years old when I first met her in her home in Nochikuppam, Madras (now called Chennai), the capital of Tamil Nadu, in 1993.¹ She lived in a one-room thatched house that looked out onto a sandy beach dotted with fishing catamarans and then onto the Indian Ocean beyond. I entered her house with a group of four other women, all of whom worked for the Working Women’s Forum (WWF), a women’s organization based in Madras. Kasthuri and Komala were both health workers for WWF; Durga was a health supervisor; and Mary was a coordinator who came along...

  6. INTRODUCTION: Childbirth and Modernity in Tamil Nadu Modern Birth and the Transformation of Gender
    (pp. 5-35)

    Whereas earlier anthropological approaches to reproduction tended to focus on how reproductive practices and beliefsreflectedsocial and cultural systems,¹ scholars now argue that anthropology can benefit from viewing reproduction itself as a key site for understanding the ways in which peoplere-conceptualize andre-organize the world in which they live.² This book also takes thisprocessualview of culture-in-the-making.

    What then is reconceptualized and reconfigured in the process of the modernization of birth for poor women in Tamil Nadu? This book does not make one, overarching point about the transformation of ideas and practices relating to childbirth in Tamil...

  7. CHAPTER 1 The Professionalization of Obstetrics in Colonial India: The “Problem” of Childbirth in Colonial Discourse
    (pp. 36-56)

    In the late nineteenth and early twentieth centuries, the management of childbirth emerged as a key issue in colonial and nationalist discourses in India, as it did in other colonial settings around the globe from Jamaica to the Sudan to Malaya and the Pacific Islands.¹ The concern with childbirth in the colonies, particularly as it related to maternal and infant mortality, echoed anxieties arising around these issues in the European metropoles. Both in the metropole and on the periphery this heightened interest in childbirth arose due to growing awareness and pronatalist fears of depopulation trends. Depopulation, particularly among proletarians, was...

  8. CHAPTER 2 Maternal and Child Health Services in the Postcolonial Era
    (pp. 57-75)

    Having described the colonial context in which the professionalization of obstetrics emerged in tandem with a resigned acceptance of midwifery, I now move quickly through time to the policies and programs of the twentieth century which have informed the structure of public MCH services throughout much of the postcolonial era. In this descriptive chapter I hope to provide a general sketch first of the official structures of health care in India and in Tamil Nadu and then of the actual landscape of MCH care in Kaanathur-Reddikuppam and Nochikuppam. This chapter is intended to provide a basic framework through which to...

  9. CHAPTER 3 Bangles of Neem, Bangles of Gold: Pregnant Women as Auspicious Burdens
    (pp. 76-111)

    It was seven o’clock in the evening when I stepped into Mohan’s yellow and black auto-rickshaw near our apartment. Mohan jumped into the driver’s seat and yanked the lever several times to start the engine. The engine sputtered and then calmed and we were off down the bumpy road leading out of Kalakshetra Colony, across the Adyar Bridge, and into the heart and traffic of Madras. We were on our way to Nochikuppam. Mohan was one of the auto-rickshaw drivers I had gotten to know traveling to and from my far-flung research sites. He was among the only ones who...

  10. CHAPTER 4 Invoking Vali: Painful Technologies of Birth
    (pp. 112-140)

    The first time I visited Nochikuppam, Kasthuri, one of the WWF health workers, summoned a group of pregnant and postpartum women from the neighborhood to gather in a dank room used primarily to house cows and chickens on the ground floor of her government-subsidized housing complex. We were well into a discussion about women’s childbirth experiences when I asked whether women were given any medication to reduce the pain of birth in hospitals. “Oh, yes,” they all agreed. “They give us injections and ‘glucose drips’ and then the pains come and the baby will be born right away.” I was...

  11. CHAPTER 5 Moving Targets: The Routinization of IUD Insertions in Public Maternity Wards
    (pp. 141-165)

    Foucault has argued that in eighteenth-century Europe “‘population,’ with its numerical variables of space and chronology, longevity and health, [began] to emerge not only as a problem but as an object of surveillance, analysis, intervention, modification, etc.” and that “the project of a technology of population” was therefore initiated.¹ It was during this period that a concern over the health of the “population” became central to the art of governance. And scientific expertise (both social and medical) was deemed essential to this project. David Horn has further suggested that in the nineteenth century the reproductive practices of men and women...

  12. CHAPTER 6 “Baby Friendly” Hospitals and Bad Mothers: Maneuvering Development during the Postpartum Period
    (pp. 166-205)

    The words of this doctor are testimony to the fact that in Tamil Nadu the postpartum period is a key site within which discourses of development are maneuvered. I use the expression “maneuvering development” in two senses. First, it refers to how development apparatuses maneuver individuals and groups to adopt new sets of ideas and practices in an attempt to fashion modern subjects. Second, it refers to how the people who are the targets of development maneuver within and around these discourses in ways which collude with, resist, or alter the discourses.

    As the anthropologist Arturo Escobar has argued, the...

  13. CONCLUSION: Reproductive Rights, “Choices,” and Resistance
    (pp. 206-214)

    During the United Nations’ Fourth World Conference on Women, held in Beijing from September 4 through 15, 1995, the largest Madras-based newspaper,The Hindu,ran a series of articles covering the event and the parallel NGO meeting held in Huairou, China. I was struck by the logo which this newspaper used for the series: the silhouettes of two figures hoeing on a hillside. Only by examining the small photo closely could I make out the drapes of the saris which hung on the two figures and thereby know for sure that they were both women. It was the weight of...

  14. Epilogue
    (pp. 215-220)

    While I was writing my dissertation, on which this book is based, people used to ask me: “And you, Cecilia? What about your own birth experience? Won’t you write about that as well?” But I did not feel compelled to do so.

    With the reflexive turn in anthropology, we are called upon to be conscious of and to reveal our social, cultural, political, and even emotional positions vis-à-vis our research topics and the people whom we study. We recognize that culture is not a “thing” which exists objectively out there in the world, but rather it is a process which...

  15. APPENDIX I. Sample Interview Questionnaires
    (pp. 221-235)
  16. APPENDIX II. Official Structure of Maternal-Child Health Care Institutions and Practitioners in Tamil Nadu, 1995
    (pp. 236-238)
  17. Glossary
    (pp. 239-242)
  18. Notes
    (pp. 243-264)
  19. Bibliography
    (pp. 265-280)
  20. Index
    (pp. 281-295)
  21. Back Matter
    (pp. 296-296)