Abstract
A
This book examines the medicalisation of childbirth in colonial Bengal which is an important yet somewhat neglected area of public health and social history. The site of zenana and the role of dais (midwives) have been discussed by many, but Guha takes a broader view and links it with midwifery as an academic subject and as a medical discipline. This makes it a pedagogical contribution. Colonisation, no doubt, focused on the colonised bodies. What did it mean to women’s bodies? Childbirth being an important attribute of a woman’s body, what the new medical knowledge and practices meant to the family, the government and the society at large? This was a period when in some areas infant mortality was as high as 35 per cent. What were the cultural constraints and how these were to be handled? The author argues that the late nineteenth century initiatives to reform child-birth practices were essentially ‘a modernist response of the Western-educated colonised middle class to the colonial critique of Indian sociocultural codes…’. Midwifery thus became a modernising project.
The introductory chapter sets the agenda and asks valid questions. It is lucid and deliberately refrains from providing a dull and drab literature review. All noted authors and books appear in the end note but in the text the author holds on her own and gives nuanced critiques of previous works. Her greatest strength is the so-called ‘cheap vernacular literature’ which helped her find new insights. Institutions like the Calcutta Medical College and the Calcutta Municipal Corporation gradually transformed a female-oriented ritual to a medical event. In this transformation the colonial government, its medical men and the new bhadralok participated almost equally. Childbirth thus became part of not only a colonial project but also of both social reform movement and nationalist politics. The author has done full justice to this tri-junction.
The book is neatly organised into four chapters, one dealing with the birth of a ‘modern-scientific’ discourse, second on the institutionalisation of midwifery, third on maternal and child welfare as a nationalist concern and the fourth on the antenatal care as reflected in Bengali public arena. This is followed by a competent concluding chapter and then the theme is carried forward to post-independence India as an afterword. Both add to the value of the book. The bibliography is comprehensive though I missed references to books by Sujata Mukherjee, Radha Gayathri and the late-lamented Srilata Chatterjee. The author has, however, explored all possible sources, especially the health magazines and women’s magazines in Bengali. This makes the book exceptionally relevant and instructive. It is a pity that similar exercises have not been carried in respect of Tamil, Marathi and Hindi sources. The idea of what another scholar calls ‘Bengaliness’ with its local flavour and relevance comes out so well in this book.
A reconfiguration of the family is critically analysed and the author does not lose sight of the revivalist spirit that permeated the vernacular literature. Even 125 years ago some people entertained the fear that the Hindu race would be wiped off! They gave a communal flavour to any explanation on child marriage and the oppressive conditions under which their women lived. It is only after the turn of the century that one finds an incipient feminist consciousness. The spirit of Brahmo reform movement and growing educational opportunities made this possible. But the struggle to find a balance between janani (motherhood) and grihani (mistress of the household) continued and probably still continues. Another significant contribution of this book is to show the gradual medicalisation of the age-old midwifery practices. It began with the incorporation of midwifery in the syllabus of the Calcutta Medical College in 1841. The author should, perhaps, have given the course content and the changes that came up later. This was just a beginning and it took two or three more decades before the training of midwives would get official patronage, some funds and local acceptability. The Countess of Dufferin Fund established in 1885 was a milestone. Women were now being encouraged to study and practice medicine. Christian missionaries also played a significant role. Gradually even the rural daktars began to prefer trained midwives over the traditional dais. Some licentiate doctors wrote articles and even books like Devendranath Roy’s Sochitro Dhatrishiksha (Illustrated Guide to Midwifery) to ‘convey the most baffling aspects of the subject in a lucid and intelligible manner’. In early twentieth century the knowledge of obstetrics and its tools (notably the forcep) made a big difference. Dr Kedarnath Das was hailed as a great obstetrician. In 1928, he published a book titled Obstetric Forceps: Its History and Evolution. I wish the author had used some illustrations from this book or other sources. How did this new knowledge and this tool differ from those mentioned in the ancient Susrut Samhita?
The nationalist concerns on maternal and child welfare are discussed in the third chapter. The author has successfully tried to shift focus from disease and epidemic oriented public health policies to the questions of motherhood and national health (jatiya svasthya). The role of the Calcutta Municipal Corporation is examined in some detail, so is the work of international organisations like the Rockefeller Foundation. The interwar period saw new developments and probably this might have been one of the reasons that population began to boom. Was this because of the Indianisation of the medical services during this period? Health had come into Indian hands under the Reforms of 1919. This period saw also developments in antenatal care which is discussed in the fourth chapter. The book brings out three clear trends. First, there appeared a marked consciousness for female health during late nineteenth century which gradually led to greater medicalisation. Second, both male and female doctors contributed to this development. The third point that the author makes, but should have really given a distinct chapter to it, is the rural–urban divide. The book remains mostly Calcutta-centric. Those days Bengal included most of Eastern India but the imperial city has always hogged maximum attention. Nevertheless, this outstanding book should serve as an example for researchers interested in other culture areas. The production quality is excellent (except p. 54, which mentions ‘Calcutta University in 1841’!).