Midwifery - this profession had its heyday in Indian cities from 1900 to 1950. Modern maternity clinics came up one by one In the 1950s, and by the end of the 20th century, most Indian cities were full of them.
Today, in the 21st century, no one seems to remember the friendly neighbourhood midwife. Has the profession has completely vanished from the scene in metropolitan Indian cities?
In the 1940s, Mary Ebenezer Navamani or, more simply, Navamaniyamma was a familiar figure to all of us who lived around Siddappa's square in Mysore - at least to lower and upper middle class people. Navamani means nine precious stones. The literal meaning of the suffix amma in Kannada is mother. Amma is used as a mark of respect for older women and those with high status in the society, with the status based on caste, wealth or professional standing.
Short, rotund, black as black can be. A compulsive wit living in our mohalla (neighbourhood) had once said that the water in which she bathed could be sold as Parker ink. [Editor's note: Parker was a well-known brand of ink used in fountain pens. Parker ink came in many colours, including black, which is the colour implied here.] So her nickname was Parker.
She moved about our mohalla in a white saree with a thick blue ribbon border, and an umbrella. Sometimes she had a leather bag that had seen better days, now wrinkled but utilitarian. She had a beautiful set of pearly white teeth and a chin-to-chin friendly smile, which disarmed everyone in the neighbourhood.
She had passed a certificate course in midwifery from one of the famous Christian hospital cum educational institutions located in the southern part of Madras Presidency (province). She was attached to a health centre operated by the Mysore Municipality. This health centre was named after a princess, as was the vogue when Mysore was a Princely State. I do not recollect the name now. The centre was housed in a two storey office building located opposite the local police station. The office had an imposing Greco-Roman façade, a high plinth and series of steps covering the entire width at the front and rising to it. In the local parlance, this office was better known as "Milk office" because it distributed free milk to lactating children living in the poorer sections of the town.
Navamaniyamma was Christian. Only a few people close to her knew which denomination of church she belonged to. And they did not care. My mother was one of them. Navamaniyamma was against family planning and did not advocate it. That was the only clue that could make one guess that she was Catholic.
She was a devout Christian, regular in attending Sunday mass. It was said she took active part in all church activities. She had a soft corner for the poor and helped them monetarily. Further, she would not miss a single opportunity to tell one and all the superiority of Christianity, benevolence of Yesu and the miracles that have happened in some churches. That way she was a good ambassador of the religion, perhaps far superior to the priests.
Navamaniyamma's father had been born a Harijan and had converted to Christianity. He was steeped in poverty, and ostracised by caste Hindus. A friendly priest of the neighbourhood church used to come to the Holakeri (harijan colony) and gave lectures about the munificence of the Lord and his son Yesu (Jesus). The priest had taken her father under his protective care and brought him and the family into Christian fold. Before their conversion, the family was bonded labour to a local landlord, had no status, and could not enter temples or other high status places open to caste Hindus. No access to education too.
Much changed once the family converted to Christianity. The greatest benefit was access to education, and treatment as equals at least in the Church. Each member of her father's family went to a school run by Christian missionary. They did not achieve great heights in education - no scholars. That was not their goal. They wanted a secure job, a roof over their head, and a place in the society. Some one went up to tenth class, some did a certificate course. In this way, they got good jobs, two in government, two odd jobs in private units, etc. The jobs brought steady income, and their pockets jingled with small coins - and they had a chance to escape from abject poverty.
Mary was good at her studies, and she could serve others with a friendly attitude. So, she was selected to be trained as a midwife at a nursing school attached to a Christian hospital. All her education was free, including boarding charges. Once educated, Mary and many her siblings did not want to go back to their village. There they would still be treated as Harijan converts. So they chose to be in some big towns as distant from their village as they could manage.
Mary found employment in Mysore, which was the capital of Mysore State, and on its way to be a model city, cosmopolitan in nature. In those days it so happened that in Mysore midwifery was the exclusive preserve of Christians. Both caste Hindus and Muslims shunned the nursing profession.
In Mysore, it was not possible for her to live on a street where caste Hindus lived - social mixing of this type was not possible in those days. She had to settle for a street where blacksmiths and dhobis (washer men) lived. The houses were all made of mud and country tiles, low roof but high plinth and a platform that ran throughout the front.
She was a spinster. Once when my mother asked her about marriage, she said that it was difficult to get a decent man in her community. Most men were illiterate, lazy, and alcoholic. How could she marry one of them? As a spinster and a woman who had to go out on nights for delivery of babies, she knew she had to have some male protection and support. So she had hired an old Muslim man, who had no relatives. He spent all his time on the platform outside her home. He slept there at night. He was devoted to her and fiercely loyal.
Navamani's day started at 8 in the morning, when she would dress herself in white and walk down the road to the office. There she and another employee would open the office, and get the place swept. By that time milk would arrive in large aluminium cans. Soon after that, mothers would come to claim the milk for their children. The milk would be measured and distributed. The names of the recipients would be entered into a register, and thumb impressions, in lieu of signatures, would be obtained. By 10.30 am, the work of distributing the milk would have been completed.
Beyond this, I am not sure what exactly the work of that office was, and under which department it fell. But the work was mostly connected with women and child welfare. Once I heard Navamani telling my mother, when she had come to examine my youngest sister, that she was busy in conducting a "baby show". She said that babies would be weighed, and measured etc., and next day there would be prize distribution for the best babies in different age groups. Another time she told my mother that she would be lecturing a group of women from Vanita Samaj (an association of middle class women) on care during pregnancy and delivery.
For some time she would attend to some records. She had to record the births she assisted with, complete with details about the names of parents, address, sex of the new born, a brief report of the health of the baby and mother. A copy of that would go to Municipal office central registry. In those days no one we knew went to an office and registered births or deaths. Perhaps the municipality got this information from midwifes, hospitals, burial and cremation grounds. Every day a black board near the municipal office gate announced the previous day's births and deaths, scrawled in chalk.
Around 1 pm Navamaniyamma would come out of the office and amble along to her house. She would eat her lunch, and have a brief nap. Then she would go round the mohalla and extensions near by, talking to pregnant women, checking their health, and examining and advising them as requested. She was welcome in most households that had a pregnant woman. She would gossip. She would advise care, food, and exercise - all according to the customs (such as vegetarian or non-vegetarian) of the family, and their income level. All that, as far as we knew, was free. She would accept an occasional cup of coffee or some fruits, but never ask for them.
She knew my father because he had a job in the Mysore municipality. She had delivered four of my siblings and me - all except my eldest brother. She had a 100 percent record of delivery of healthy babies in my house. So I would not hesitate to say that she was proficient and conscientious in her job.
When she assisted with a delivery at a home, she would get Rs 5 plus a measure of rice, some fruits as her fees. Of course Rs 5 went a long way in those days when a municipal clerk had a salary of only Rs 30 per month. A rupee those days was a silver coin, not a paper note. A measure of rice was worth two annas - an anna was one-sixteenth of a rupee. If some family called her for an examination of an expectant mother, she would charge a rupee.
In those times, household delivery was almost a yearly event in a middle class household. For each couple in the reproducing age, there was a birth every two years, if not earlier. Many people had more than 10 children, of which eight or nine survived. In many families, it was common for a mother and her eldest daughter to be pregnant at the same time.
In this era of large families, Navamaniyamma's hands were always full.
In many families, women in the stages of advanced pregnancy and birth were considered as unclean. Pregnant women were kept in dark rooms by upper class families. In some bungalows, that room was outside the main house in a separate outhouse. Diet and medicines were based on Ayurvedic (Hindu) or Unani (Muslim) tradition. The diet of a pregnant woman was determined by the older ladies of the household, based on the wisdom handed down through generations.
Even though Navamaniyamma did not approve of the views of some of the older ladies, she was tactful. She would not give any advice unless asked for, and not in front of the older ladies. Instead, she would whisper her views into the ears of the pregnant woman. She knew who among her patients was vegetarian, who did not eat garlic and onions. So if asked for dietary recommendations, she would be careful not to include items that would hurt the sentiments of the family.
Whenever epidemics like plague or cholera hit Mysore, which was at least once in five years, she would join the municipal staff in the awareness and vaccination campaign. In those days, most people were reluctant to come to vaccination booths. We had seen many of our neighbours fleeing to their villages to escape being vaccinated. Many people thought it was an alien practice. They were worried that doctors who practiced English medicine were injecting some thing foreign, containing some worms and unclean materials into their system.
After my father's death, Navamaniyamma's visit to our house became rare. Literacy among people and in women from the upper caste was expanding. So also was the awareness of the need for better maternity care. The reluctance to visit mainstream hospitals was decreasing. Municipal and Christian hospitals started experiencing overcrowding. Maternity homes were coming up one by one to fill the gap.
I left Mysore in the 1950s, soon after completing my studies. In one of my visits to Mysore in the 1970s, I remembered Navamaniyamma when I was passing through the street on which she lived. I asked my mother about Navamaniyamma's whereabouts. She told me that Navamaniyamma had retired and had gone back to her village in Tamilnadu, to stay with her relatives in old age. Before leaving Mysore, she had come and taken leave of my mother. With the mushrooming of the maternity homes, the institution of personalized service, where a midwife acted as comforter for first time pregnant women, friend, philosopher and guide to others, was slipping into past. In its place, a highly commercialized, Caesarean-knife wielding industry was growing from strength to strength.
© M P V Shenoi 2010