Modernizing Childbirth in Colonial Bengal: A History of Institutionalization and Professionalization of Midwifery, c.1860-1947

Abstract

In colonial India, medicalization of childbirth has been historically perceived as an attempt to ‘sanitise’ the zenana (secluded quarters of a respectable household inhabited by women) as the chief site of birthing practices and to replace the dhais (traditional birth attendants ) with trained midwives and qualified female doctors. This thesis has taken a broader view of the subject but in doing so, focusses on Bengal as the geographical area of study. It has argued that medicalization of childbirth in Bengal was preceded by the reconstitution of midwifery as an academic subject and a medical discipline at the Calcutta Medical College. The consequence was the gradual ascendancy of professionalized obstetrics that prioritised research, surgical intervention and ‘surveillance’ over women’s bodies. The thesis also shows how the medicalization of childbirth was supported by the reformist and nationalist discourses of the middle-class Bengalis in the late nineteenth and early twentieth centuries.

The thesis begins from the 1860s when the earliest scientific essays on childbirth and pregnancy began to appear in Bengali women’s magazines such as Bamabodhini Patrika. It ends in the 1940s, when nationalism profoundly influenced the professionalization of obstetrics - midwifery being perceived as the keystone in a nation’s progress.

Bengal being the earliest seat of British power in India it was also the first to experience contact with the western civilization, culture and thought. It also had the most elaborate medical establishment along western medical lines since the foundation of the Calcutta Medical College in 1835. It is argued in the extant literature that unlike the West where professionalized obstetrics was characterised as essentially a male domain, the evolving professional domain of obstetrics in Bengal was dominated by female doctors alone. Questioning that argument, the thesis demonstrates that the domain of obstetrics in Bengal was since the 1880s shared by both female and male doctors, although the role of the latter was more pedagogic and ideological than being directly interventionist. Together they contributed to the evolution of a new medical discourse on childbirth in colonial Bengal.

The thesis shows how the late nineteenth century initiatives to reform birthing practices were essentially a modernist response of the western educated colonized middle class to the colonial critique of Indian socio-cultural codes that also included an explicit reference to the ‘low’ status of Bengali women. Reforming midwifery constituted one of the ways of modernizing the middle class women as mothers. In the twentieth century, the argument for medicalization was further driven by nationalist recognition of family and health as important elements of the nation building process. It also drew sustenance from international movements, such as the global eugenic discourse on the centrality of ‘racial regeneration’ in national development, and the maternal and infant welfare movement in England and elsewhere in the inter-war years. The thesis provides a historical analysis of how institutionalization of midwifery was shaped by the debates on women’s question, nationalism and colonial public health policies, all intersecting with each other in Bengal in the inter-war years.

The thesis has drawn upon a number of Bengali women’s magazines, popular health magazines, and professional medical journals in English and Bengali that represent both nationalist and official viewpoints on the medicalization of childbirth and maternal and infant health. It has also used annual reports of the medical institutions to chart the history of institutionalization of midwifery and draws upon archival sources - the medical and educational proceedings in particular - in the West Bengal State Archives and the National Archives of India.