historical vilification of midwives in Europe and America has been well documented.14 In Europe female healers were accused of witchcraft by the emergent elite male biomedical establishment as early as the thirteenth century, when medicine was becoming a secular science and profession. By the seventeenth and eighteenth centuries, midwives were singled out as a danger to society.15 This clearly had an impact on colonial representations of dais in South Asia, and such negative representations continue to stigmatize dais in India today. Recently, some scholars have attempted to excavate the history of the social and cultural significance of dais in India, highlighting both their authority as ritual specialists and their expertise in many areas of the physical management of birth.16
Anthropologists working in other areas of the world have discovered that prior to colonial contact and the concomitant spread of biomedicine, lay midwives often garnered a great deal of respect and held positions of political authority. This was apparently the case for the nanas in Jamaica and members of the Sande society, who traditionally provided maternal and child health care, in Sierra Leone.17 We should not, however, assume that in precolonial India lay midwives must have held similar positions of respect. To do so would be to fall into the trap of romanticizing about the “traditional other.” Indeed, it may well be that in the precolonial era lay midwives in many parts of South Asia were viewed as unskilled, menial, and “polluted” members of society, as they are often considered today.18 Both assertions need to be investigated rather than assumed. The problem is, of course, that this is an extremely difficult history to recover.
During the late nineteenth century, colonial administrators, missionaries, and medical professionals began to lump a variety of traditional midwives together under the term “dai,” applying it to midwives throughout colonial India (including contemporary Bangladesh and Pakistan) and to midwives of different religious communities. Stacey Pigg has pointed out that in contemporary international development projects undertaken in Nepal, the term “traditional birth attendant” is similarly used as a homogenizing gloss for a wide variety of local healers.After this category of TBA had been created, the Nepali word chosen to translate the category was sudeni, which originally referred to only one kind of healer involved in childbirth. Consequently, the word “sudeni” itself has come to have new meaning in Nepali society.19 An important and difficult task for historians of South Asia is, therefore, to begin to tease apart the regional and religious differences in the roles and representations of midwives prior to the colonial encounter. Remnants of these differences still exist today and must be studied more carefully by anthropologists and other social scientists.
In Tamil Nadu, for example, a hereditary Hindu midwife is most commonly referred to as a maruttuvacci, and a hereditary Muslim midwife is usually called a nācuvar or an ampa
Due to the establishment of government “dai-training” programs, in Tamil Nadu the term “maruttuvacci” has come to be associated with those who have not been officially “trained” and thus to connote a lack of scientific knowledge and state recognition. Women who go through dai-training programs, whether they are hereditary maruttuvaccis or not, tend to prefer the label “dai” to “maruttuvacci,” since they feel this gives them greater legitimacy in relation to the communities they serve and, more important, to government and nongovernmental health workers. I try, therefore, to maintain distinctions between such terms as “maruttuvacci” and “dai” in order to highlight the meanings that various terms come to have for people in different contexts. When speaking of India as a whole, I use the term “dai” because that is how most people refer to midwives, even, or perhaps particularly, when they are speaking English.
In colonial discourses the practices of the dai were repeatedly decried as “barbaric,” and the dai herself was represented as the primary cause of high rates of infant and maternal mortality and as an obstacle to “progress,” which the colonial government was promising. Once again, concerns about mortality rates were tied to anxieties about depopulation of the labor force. Two tactics were taken to rectify the situation and to bring Western medical care to Indian women during childbirth. On the one hand, efforts were made to increase the number of Western-trained doctors, nurses, and nurse-midwives who provided services to Indian women primarily in institutional settings. This effort was initiated throughout India under the Countess of Dufferin Fund in 1885. On the other hand, the Victoria Memorial Scholarship Fund was initiated in 1903 to provide training to the hereditary dais already working in communities throughout India.
THE COUNTESS OF DUFFERIN FUND
The first woman doctor trained in biomedicine to work in India was an American missionary named Clara Swain who arrived in India in 1869.21 For some time following her arrival, missionary women made up the bulk of the women doctors in India. It appears that the first woman doctor to be employed by the government was Elizabeth Beilby, who began working in Lahore in 1885. It was in this year that the Countess of Dufferin Fund (known in full as the National Association for Supplying Female Medical Aid to the Women of India but generally referred to as the Dufferin Fund) was established, setting the stage for a nation-wide, nonsectarian project to employ women in the medical services. Queen Victoria herself issued a plea for the formation of this fund.22
The Dufferin Fund and the Victoria Memorial Scholarship Fund were initiated by then-vicereine of India, Lady Curzon. Both funds, as well as subsequent funds for women’s medical care in India such as those initiated by Lady Chelmsford in 1920 and by Lady Reading in 1924, received support from the colonial government, but they were independent of the government in terms of administration and policy and had to raise much of their money from individual philanthropists. This lack of full government funding demonstrates that ultimately the government did not consider maternal health to be an issue of the state, and without full government support it was difficult for these funds to survive.
The stated purpose of the Dufferin Fund was “to bring medical knowledge and medical relief to the women of India.”23 Maneesha Lal writes that this goal was to be achieved through the provision of:
(1) medical tuition, including the teaching and training of women as physicians, hospital assistants, nurses, and midwives, the education to be supplied first by England and America but then by India; (2) medical relief, which included establishing, under female superintendence, dispensaries and cottage hospitals for the treatment of women and children, opening female wards under female supervision in existing hospitals and dispensaries, providing female medical officers and attendants for existing female wards, and founding hospitals for women where
