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Menstruation Meanings: Blood, Time and Magic

This paper was written at the request of the Dharam Hinduja Center for Indic Studies by Janet Chawla

At a Dharam Hinduja Center for Indic Studies organized gathering in Bangalore some years ago I met an old colleague and friend, an NGO activist working in the Northeast of India with women and women’s health. We conversed outside of the formal sessions about my work on indigenous ‘reproductive health’ (specifically menstruation and childbirth) and her activist and training work. She told me that at a recent training program conducted for her NGO by an activist-physician from Uttar Pradesh, he had stated that the practice of allowing menstrual blood to flow down one’s legs, under their skirt-like wraps (which was observed by some of the traditionally oriented tribal women) was unhygienic and a possible source of infection and should be stopped. She asked me what I thought of the practice and the physician’s intervention.

I responded by saying that although we, with our sense of personal hygiene and decorum, might find this manner of handling menstruation distasteful, it probably would be far less likely to cause infection than an unclean menstrual cloth and I felt his advice reflected his own discomfort with the thought of menstrual blood flowing freely down female legs rather than any actual knowledge of vectors of infection.

At an NGO health workers meeting in Gujarat, I was an observer to an interaction between the local dais/health workers and the head of the health program as well as an outside resource person--a doctor and health activist of long standing. The meeting was called in order to monitor the progress of an effort to build the skills of the dais to help women chart their menstrual cycles--and enable them to practice ‘natural family planning’. Becoming aware of the time of ovulation would help them practice birth control without invasive methods--was the idea. The non-literate dais had been provided calendar-charts to fill in with signs, one for each woman’s menstrual cycle.

However, much to my amazement, they used the solar, rather than the lunar calendar format. There was total confusion (which may have existed anyway) but the whole process would have been more effective had a lunar calendar been used for reckoning, as it is closer to the 28 day menstrual cycle, and the ritual festivals observed in the area follow lunar, rather than solar months. When I enquired as to how the NGO leaders decided to use the solar calendar, they said that they left the decision to the dais and village women and they voted to use the solar--the one that they knew the NGO followed!

More recently I attended a national women’s health meeting in Delhi. During one presentation made by a women’s health NGO on their work with adolescents, the speaker said that they had taught young women to hang their menstrual cloths out to dry in the sun after washing them. She self-righteously stated that one mother even beat her daughter for putting her cloth outside (in view of others). The subtext of the presentation being “These backwards and violent mothers—we must save poor adolescents from them! During the discussion period I raised my hand and voiced my concern that NGOs should not intervene in personal bodily practices in a manner which would lead a mother to react so vehemently to her daughter’s behavior and I questioned whether the activists had investigated the mother’s reasoning and cultural assumptions. I received no answer but afterwards, in private, other participants expressed their appreciation of my speaking out.

At issue here is the dominance of modernist biomedicine in the policies and programs of health policymakers (be they global--WHO, Unicef, UNFPA etc, national and even local feminist and NGO groups. Their ‘delivery of services’ and ‘training’ approaches to health generally, and women’s ‘reproductive health’, specifically, operate in complete ignorance of the epistemological and ontological foundations of indigenous body culture and health traditions. In South Asia one might even say ‘civilizational’ body knowledge and practice.

I have paid attention to indigenous Indian understandings, imaging and practical handling of menstruation and birth and the visions of the world and cosmos upon which they are based for many years. While studying theology with the Jesuits at Vidyajyoti Institute of Religious Studies in Delhi, I wrote a paper, “The Mythic Origins of the Menstrual Taboo in the Rig Veda,” (later published both in Manushi and in Economic and Political Weekly, Vol. XXIX, No 43, 22 October 1994) The paper used feminist protests against the use of Depo-Provera and other injections and implants of hormonal contraceptives as a starting point—because these drugs interfere drastically with the rhythm and nature of a woman’s menstrual cycle. I investigated the narrative of Indra slaying Vritra as an explanatory mechanism for indigenous meanings and directives regarding menstrual blood and menstrual time. And I have continued to pursue these topics intellectually as well as practically with NGOs and what I call health and development wallahs.

Menstrual bleeding, although often signified in terms of ‘pollution’, ‘traditionally’ marked the cyclicity of nature (Sanskrit rta) and is simultaneous with seasonality and fertility. The fertile capacity of women is conflated with that of the earth (and of the Devi, although that is not my concern here) and in women’s ritual enactments this cyclicity is often honored and I would argue even sacralized. Priestly notions of pollution fade into the background when one listens to the dais and their notions of ‘ narak’ – which I will develop below -- and the ‘sin’ of cutting the umbilical cord. In a MATRIKA produced documentary film “Born at Home” the filmmaker interviews an elderly Rajasthani dai, Rukma Dadi, who laughs as she relates that some say it is a ‘great paap’ to cut the cord. She confidently dismisses society-at-large in their categories of sin and pollution and purity (so ardently amplified in early Indological writings). This confidence was shared by the elderly dais with whom we interacted during our MATRIKA project. Dai work is ‘ seva ka kam’ or, as one Punjabi dai stated “ Raab (God) is the doer, the hands are mine.” We attempted, through this field level research to document and conceptually interpret their imaging of body and world.

My purpose here, however, is not to untangle Indological misrepresentations and modernist ‘maldevelopment’, but rather to relate some of my own intellectual journey as wife, mother, bahu and now grandmother within a Sikh family in Delhi; teaching childbirth preparation classes to a middle and upper class clientele; studying theology with the Jesuits focusing on Leviticus, the Dharamshatra, Rig Veda, caste and gender and birth traditions; and, my favorite, interacting with dais on their lives and understandings of the female body. I have moved through Indian, US, British and South Asian academic, public health, feminist and activist circles. This game of musical chairs is sometimes called networking.

MATRIKA Research

MATRIKA, (Motherhood and Traditional Resources, Information, Knowledge and Action), which I initiated, was a three year research effort to document, interpret and analyze traditional midwives’ ethno-medical and religio-cultural traditions. The MATRIKA team learned from dais in workshops held collaboratively with NGOs in Bikaner District of Rajasthan; Gomia, Bihar; Fategarh District in Punjab and the resettlement colonies of Delhi. We inverted the common dai-training model and asked them to train us. After they became convinced of our sincerity we collectively explored their knowledge and practice through discussions and interviews, role plays of birth and rituals, as well as ritual drawings, body mappings and sohars or birth songs.

Our reclamation effort, however, required putting aside the assumption, often shared by both researcher and religious elite, that spiritual power entails ritual purity. The midwife has not been seen in the Indian context as a ritual specialist and a resource for sacred knowledge, or in anyway related to “spiritual” activity, because of their caste status and the fact that female bodily processes were deemed antithetical to spiritual power and practice. Probing, not to mention theorizing the ‘subaltern’ is not an easy task. Modern institutions and academic disciplines since colonial times have marginalized dais, in part, because they have not been able to comprehend them. As poor, illiterate and mostly low and outcaste women, their health knowledge and practice has been denigrated and invisiblised. Our MATRIKA approach allowed the categories of religion and medicine to intertwine—and we adapted our research methodologies to grapple with these indigenous, holistic childbirth and healing modalities. We also resisted the dominant modern perspective that labels dais’ ways of knowing and practices as ignorance and ‘superstition’.

Narak and the ‘Dirty’ Female Body

For many years I have been puzzled by the seeming contradictions I have encountered when researching traditionally oriented women’s birth knowledge and practice. On the one hand they use expressions such as nau mahena ka narak kund (nine months’ hell spring or pond) for the afterbirth (placenta, cord and membranes) and observe what we call ‘pollution taboos’ (not doing puja, going to the mandir or reading holy books) during menstruation or postpartum. In the Indian context it is important to note that women of all the dominant religions on the subcontinent have observed ritual pollution. Muslim, Sikh, Christian and Buddhist women have practiced their own forms of pollution which involve ritual distance from religious practice. (Of course similar ritual separation between women’s reproductive capacity, considered ritual ‘impurity’, and religious practice is also to be found in the Judeo-Christian-Islamic tradition. The Book of Leviticus, in the Old Testament is strikingly similar to the Dharamshastra injunctions which regulate the behavior of women during menstruation and postpartum.)

On the other hand the same women report empowering birth rituals both during labor and the post-birth period. Differing perspectives on the significance of narak reveal the gendered power relations which have existed on the Indian subcontinent for millennia.
I have come to the conclusion that when women and men participate in common rituals, as in all of the dominant religions, the special female experiences of the body, become inserted in a male-centered, often abstract, conceptual or ‘mystical’ ritual or praxis domain—leaving behind uniquely female bodily experiences and the religio-cultural customs which celebrate it. The internal logic of dais’ ethno-medical and religio-cultural practice proceeds from ways of perceiving and knowing which can be legitimately termed religious or even ‘theological’. They follow a chain of reasoning and use causal linkages embedded in divine and demonic figures. Furthermore dais’ epistomology and ontology are entirely congruent with other indigenous systems such as Tantra, Yoga and Ayurveda. A gender-sensitive perspective requires questioning why sophisticated and holistic body-spirit knowledge and practice are acknowledged within these systems-- but when it comes to knowledge and ‘spirituality’ related to the female body, dais are perceived as ignorant and superstitious. Narak, a concept from our MATRIKA data which I have developed and amplified, functions as an entry point and fundamental organizing principle for the world view of dais.

Narak’ as the Unseen and Fertile Inner World of the Earth and of the Female Body

Bemata dwells in the realm of narak, deep within the earth. She is a Creatrix causing the conception, growth within the womb, and birth of human beings as well as the growth of all vegetation. During our first workshop in Gomia, Bihar dais explained the meaning of narak to us in terms of menstruation and postpartum:

Girls are considered holy before puberty. The marriage of a young girl who has not had her periods is performed with her sitting on her father’s lap. After puberty the woman is considered unclean, and is unholy, because she bleeds, and this is narak.

On Chhati day (after birth) the narak time ends. The Dai checks if the umbilical cord has fallen off. Then she bathes the baby and beats a thaali and gives the baby to Chachi. Then the woman is bathed and wears new clothes. The Dai then cleans the room where the birth took place and the mother was kept separately for six days.

Although often translated as hell or demonic place, narak can be understood as the site or energy of the unseen inner world - of the earth and of the body. Narak has the connotation ‘filth’ but also signifies the fertility or fruitful potential of the earth and woman’s body. Pollution ‘taboos’ are related to narak, as the idea of the sacred is radically separated from the reproductive potential of the female body. During menstruation and post birth women are considered ‘unclean’. However the dai speaks with a very different voice than the pundit and the Puranas about narak. To her the placenta, the ultimate polluting substance to the “twice born”, is spoken of reverently, as ‘another mother’. It is no coincidence that dais are mainly from low and outcaste communities. Both caste and gender are implicated in concepts of narak. Ayurvedic and naturopathic practitioners often employ low caste people to apply the hands-on therapies they prescribe. And interestingly in our MATRIKA team’s analysis of birth time (which in obstetrical terminology is referred to as ‘labor’, ‘birth’ and ‘postpartum’) we adopted the dais’ language of ‘the opening body’, ‘the open body’, and ‘the closing body’. Narak can be viewed as representing ‘the open body’. This is the time when what is normally closed, is open, the liminal and dangerous time/space of generative, female bodily processes. Interestingly, within the dais’ rubric the danger that they are concerned about is to the mother--her openness implying her vulnerability.

Narak functions as a basic ethno-medical idea, providing a conceptual framework for a host of non-invasive therapeutic interventions. Narak speaks of the inner world of the body, particularly to the mysterious creative power of the female body (and simultaneously the earth body) invisible to the human eye. This concept provides a mode of understanding which facilitates non-invasive diagnostics and therapeutics. Dais practice many gentle, non-invasive techniques which affect physiological functioning without violating the integrity of the skin/body/life force. Their ‘holistic’ health modalities utilize touch (massage, pressure, manipulation); natural resources (mud, baths and fomentation, herbs); application of ‘hot and cold’ (in food and drink, fomentation etc.); and isolation and protection (from domestic, maternal and sexual obligations).

In my networking in North India, as well as our MATRIKA research areas, I have found that ‘traditionally’ dais serve and move between the homes of different religious communities--and so do concepts such as narak. Caste operates as a category, but religion doesn’t. It seems as if dais and women’s birth traditions have flown beneath the radar screens of the dominant religious orthodoxies that haven’t bothered to police this dirty women’s business.

Shakina Dai, a Muslim midwife, mentions offerings to Sayyid, an Islamic figure, but similarly invokes Bemata. She also refers to the laboring woman as having one foot in heaven and the other in narak or hell.

Look, sister, at the time of birth it’s only the woman’s Shakti. She who gives birth, at that time, her one foot is in heaven and the other, in hell. Before doing a delivery I get the woman to open all the trunks, doors and so on. I pray to the One Above to open the knot quickly. I take off the sari, open the hair and take off the bangles or any jewelry. I put atta on a thali and ask the woman to divide it into two equal parts. Also I get Rs.1.25 in the name of Sayyid kept separately. But mostly I remember Bemata. Repeatedly I pray to Bemata “Oh mother! please open the knot quickly.”

Dais from all religions have invoked Bemata. In workshops in the Punjab, Mazbi (outcaste) Sikh dais, after first claiming they had no rituals, said that they, too, pray to Bemata.

Networking Knowledge - Advocating for Indic Systems of Medicine

I have been enabled to follow my own woman-centered curiosity and move through varied domains and disciplines, beholden to no institution or way of thinking, in good part by networking. Particularly valuable to me personally, and society at large (especially as caesarean section rates skyrocket and the female body is increasingly perceived as incapable of menstruation, birth and menopause without pharmaceutical or surgical assistance) is the nexus between midwives, who actually handle the female body and the stuff of birth, and scholars or academia.

As I write this essay at my mother’s home in Port Townsend, Washington, I have just traveled to Vancouver, BC to show our MATRIKA film ‘Born at Home’ to a group of ‘guerilla’ midwives--this has been organized by a midwife-scholar, Nane Jordan, whom I had never met. Nane learned of my work in a Women’s Spirituality Masters Program in San Francisco! Through email and mutual friends we came together to watch a film on dais--whom the health establishment refuses to dignify with the term “midwives”--they are Traditional Birth Attendants or ‘TBAs’--to be trained, not the inheritors of India’s midwifery traditions. And the women who eagerly watched the film are ‘guerilla midwives’ for much the same reason. Since the regulation of midwifery under the British Columbia College of Midwives in 1998, any woman who ‘attends’ a woman’s birth is doing so illegally--and they also are not allowed to call themselves midwives! “This is freedom? This is gender equality? This is women’s empowerment?” I ask myself as I learn that Nane’s chosen midwife, who attended her previous home birth and is known and respected in their Vancouver birth community, was jailed for 5 months for attending births and leading a birth workshop.

This issue of regulation, legitimization is not new to me. When I was a scholar-in-residence at the Five College Women’s Studies Research Center, in Western Massachusetts I heard an American nurse-midwife speak of a bill that they had introduced to the state legislature which would take the certification for midwives out of the hands of the Nursing Board and creating a Midwifery Board. My sensitivity to the outsider status of dais in India alerted me to the fact that some group of midwives would be negatively affected by this move. When I asked the midwife about who would be further marginalized by the proposed legislation, she immediately said that it would be three categories of women attending births: Native Americans (who have their own traditions regarding birth); street midwives (who catch the babies of drug addicts, commercial sex workers and homeless women) and Amish women (who have a spiritual practice within which birth is not defined within a state, professional or technological frame). Each of the above group would be further marginalized, denied any possibility of medical backup and even liable to prosecution for helping women birth.

The intention of midwifery, as the word’s origin implies, is ‘with women’ and not hierarchically or externally placed. These Canadian “guerilla midwives” are not a homogenous group, nor are they silly and irresponsible women, as the media and the medical profession might have us believe. One young recent graduate of nursing school was chatting with me after the film and said that she had just turned down a job offer at the hospital where she had studied. She found the hospital procedures so degrading for herself, as midwife and the mother and family and she would not have been allowed to practice her ‘calling’ and vision of what a midwife could be.

Last summer I presented a power point presentation on Narak at a conference “Pollution and Safety: the Dirty Side of Women’s Health” organized by a dynamic scholar midwife who heads the Department of Nursing and Midwifery at Sheffield University. I was suggested as a presenter by another scholar- midwife whom I’d met at an International Confederation of Midwives conference in Delhi 10 years ago. At the time of the conference I was editing a book on birth commissioned by an Indian publisher and editor of their “Shakti” imprint and I was searching for a paper attempting to place an economic value on dais’ health work contribution. Birth and Birthgivers: the Power behind the Shame, which is now in press, is an assembly of pieces on birth from varied positions and perspectives. It now includes an essay by Subhadra Rai, another conference presenter, which she had presented in Japan, “Towards Calculating the Monetary Contributions of Dais’ Work.”

Without these networks which have shown interest in my work and the young women interns, volunteers, researchers, MATRIKA team members, who are terribly excited by non-biomedical understandings of femaleness--I would not have the confidence to continue to theorize, flesh out and advocate for what I have learned from dais.

This essay has presented to me clearly that what I do is indeed called networking. It is not the usual business-sense or even academic-sense of networking where one moves among colleagues to exchange information within a certain domain. In a way I network amongst networks--health and religion, anthropology and art, scholar and activist, feminist and NGO.

It seems to me the task at hand involves a more active role for academicians and scholars in interfacing with public health problems such as safe motherhood. For too long scholars have been preoccupied with the local; they have not produced coherent and simple descriptions of the broad sweep of Indian or subcontinental body knowledge and culture. In order to effectively advocate for inclusion of indigenous practitioners such as dais, data is needed on commonalities across regions. Certainly herbs may be different in different areas--but concepts underlying their efficacy (‘heating’ or stimulating metabolic action during labor) will be similar. Dais practices will certainly be couched in different regional languages--literally and metaphorically--but traditionally, from Punjab to Kanya Kumari, no dai would cut the umbilical cord before the placenta emerged. And all dais would stimulate the placenta by heating it--in order for the “jee” or life force to pass into the newborn, should he/she require resuscitation.

In India national health policy has been, and continues to be significantly determined by ‘globalization’. First, by colonial hegemonic valorization of western medicine and science. Now, by World Health Organization, Unicef and the like. Under this influence the stated Government of India policy of institutionalization for all births is absolute folly and continues to deskill the midwives (and other women who attend by far the majority of births) and create dependency on nonexistent or abysmal quality services. Today even Ayurvedic Colleges teach more allopathy than Ayurveda! And government programs in the Department of Health and Family Welfare devoted to ISM or Indigenous Systems of Medicine focus on the promotion of growth of herbal medicine, rather than the development of the human resources who ‘traditionally’ practice this kind of medicine. Surely the project of Indic Traditions of Healthcare remains unfinished.
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