i Modernizing Childbirth in Colonial Bengal A History of Institutionalization and Professionalization of Midwifery, c.1860-1947 By Ambalika Guha A thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Doctor of Philosophy Victoria University of Wellington (2015) ii iii 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 iv 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. v Contents Acknowledgement ............................................................................................................................... vii List of Abbreviations ........................................................................................................................... ix Glossary ................................................................................................................................................ xi Introduction ........................................................................................................................................... 3 Chapter One ........................................................................................................................................ 29 Scientific Mothers and Healthy Infants: The Birth of a 'Modern-Sientific' Discourse in Bengal, 1860s-1900 ............................................................................................................................................ 29 Chapter Two ........................................................................................................................................ 67 The Institutionalization of Midwifery and the Constitution of a Medical Discourse, 1860s-1930s .............................................................................................................................................................. 67 Chapter Three ................................................................................................................................... 109 Maternal and Child Welfare: ........................................................................................................... 109 A Nationalist Concern in Late Colonial Bengal, 1900-1940s ........................................................ 109 Chapter Four ..................................................................................................................................... 151 The ‘Care-Givers’: Ante-Natal Care in Bengali Public Discourse and Practice 1860s-1940s ... 151 Conclusion ......................................................................................................................................... 183 Bibliography ...................................................................................................................................... 195 vi vii Acknowledgement During the three years of my doctoral research at the Victoria University of Wellington, I have incurred a number of debts. My foremost gratitude is to my supervisors, Prof. Sekhar Bandyopadhyay and Prof. Charlotte Macdonald for their constant encouragement and support. Their perceptive comments and painstaking correction of the drafts of my chapters helped me sharpen the focus of my thesis and give it a better shape. I am also grateful to the other faculty members of the History Programme for critically commenting on my work during the two seminar presentations that I made in course of my research. I am particularly indebted to Dr Steve Behrendt and Dr Giacomo Lichtner for sharing useful tips on enhancing the quality of research during the weekly students’ seminar.I acknowledge my debt to our department librarian Justin Cargill for his untiring support and promptness in answering the most trivial queries even while I was in India for my research trip. My deepest gratitude is to my teachers at Presidency College, Kolkata, Prof. Rajat Kanta Ray and Subhash Ranjan Chakrabarty for instilling in me an enduring love for History. I owe my interest in the history of medicine to the meaningful conversations with Dr Rajsekhar Basu who was my teacher and mentor at the University of Calcutta. Dr Basu introduced me to the vast historical and anthropological literature on the subject. I am greatly indebted to Dr Arabinda Samanta who suggested that I explore the arena of women’s reproductive health. I have gained immensely from the erudition of my teachers at Calcutta University, Prof. Hari S Vasudevan, Prof. Suranjan Das, Prof Arun Bandopadhyay, Prof. Bhaskar Chakravarty, Prof. Amit Dey, Prof. Suparna Gooptu and Dr Sanjukta Dasgupta who have influenced me in various ways. The late Dr Krishna Soman of the Institute for Development Studies, Kolkata shared her research experience with me and took pain to go through my proposal, adding valuable insights to it. I would also express my gratitude towards Dr Supriya Guha for kindly agreeing to read and comment on my research proposal even though we never met in person. The initial years of my research would have been impossible without the generous support of the staff of National Library, Kolkata who helped me access rare and brittle documents, including the nineteenth century medical journals and reproductive pamphlets. I would thank in particular, Ashim Mukherjee, Sunita Arora and Uttam Malakar for allowing me to viii photograph brittle books and journals. The staff members of the Annexe building of the National Library kindly permitted me to procure photocopies of materials in the shortest possible time. Their support and friendly behaviour made research an enjoyable experience at the library. Thanks are due to Bidisha Chakraborty and Madhuri Banik of the West Bengal State Archives for helping me procure important nineteenth century Government files related to my research and also suggesting