...I amended my previous post (Busy In The Village) after new insight and clarification gained today. Be sure to check out where I have noted the change in the discussion of the caste system’s impact on child and maternal health care. Today, we went back to the same hospital in Tigaon. I learned that the two doctors, one homeopath, and one dental surgeon here provide healthcare to more than 45,000 people throughout their village and the nine surrounding communities. As soon as we arrived, the female volunteers were taken into the delivery room and observed two side-by-side and nearly simultaneous child deliveries. Unfortunately, males are not allowed to view normal deliveries in India. Even male doctors and fathers are not allowed in the room during labor. I say “normal deliveries” as opposed to Cesarean sections because C-sections fall under the classification of surgeries. I know this to be the case because last Monday, on my first day here, I observed a C-section during which the operating room technician was also male. Although I did not get to see today’s deliveries, I made sure to record a detailed account of what the ladies told me about it after.

--The primary OR in which I observed a C-section on my first day--

Just as in the operating room last week, everyone in the delivery room was required to be barefoot or in simple sandals. The expecting mothers were placed side-by-side and labor was induced in both. One female doctor and three nurses tended to both patients. The volunteers said that, as I had similarly noted during the C-section last week, there was little done to comfort the patients. At times, the staff was shouting at the women forcefully and even slapping them on the legs to work harder. The only protective equipment used by the staff were latex gloves. There were no masks, eye protection, or gowns. Everyone was in street clothes although the doctor did wear an apron because she had an important engagement to tend to and left part of the way through the procedure. The volunteers’ first reaction to the delivery was that “it looked like a crime scene in there.” When I asked what kept the staff from getting exposed to blood, they said simply, “Quick reflexes!”

--The hospital catering to a population of 45,000 people--

The first woman to deliver was the older of the two women who has two daughters and desperately wished for a son. After two hours of exhausting labor that could be overheard throughout and outside the small hospital, she gave birth to baby boy. The doctors and staff do not notify the mother of the gender of the child, however, until the placenta has been delivered and the mother has stabilized. It is believed that some women have died from shock related hemorrhaging due to overwhelming depression of having delivered a daughter. The placenta was delivered and all celebrated cheerfully the birth of her baby son.

The next woman to deliver was 21. It was her first child and labor for her appeared to be much more difficult. She delivered a baby girl. The volunteers noted that upon announcement of the baby’s gender, the mood was much less celebratory and the mother was given consolation as if to say “at least you're young and it's just your first child.” She will likely try again for a boy, just like the other mother.

In a similar manner to government incentives for pre and post-natal care, I also learned today about financial incentives related to child raising and contraception. If a mother bears a second female child here, an account for that daughter will be automatically created and the government will place Rs 25,000 ($500) into it to be withdrawn once she becomes 18. Apparently, many mothers and families do not take adequate care of or properly nourish their second daughters, sometimes even leading to death. Condoms and birth control can also be obtained from the hospital for free and the government will actually pay men approximately Rs 1100 ($22) to have a vasectomy. I believe there is also an incentive for women to have tubal ligation, but I do not know what the financial incentive is.

--Men huddled around a fire in the chilly morning fog next to the hospital--