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The George Washington University

Publication Date

Fall 2019

Program Name

India: Public Health, Gender, and Community Action


Over the past two decades birthing practices within India have drastically changed. This change is most visible in the shift from homebirths to hospital births following the implementation of the National Rural Health Mission. This study aims to understand and give voice to women’s perceptions of birthing practices in the rural villages of Kangra District of Himachal Pradesh. A total of ten interviews were conducted with both mothers and healthcare practitioners in the surrounding villages of Kangra District in order to gain a thorough, qualitative understanding of birthing practices in the local communities. The healthcare practitioners’ responses were divided according to their profession: Accredited Social Health Activists (ASHAs), Anganwadi Workers (AWWs), and Birth Attendants. The mother’s responses were categorized according to five themes: Preparation for the Birth and Prenatal Care, Birthing Experience, Traditions and Cultural Norms Surrounding Birth, Changes in Birthing Practices over the Generations, and Hope for the Future: How to Improve Birthing Practices. Analysis of the interview responses indicated that the National Rural Health Mission has greatly influenced women’s perceptions of birthing practices. When combined with a greater level of education and health literacy, these government schemes have fully changed the narrative surrounding birth. Women now view hospital births as the norm and homebirths are seen as backwards and too risky. The NRHM has also greatly altered how women interact with other aspects of birthing practices, such as prenatal and postnatal care. The incentivization of institutional births has created a large generational gap in perceptions of birthing practices. While childbirth in India has become much safer for both mothers and children through these government policies and schemes, all of the women interviewed agreed that there needs to be efforts made to achieve more comprehensive, womencentric maternal care.


Asian Studies | Family, Life Course, and Society | Health Communication | Maternal and Child Health | Nursing Midwifery | Obstetrics and Gynecology | Social and Cultural Anthropology | South and Southeast Asian Languages and Societies | Women's Health | Women's Studies


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