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Birth on the Threshold

Childbirth and Modernity in South India

Cecilia Van Hollen (Author)

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Even childbirth is affected by globalization—and in India, as elsewhere, the trend is away from home births, assisted by midwives, toward hospital births with increasing reliance on new technologies. And yet, as this work of critical feminist ethnography clearly demonstrates, the global spread of biomedical models of childbirth has not brought forth one monolithic form of "modern birth." Focusing on the birth experiences of lower-class women in the South Indian state of Tamil Nadu, Birth on the Threshold reveals the complex and unique ways in which modernity emerges in local contexts.

Through vivid description and animated dialogue, this book conveys the birth stories of the women of Tamil Nadu in their own voices, emphasizing their critiques of and aspirations for modern births today. In light of these stories, author Cecilia Van Hollen explores larger questions about how the structures of colonialism and postcolonial international and national development have helped to shape the form and meaning of birth for Indian women today. Ultimately, her book poses the question: How is gender—especially maternity—reconfigured as birth is transformed?
Note on Transliteration
Prologue: Birth on the Threshold

Introduction: Childbirth and Modernity in Tamil Nadu
1. The Professionalization of Obstetrics in Colonial India: The "Problem" of Childbirth in Colonial Discourse
2. Maternal and Child Health Services in the Postcolonial Era
3. Bangles of Neem, Bangles of Gold: Pregnant Women as Auspicious Burdens
4. Invoking Vali: Painful Technologies of Birth
5. Moving Targets: The Routinization of IUD Insertions in Public Maternity Wards
6. "Baby Friendly" Hospitals and Bad Mothers: Maneuvering Development during the Postpartum Period
Conclusion: Reproductive Rights, "Choices," and Resistance

Appendix I. Sample Questionnaires for Interviews
Appendix II. Official Structure of Maternal-Child Health Care Institutions and Practitioners in Tamil Nadu, 1995
Cecilia Van Hollen is Assistant Professor of Anthropology at Syracuse University.
“This is an engaging book, which is both scholarly and readable. As such it is a very useful piece of comparative work and throw a fresh light on concerns of writers elsewhere.”—Chris McCourt Anthropology In Action
"This is a beautifully written and well-organized book, combining theoretical insights and ethnographic detail. It represents an important contribution to medical anthropological scholarship on reproduction as well as to the theoretical debates on modernity and development."—Carolyn Sargent, author of Maternity, Medicine and Power

"By locating women's experiences of childbearing within a local political economy of class, caste and gender politics and international debates about development and human rights, Birth on the Threshold provides a subtle and important contribution to the understanding of Indian modernity. With telling use of case material, the author shows us how poor Tamil women in contemporary south India are both willing collaborators and victims of changes in medical practice. Women's experiences at the hands of hospital staff, who often insert intrauterine contraceptive devices without their consent, are juxtaposed with their own perceptions and strategies of accommodation, negotiation and resistance. This book will be essential reading for students of gender, medical anthropology and of South Asia in general."—Patricia Jeffery, co-author of Labour Pains and Labour Power: Women and Childbearing in India

"Compellingly argued and exquisitely written, Van Hollen's work stands as the best of a new generation of ethnographies critically rethinking the anthropology of childbirth. Accessible to anyone with an interest in the everyday and extraordinary politics of development, family planning, and poor women's lives, Birth on the Threshold is necessary reading for all scholars of body, gender, and governmentality in South Asia and destined to become a classic in medical anthropology. "—Lawrence Cohen, author of No Aging in India: Alzheimer’s, the Bad Family, and Other Modern Things

Coomaraswamy Book Prize, Association for Asian Studies

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