Drop the Demon Dai: Maternal Mortality and the State in Colonial Madras, 1840–1875

Writing on midwifery and women's health in nineteenth-century India has concentrated on the role of medical missionaries and on voluntary organizations, such as the Countess of Dufferin's Fund; the role of the state has been generally discounted. However, a close study of government records from Madras Presidency suggests that there was considerable state interest in the issue from the 1840s onwards. This took the form of running and supporting a major lying-in hospital in Madras and smaller lying-in wards at provincial dispensaries, in order to train midwives to work throughout the Presidency. State action was heavily influenced by revulsion at the methods of the dai, the traditional Indian birth attendant. The strategy both at Madras and elsewhere was to replace her with a class of Indian trained midwives who would operate within the community. Various explanations for state interest in the issue are suggested, including political rivalry between the different British Presidencies.