Praxis and concepts of midwifery: Indian dais, cosmopolitan obstetrics and Japanese seitai - Andréine Bel
Date of interview:
Name of interviewer:
Village or city:
[d1_1] Important dates for control?
[d1_2] When is the foetus not in a favourable position? What interventions can take place? Do they have side-effects?
[d1_3] When is there a tendency to miscarriage? What is done?
[d1_4] Any specificity in diet for giving strength and for helping breast-feeding?
[d2_1] Which sign is considered as the non-reversible point of the delivery?
[d2_2] Where does the delivery take place? What would be the ideal environment? What is recommended?
[d2_3] Who is present? Why?
[d2_4] Who directs?
[d2_5] What is prepared, sterilised? How?
[d2_6] Which position is chosen for the delivery? Why? By whom?
[d2_7] Does the position have incidence on the pain? On the labour?
[d2_8] Does the attendant monitor the progression of the baby? How?
[d2_9] Does s/he control the mother's breathing, pushing? When?
[d2_10] Does s/he massage the mother's belly, back, opening of the vagina, with which oil?
[d2_11] Once the baby is born, does s/he make him cry? When? How?
[d2_12] When out of the womb, where is the baby put? Why?
[d2_13] Is the mucus taken from the baby's mouth? How?
[d2_14] When does the attendant cut the cord? With what? Where are made the knots on the cord? With what? How?
[d2_15] Does the attendant induce the placenta to go out? How?
[d2_16] What does s/he do of the placenta?
[d2_17] When does s/he give the first bath to the baby? Should the vernix be washed out carefully, or on contrary not completely removed, so as to keep some of it till it goes by itself? Does s/he clean his/her eyes? With what? What are the precautions to be taken?
[d2_18] Is the baby's weight checked? How?
[d2_19] Does s/he give to the baby anything before breast-feeding (such as water with lemon, or with sugar, honey, goat milk...) ?
[d2_20] Should the mother wait for the baby's meconium to go out before breast-feeding? Why?
[d2_21] Should the mother give her colostrum (first milk)? Why?
[d2_22] What is done to the mother for helping her recovering (massage, dry heat, herbal tea, etc.)? Do her hips open and close, during and after the delivery.
[d2_23] When should the mother get up? Will it have incidence on her health later?
[d3_1] When is the timing of the delivery considered a problem (in ante and post-due date)?
[d3_2] When is a delay considered to become risky?
[d3_3] What is done then? How are premature babies taken care of?
[d3_4] What are the foetus positions considered as problematic, or dangerous?
[d3_5] What is done to place the foetus in the right position during delivery? Do manipulations have side-effects? Is there cases where medical intervention is compulsory?
[d3_6] When the baby does not breathe air and does not cry, in spite of stimulations. What is done?
[d3_7] When the baby does not take mother's milk, what is done? What are the possible causes.
[d3_8] Are there any other complications and remedies?
[d4_1] Fear, panic, how to give her confidence?
[d4_2] Extreme pain, its cause, how to lessen it?
[d4_3] Insufficient pain and contractions, the causes, how to stimulate them?
[d4_4] Mother's weakness, or fatigue, how to give her strength?
[d4_5] Torn of the vagina, what is done? Should episiotomy be performed in hospital to avoid the problem? In which case?
[d4_6] Haemorrhage of the womb, causes, remedies and prevention?
[d4_7] Infection of the womb, causes, remedy, prevention?
[d4_8] Congestion of the breast, small cracks and pain during breast feeding. What are the causes, remedies and prevention?
[d4_9] Other complications, remedies and prevention?
[d5_1] What seems to you the most important in the baby's care?
[d5_2] How to avoid and cure diarrhoea for the baby?
[d5_3] How to avoid and cure constipation for the baby?
[d5_4] Should bath and massage be given every day? When? How? Should it be followed by herbal fumigation (which herbs and woods)? Up to which age of the child?
[d5_5] Is there any timing for breast feeding, or is it up to the baby's manifestation of need?
[d5_6] When does the mixed-feeding start? With what? (list of ingredients given to the baby according to his age)
[d5_7] When does the complete weaning take place? How?
[d5_8] What is most important for the baby during his first three years?
[d6_1] Whom did she learn her practice from?
[d6_2] What does the dai receive for her services?
[d6_3] Does she has a legal status?
[d6_4] Did she receive training from a doctor or health worker?
Did she agree with it? Did she find it useful and relevant to her?
Was it a requirement for being granted legal status?
[d6_5] What is her perception and opinion about doctors?
[d6_6] Does she get recognition from the allopathic doctors and nurses?
Do they know her technique well? Do they wish to learn from her?
[d6_7] Does she get recognition from the people?
[d6_8] Are there complications in child delivery that cannot be handled by dais?
[d6_9] Within her experience, did she meet cases of death, mother or/and child?
(According to her, what is the percentage of death, mother and child, encountered by dais in general)
[d6_10] How often does she send her patients to the hospital? (percentage)
[d6_11] Did she personally handle cases "abandoned" by doctors? Did she save the life of these patients?
[d6_12] Does she have personal advice and suggestions to give to doctors and nurses?
[d6_13] Does she teach future dais? Who? How? What are the skills that a dai should have?
[d6_14] Does she exchange knowledge with other dais? Does she feel the need of it? Would she like to form a group?
[d6_15] What would be her wishes and plans of action to improve her practice?
Does she wish this comparative study on child delivery to be known to her, to others, published?
[d7_1] What would be considered as "natural", "normal" and "abnormal" child delivery in obstetrics?
[d7_2] When does medical interference take place?
[d7_3] In your hospital, what is the percentage of obvious cases demanding medical intervention?
[d7_4] What is the percentage of cases where intervention is taken to minimise the risks, or/and prevent any possible legal charges against the doctor?
[d7_5] What is the percentage of the following medical interventions: inducing contractions, episiotomy, caesarean section, forceps, vacuum, epidural, others?
[d7_6] How often do they succeed in their respective aim?
[d7_7] What are, for each of them, their short and long term side effects, if any?
[d7_8] What are their percentage, for each of them, of failure and death consequence, if any?
[d7_9] During the delivery, do the mother's heaps open, and how? How do they close? Is the opening conditioned by the psychological environment?
[d7_10] Concerning health care in general:
What are the different mechanism of fever?
What are the benefits of fever in the organism?
Can fever be dangerous?
What are the complications it may provoke?
What would be the percentage of complications and death if the fever were allowed to develop and terminate?
[d7_11] What does the doctor receive for his/her services?
[d7_12] What is the obstetrician's perception and personal opinion about dais, traditional midwifes?
[d7_13] Does the doctor personally wish to know about their skill and technique, and learn them?
[d7_14] Does s/he exchange knowledge with other doctors?
Does s/he feel the need of it? What are the skills that a doctor should have?
[d7_15] Are there complications in child delivery that cannot be handled by obstetricians? Are there complications that could be better handled by dais? Do the doctor send such patients to dais, traditional midwifes?
[d7_16] Did the doctor personally solve cases sent, or "abandoned" by dais, did s/he save the patients?
[d7_17] Does the doctor personally wish to give suggestions and advice to dais?
[d7_18] What would be his/her wishes and plans of action to improve his/her practice? Does s/he wish this comparative study on child delivery to be known to him/her, to others, published?
Interviewer's comments about this interview:
Colostrum: first mother's milk just after the delivery.
Episiotomy: surgical cut alledged to protect against a torn of the vagina.
Meconium: the first defecation of the baby after his/her intra-uterus life. It comes out within one or two days. It is black and greasy.
Vernix: grease covering the baby at birth.