MOTHER AND CHILD CARE IN TRADITIONAL MEDICINE

( By LSPSS )

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LSPSS Survey of Practices Relating To Mother And Child Health

In 1987 it was decided that LSPSS (Lok Swasthya Parampara Samvardhan Samithi) and CHETNA (Centre for Health Education Training and Nutrition Awareness) would jointly sponsor an All India Survey on the practices of Mother and Child Health prevalent in the community. The objects of this survey were-

  1. To gather baseline data regarding the various local health traditions in the area of mother and child health.
  2. To evaluate the soundness of the practices from the perspective of Aayurveda.

It was felt that the above exercise would help us to identify the strengths of the tradition, the areas of weaknesses where input is required from outside and to correct any distortions that may have crept in . The survey was structured in the form of an indepth interview based on a questionnaire which was in three parts. Each part pertained to a specific area -

  1. Ante-natal care of the pregnant women
  2. The practices of the dais and
  3. Post-natal care of the mother and the baby

The survey was taken up by 26 different agencies spread in 12 states all over India. The questionnaires were prepared in Hindi and various regional languages of the States. In each area one hundred respondents were interviewed. The questionnaire regarding ante-natal care had 25 repondents (pregnant women) the questionnaire regarding dais has 25 respondents (dais), and the questionnaire regarding post-natal care had 50 respondents (25 of these were mothers with children less than a year old and 25 respondents were women who had experienced several pregnancies). Thus 100 responses were obtained from each area and a total of 2600 women from across the country were interviewed.

The tabulated results of the survey were given for evaluation to 22 Vaidyas (all of them Aayurvedic Aachaaryaas) from various parts of the country. They were requested to evaluate the practices from the point of view of Aayurveda and pronounce upon them by assigning each reply to one of the following categories:-

  1. Sound and complete
  2. Sound but incomplete
  3. No basis for commenting on the practice
  4. Harmful and potentially dangerous

We are aware that such an assessment can only be tentative since there can be a wide regional variation in practices and it may require a very intimate knowledge of various other aspects of the field group conditions before they can be evaluated. Hence a meeting was organised in February 1989 in Aalandi (near Pune) wherein representatives of the field groups who carried out the survey as well as the Aachaaryaas who performed the evaluation got together for a detailed discussion on the data gathered. Some of the evaluations were modified in the light of these discussions and the data was summarised in fresh after the meeting.
The response to these questionnaries have been extensively used in this text used in this text to illustrate the local health traditions.

Given below are the questionnaries which were used in this survey.

An All India Study on Traditional Practices in Maternal and Child Health Care
(The following questions are common to all three parts of the Questionnaire)

  • Name of Surveyor:
  • Date:
  • Area: Tribal/Slum/Rural/Urban
  • Name of the village:
  1. Name of the respondant:
  2. Caste:
  3. Age:
  4. Education:
  5. Address:
  6. Please note your comments and general remarks regarding the socio-economic status of the respondent's family.

I.Questionnaire regarding traditional practices followed during Pregnancy

 

  1. Do you confirm pregnancy? When? How?
  2. Can you estimate the date of delivery? How?
  3. Is there any tradition to consume a special diet or food during every month of pregnancy?
    1. Yes/No
    2. If yes, which foods at what month and why?
    PeriodFoodsReasons
    During first three months
    During fourth, fifth and sixth months
    During last three months
  1. What foods should be avoided or should be taken in more amount during pregnancy
    Food avoided When Reason
    Food consumed
  1. Does a pregnant woman wish strongly to eat any particular food or any other materials (e.g. Mud, clay material, sour foods, etc.)
    Yes/No
    Which foods or materials?
    Reason(s)

     

  1. a. Does a pregnant woman wish to do some special activities (such as running, walking) or are there any changes in behaviour(e.g. irritability)
    Yes/No
    Which activities?
    Reasons
    b. Is there any relation between the above activities and the unborn child?
    Yes/No
    If yes, which pre-conceived notions exist in the community?
  1. What are the do's and don'ts for pregnant woman? (in terms of thinking, behaving, talking, sexual habits, sleeping posture, exercise, household work). Are there any beliefs behind it?
    1. Yes/No
    2. Do's: Reason for the same
    3. Don'ts: Reasons
  1. Can you assess whether the pregnant woman will deliver a male or a female baby? Twins? How?
  2. What steps are followed to achieve the child of desired sex? (Punsavana vidhi)
  3. Do the pregnant women go to the traditional dai or to any other health worker for check up before delivery?
    Yes/No
    1. If yes, at what time and for what?
    2. If no, why not?
  1. What treatment do they give for the problems during pregnancy?
    Sl.no.ProblemsWhere do they go for treatment Treatment given
    1Body Pain and joint pain
    2Dizziness
    3Weakness (Anaemia)
    4Vomiting/morning sickness
    5Swelling (oedema)
    6Night Blindness
    7Blurred vision
    8Worms
    9Piles
    10Constipation
    11Diarrhoea
    12Fever
    13Malaria
    14Jaundice
    15Measles
    16Itching in vulva
    17Excessive vaginal discharge (Red/White)
    18Burning sensation while urinating
    19Convulsions
    20Pain in the abdomen
    21Headache
    22Insomnia
  1. For which of the conditions does a dai advise the pregnant woman to go to a hospital for delivery?
  1. a. State the cause of natural abortion in your area.
    b. How is abortion being done in your area?

  2. Details of death of babies in the perinatal period including still births..

  3. Reasons for the death of the children
    Age groupsReasons for mortality
    0-1 year
    1-5 year
    5-12 year

II.Questionnaire regarding Dais Practices

Ask the following questions to the Dai

  1. i. Can you detect pregnancy?
    Yes/No
    How?
    ii. Can you determine the duration of pregnancy?
    Yes/No?
    How?
  1. If a child is born preterm, is there any effect on the health of the child and the mother?
    Yes/No
    If yes, at what month effects are noticed? What are the effects? What is done to protect the child?

  2. Can you diagnose an ectopic pregnancy? How?

  3. How do you identify when the delivery is impending?

  4. How do you identify (distinguish) between true and false labour pains?

  5. Have you come across post mature deliveries? (after ten months)
    Yes/No.
    If yes, what do you do about it?

  6. what do you do to conduct a safe and easy delivery? Do you advise any of the following? What and Why?
    What Situation What reason
    Special food and diet
    Enema
    Exercise
    Massage with oil on the stomach
    Special posture
    Medicine
    Dhupan
    Pushing out t the abdomen during the pain
    Others
  1. What do you do to prepare for a delivery? What special arrangements do you make (ventilation, lighting, etc.)/ Why?

  2. Which is the best posture for a delivering women?
    Posture
    Reason

  3. Can the Dai conduct the following type of deliveries?
    1. Premature delivery
    2. If the head comes first
    3. Excessive bleeding before labour pains
    4. If the legs and hands come first
    5. If the umbilical cord is tied around the neck
    6. Twins
    7. Breech Presentation
    8. Transverse Presentation
    9. Premature rupturing of membrane(water)
  1. In which conditions does a dai advise the pregnant woman to go to the hospital for delivery?

  2. How can you find out if the child has died in the uterus?

  3. What do you do if there is excessive (more) bleeding before delivery

  4. What do you do if there is excessive (more) bleeding after delivery?

  5. What steps do you take if a woman faints after delivery?

  6. When do you cut the umbilical cord (Tick) Why?
    a. Before placenta comes out
    b. After placenta comes out
  1. a. Who cuts the umbilical cord? Why (Reason)
    b. It is the umbilical cord tied or not before cutting? Reason.
    c. What do you use to tie the umbilical cord?
    d. With what do you cut the umbilical cord?
    e. Is the instrument used for cutting the umbilical cord treated in any way? Yes/No Why (Reason)
    f. How is the instrument treated?
    g. At what site do you cut the umbilical cord?

  2. Do you apply anything on the umbilical cord after cutting it?
    Yes/No. Why?
    a. If yes, what do you apply? Tick appropriate answer
    Material Reason
    i. Ash (which one)
    ii. Cow dung
    iii. Medicine
    iv. Oil/ghee
    v. Other

    b. What is applied to dry the umbilical cord?

  1. If placenta does not come out, what measures do you take? Reason.

  2. What is done of the placenta after a delivery?
    (Tick) Why?
    1. Buried
    2. Burnt
    3. Thrown away
    4. Other
  1. From your experience during delivery if there are cuts and tears in the vagina what do you do? Why?

  2. Do you give anything to facilitate cleaning the uterus immediately after delivery? What? Why? (Reason)

  3. Is a woman advised vaginal smoke heat therapy after delivery?
    Yes/No
    How (material used)?
    Reason (why)?
  1. What signs and symptoms are looked for in a new born?

    Signs Reason
    I.
    ii.

  1. What do you do if a newborn does not cry?

  2. What do you do if a male newborn's urinary opening is narrow? why?

  3. What do you do if there is gland on the neck of the new born? Why?

  4. a. Is the practice of cleaning new born infant's following parts followed?When? How? Give reason.
    When? How? Reason?
    iMouth
    iiNose
    iiiEar
    ivUmbilical cord
    1. What medicines and or materials are used to clean the above mentioned parts of the infant's body? Reasons.
    2. When is an infant given a bath? Why?
    3. Is a premature baby given a bath? Yes/No
      if yes, when?

III. (a). Questionnaire regarding the care of the new born baby

  1. What things do you use to clean the new born's body? (Tick) (a) and why?
    1. Oil
    2. Soap
    3. Medicine (specify)
    4. Cold water
    5. Hot water
    6. Bengal gram flour and milk cream
    7. Turmeric powder
    8. Any other

    b. When and How a new born baby is bathed the first time

     

  1. When do you start breast feeding the infant?
    1. First, Second, Third, Fourth, Fifth
    2. Do you remove yellow milk before breast-feeding
      Yes/No How much? Why?
  1. How long is the breast feeding continued? Why?

  2. Is there any difference in the period upto which breast milk is given to a boy and a girl? Reason (Why)?

  3. How many times a day is a child breast fed? Reason (Why)?

  4. How many times do you give water to a child? Do you add anything in the water? How much water do you give at a time?

  5. Which are the common ailments/diseases noticed amongst the new borns?
    Ailment/disease Treatment From whom Reason
    Constipation
    Jaundice
    Colic
    Conjunctivitis and eye infection
    Breathlessness
    Fever
    Diarrhoea
    Vomiting
    Cough and cold
    (Respiratory Diseases)
    Distended stomach
    Convulsions and fits
    Refusing breast feed
    Any other
    1. In addition what other treatment is given e.g. branding, etc. Why?
    2. What treatment do you administer if umbilical cord gets infected?
  1. What treatment using Aayurvedic herbs is given to protect the child against the disease? Which ones? Why?

  2. At what age do you start weaning foods besides mother's milk? Which foods do you give? List the foods given to the child at what age and reasons why?

  3. What are the problems that arise during teething? What treatment is normally given for the same and why?

  4. Do you massage the baby? Yes/NO
    1. If yes what are the ingredients used in the oil (powder, medicine, leaves)? For how long do you continue this treatment? Which parts of the body? Why?
    2. Who usually does it? Is the practice of putting (kajal) in eyes followed? How do you make it? Why?
    3. Is any other material used for massaging after the oil massage? Yes/No which one?
    4. Mention in detail the method of massaging.
  1. What type of water do you use to bathe an infant?
    Tick
    Cold
    Hot
    Lukewarm
    Medicated

  2. What are the methods of cleaning the infant's clothes?

  3. What are the diseases commonly encountered in an infant below 1 year? From whom do you get treatment? Why?
    Sl. No.Disease Treatment From whom Reason
    1T.B.
    2Tetanus
    3Polio
    4Pneumonia
    5Undernourishment
    6Anaemia
    7Rickets
    8Scabies
    9Measles
    10Whooping cough
    11Diarrhoea
    12Boils
    13Chicken pox
    14Ear infections
    15Meningitis
    16Fever
    17Worms
    18Any other

15.a. What type of toys are given to the children for playing? Tick Correct answers.

Toys Age groups Reason
iMud
iiWood
iiiPlastic
ivGlass
vCloth
viBamboo
viiAny other

b. Which toys should not be given to the child? Why? (Describe colour and shape).

    1. Do you determine whether the child's milestones correspond to his age? How?

    III. (b). Questionnaire on the care of the mother after delivery

    1. What problems does the mother usually face after the delivery?

      Sl. No.Disease TreatmentFrom whom Reason
      1Fever
      2Bodyache
      3Cracked nipple
      4Breast engorgement
      5Swelling (oedema)
      6No breast milk
      7Breast milk
      8Constipation
      9Excessive vaginal discharge
      10Excessive bleeding
      11Inversion of nipple
      12Depression
      13Any other

    1. What medicines should be given to a lactating mother who has just delivered a child? Why?

    2. For how long after the delivery is the mother massaged with oil? Why?

    3. What do you do to improve the quality and quantity of breast milk? State the medicine given and treatment.

    4. a. In what conditions do you advise not to breast feed the child? Reasons (Why)?
      b. Mention the test for checking breast milk.
    1. What is the diet for the lactating mother? Which special food should be taken ( should not be taken) by the lactating mother? Why?

    2. If the mother is unable to breast feed, which milk do you feed to the baby? Why? How?

      Type of milk Reason How
      Other lactating mother's (Bottle, spoon, cotton)
      Cow
      Goat
      Any other

    1. How long after the delivery, is the mother required to follow certain dietary pattern? Why?

    2. What special foods are given to the nursing mother for the first five days after the delivery? Why?

    3. What difference in diet is observed for a boy or a girl? For how long does the mother have to follow the required dietary pattern? why?

    4. Are there any special foods for the mother in the case of the first born child? Yes/No.

    5. If after consuming the breast milk the newborn vomits and has diarrhoea, distended stomach, constipation. What charges are made in the mother's diet? Why?
      Disease Change in mother's diet Reason
      Diarrhoea
      Constipation
      Colic
      Distended stomach
      Others


    6. What do's and Don'ts do you advise for the following? Reasons?
      1. Posture for breast feeding
      2. Demand v/s scheduled feeding
      3. Night feeding
      4. Burping after a feed
      5. If the new born dies, how do you stop the flow of mother's milk? Or how do you take out this milk . What medicines are given to the mother for it? why?
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