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Pregnant women here prefer ‘home delivery’ as they trust self-claimed midwives more than a distant PHC

Pallala Lakshmamamma with the 11-month-old baby she delivered at home, at Reddi Nagaram in Alluri Sitharama Raju district.

Pallala Lakshmamamma with the 11-month-old baby she delivered at home, at Reddi Nagaram in Alluri Sitharama Raju district.
| Photo Credit: T. Appala Naidu

Five infants, four of them female, share a unique history in Reddi Nagaram, an hamlet inhabited by the Konda Reddi tribe, a Particularly Vulnerable Tribal Group (PVTG) in Andhra Pradesh.

All of them were born within one year in the mud-walled houses, thanks to the deliveries performed by the hamlet’s self-claimed midwives who had come to their “aid” following a health emergency.

“We all rush to the pregnant woman whenever she complains of labour pains and perform the delivery in her house. The ANM will be informed about the health condition of the baby and the mother later,” says Sadala Chinnalamma.

She is among the five women who have been performing ‘non-institutional deliveries’ for some years at Reddi Nagaram in the Chintoor Agency in Alluri Sitharama Raju (ASR) district.

The hamlet, with 23 households and 110 population, is located on the Andhra-Odisha border, and the entire 50-km zone surrounding it is declared a Naxalite-hit pocket. It is also adjacent to the Bastar region in Chhattisgarh.

“Almost 99% of the home deliveries performed in our hamlet in the recent years were successful without any major health complications,” Pallala Chandramma, Sadala Balamma, Sadala Chinnalamma and Pallala Neelamm, all of them self-claimed midwives, told The Hindu in one voice when this correspondent met them on July 27.

“The following day, the baby and the mother will be taken to the hospital for further treatment and vaccination,” they said.

In August last, Sadala Chinnalamma herself performed the delivery of her 18-year-old daughter Pallala Lakshmamma, who gave birth to a baby girl, named Sunita.

“I performed the delivery of my daughter at night in our home. My daughter and granddaughter are absolutely fine. For me, it was like any other delivery,” she said. At the age of 15, Ms. Lakshmamma’s wedding was consanguineous.

“We do offer ‘saayamu’ (aid) to pregnant women. Fellow women will rush to the pregnant woman whenever she complains of labour pain. Those with experience in conducting deliveries at home will continue to be with the woman post delivery too. Later, we will accompany her to the hospital,” said Ms. Neelamma, an elderly woman who had performed more home deliveries among the five.

The ‘saayamu’ is an unwritten custom that exists in the hamlet. Breastfeeding for one-and-a-half-years is mandatory. However, the midwives recommending “herbal medicines” during the ‘golden hour’ is a cause for concern.

For Reddi Nagaram, the nearby Primary Health Centre (PHC) is at Mangampadu, which is 12 kilometers away. The PHC covers four tribes — Porja (PVTG), Konda Reddi, Bagata and Kondh. The other nearby PHC is at Tulasipaka, which is 40 kilometers away. In both the PHCs, there is no gynaecologist, but a medical Officer will attend to the pregnant women.

On an average, the four tribes need to travel for nearly 70 kilometers through the Sileru forest cover in order to access the services of a gynaecologist, who is available at the government hospital in Chintoor, the administrative headquarters of the Agency.

“Our local ANM recommens Mangampadu PHC if the newborn baby reports low weight at birth. In case of any further complication, we will rush to Chintoor by an autorickshaw or the government ambulance,” said 22-year-old Pallala Lokesh Reddy.

Mr. Lokesh has three children. The second, named Srinivas, was born in the government hospital at Badrachalam in Telangana.

“The villagers mostly prefer delivery at home. Timely access to the doctors at the PHCs and ambulance, and travel for hours through the forest are causes for concern. We cannot dare overcome these challenges at a time when a pregnant woman needs emergency services, particularly during night,” said Mr. Lokesh.

“We admit that there are many cases of home deliveries being performed by the tribal women. It is due to a lack of awareness among them of the health complications. We have been appealing to them to stop such deliveries. However, the response is very poor,” said District Medical and Health Officer C. Jamal Basha.

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