MUDHAGARBHA | Anisha Kumar

India circa 500 BCE

In a room lit only by a small flame, Sita cradled her swollen belly, unsettled by the three pairs of watchful eyes on her. The women asked her questions. The instant her words left her lips she forgot what she had said. Her entire consciousness centered on the kicks against her navel. She knew something was wrong.

She had heard of this happening before. Babies born upside down, without breath. Their lives ended in such little time. She wondered how long it took for the women to feel they could breathe again. One, two, three…days, weeks, years? Or perhaps never again. Each breath instantly stolen by the memory of the baby who never had one.

And how would she face her husband, her mother, her mother-in-law? Who would no doubt blame her outwardly or at the very least deep down. Wondering what went wrong, they would whisper to each other, speculating that she did something wrong, insisting that this could not happen to just anyone. Sita understood why. It is far easier to blame bad things on bad people than to live in fear. She understood because that fear consumed her now.

One of the women lightly prodded her stomach and asked, “Is the kicking here?” Sita noticed the youngest dai’s eyes widening just slightly, a flicker of recognition. It hurt her chest, the sharp turns from believing to despairing back to hoping. Hope. Such a fleeting thing. She felt as if she was constantly catching her breath in the thick air of cow dung and dirt permeating this cursed room.

When the dais turned to leave, Sita grabbed the youngest one’s wrist. The girl, Dhriti, turned around sharply, her braid slapping her in the face.   

“Please, child. God willing, please help my baby survive,” Sita pleaded, tightening her grip. Dhriti freed her arm and adjusted her sari, the ends of the white fabric collecting soil. The girl’s eyes darted everywhere, but never met her own.

“Tell me you know what to do?” Sita pressed.

Dhriti shook her head, still refusing to meet her eyes. Before Sita could say anything else, the girl left, her shadow dancing across the dimly lit room.

***

The words of Gauri, the senior midwife who had attended her own birth, echoed through Dhriti’s head. Your mother kept telling us that the kicks were too low in her stomach. We thought she would survive until it was too late. Dhriti wanted to help Sita. Of course she did. But what could she possibly do?

Gauri was now standing outside the family's little brick house with Ambika, another of the midwives. Dhriti left the Suthika Griha, a makeshift wooden structure built to house Sita until she recovered from childbirth, and made her way towards them. Gauri seemed to tower over Ambika despite her smaller stature. The older woman always had a sharpness in her gaze, which seemed to relay, along with her graying hair and sunken eyes, the haunting things she had seen in this life. Meanwhile, Ambika skipped through the world with more optimism than her years would suggest. Dhriti had known these women her entire life, taken under their wing after her mother passed. A few years ago, after her first menstruation, they began to train her to become a dai, as her mother had been.

As she drew closer to them, Dhriti overheard Gauri stating, “We will ask Vikram-ji to be present in case we need him to surgically remove the baby.”

“Would that not kill Sita, Gauri-ji?” Dhriti interjected.

“We would only resort to this if she was already dying.” Dhriti nodded. “Tomorrow, as is standard in cases of mudhagarbha, we will try to turn the baby through various poses with Vikram-ji present.”

When Dhriti was a child, her father would honor her mother solely in silence. He would respond to Dhriti’s endless questions about her by simply placing a small square of white cloth speckled with blood in her hands, cut from the sari her mother had worn when she died. “Close your eyes and ask her yourself,” he would say. “She will protect you, always.” Her older brother stopped asking about their mother early on, but Dhriti never seemed to learn.

After leaving the other dais, Dhriti paid her father a visit. He complained about his back pain, how cold the weather had been getting, and how long his daughter-in-law took to cook before he finally asked, “Child, how is that husband of yours?”

Dhriti took a breath, “Father, I came to ask about Ma.” Seeing her father’s expression close off, she quickly added, “About what the dais did in my birth.”

As she expected, he reached into his pocket and placed her mother’s cloth in her hands. “She can tell you better than I can. I was not there.”

Dhriti closed her eyes and willed her mother to give her the answer—to tell Dhriti what would have saved her. After a few moments of silence, her sister-in-law popped her head in from the kitchen, letting them know breakfast was ready. Dhriti smiled at this, but her father’s gaze remained on his hands.

Later, as Dhriti sat on the floor of her bedroom, her husband of a few months snoring on the cot beside her, she could not help but feel the shadow of Sita’s hand on her arm. She traced patterns in the dirt on the ground, consciously unclenching her jaw. Sita’s pleas echoed in her head. The voice soon morphed into what she had always imagined her mother’s voice to sound like. God willing, please help my baby survive. She wondered if her mother pleaded with Gauri and Ambika. Did she also beg for her baby to be delivered safely? At whatever cost?

That night, Dhriti dreamed of Sita. Feeling Sita’s sharp grip on her arm, Dhriti tried to reach for her. Dhriti blinked. A child swaddled in a white, bloodstained cloth was in her arms. And as she looked into the eyes of the wailing baby, Dhriti knew she was looking at herself.

The next morning, she woke up alert despite the ache behind her temples. She stayed in bed thinking of the first birth she attended. Dhriti could never forget the relief in the woman’s tear-flushed face as she held her baby boy for the first time. He had stopped crying and looked at his mother, the mixture of ghee, honey, and curds the dais had fed to him still on his lips. The woman began to laugh, softly at first and then crescendoing, the relief coursing out of her in waves. Dhriti wished every birth was like this. The dais moving in well-rehearsed choreography, not a person out of step. She thought of Sita then. God willing, please help my baby survive. An image flashed in her head of a vaidya leaning over Sita’s limp body, a knife running through her flesh. Her skin prickled.

Later, when the women walked to Sita’s Suthika Griha, Dhriti managed to ask, “Is this situation with Sita similar to what my mother went through?”

“Yes, but you knew that,” Gauri, walking a few paces ahead of her, replied without turning.

Dhriti remained silent for a few seconds. “Can anything be done?”

“I already informed you of what we were doing.”

Dhriti felt a burning in her chest at this. “Perhaps we could try other methods beyond the poses?” Gauri sighed. Dhriti added, “We are not doing all we can do.”

Ambika sucked in a sharp breath. “Yes. We. Are.” Gauri punctuated each word.

“Well then my mother would be here, wouldn’t she?”

Gauri turned around suddenly, the hurt clear in her eyes. She opened her mouth, but said nothing. Dhriti and Ambika had stopped walking, and Gauri left them where they stood.

Ambika sighed and led Dhriti off the dirt path, towards a fallen tree trunk to sit. “I know you want us to talk to you about what happened, but . . . your mother’s death haunts us. We loved her dearly.” Ambika wrung her hands in her lap for a few moments, “We had her do various asanas to try to turn you. But when this failed, she was dying in labor and we had to . . . cut into her stomach to retrieve you.” Tears now streamed down Ambika’s face, but Dhriti was still. “We had to remind ourselves that we did what she wanted us to do.” After a hard swallow, she added, “We blamed ourselves for a while after. Some members of the community did too.”

The sun was now directly above them. The women sat in silence for some time, sweat beading on their faces. “Thank you,” Dhriti whispered. The bustle of the day was in full swing, men herding cows, women drying laundry on clotheslines, and children playing. Dhriti watched the commotion, still thinking of Sita.

Now knowing without question that nothing would change in how they approached Sita’s case of mudhagarbha, she was determined, more than ever, to do something. “Don’t vaidyas sometimes try massaging the stomach to turn the baby? Was that tried for my mother?”

Ambika turned to her, the exhaustion clear on her face, “That has only been tried recently. The asanas we asked her to do are far safer as these different poses more gradually encourage the baby to turn.”

“But it could work,” Dhriti sat up straighter.

Ambika put a hand on Dhriti’s shoulder, “We can discuss it with Gauri. But please, dear, don’t get your hopes up.”

They arrived at Sita’s house to find Gauri seated in front of the Suthika Griha, picking weeds and breaking them into pieces. Upon seeing them, she rose to her feet and brushed down her sari.

“Gauri-ji, I wanted to apologize—” Dhriti started.

She was interrupted by Gauri tersely shaking her head, “Let us just go see what can be done.” Gauri turned to enter the Suthika Griha. “There is much to do.”

“What if Vikram-ji manipulated Sita’s baby into the correct position?” Dhriti asked Gauri abruptly.

Gauri turned around, a few paces away from her, and rubbed at her forehead in thought, “That method is enormously painful and could prematurely stimulate labor. It has been done with some success, but does not always work.” Gauri paused, “But we can ask Sita and discuss it with Vikram-ji if she agrees.”

Dhriti nodded and released a breath. A moment later, the three dais convened in the Suthika Griha.

“How have the pains been?” Gauri asked, approaching the cot Sita was perched on.

Sita answered, “Still under the navel and it has been happening more often.” Sita looked down at her stomach and swallowed, “I am scared, Gauri-ji. Will my baby be safe?”

“These births tend to be more difficult than most. We often cannot predict how it will go,” Gauri crouched on the ground so her eyes were level with Sita’s. “But we will do all we can to keep you and your baby safe.” Sita nodded. “Now, we do have something we can try. Vikram-ji, the vaidya, can try to massage the baby into the correct position. But it is very painful and may not be successful.”

Sita nodded, “I want to try.” She turned to Dhriti and smiled slightly. Dhriti’s chest constricted and she prayed this would work.

Inside Vikram’s house, tables and shelves were covered with surgical tools and bottles filled with herbs. After exchanging pleasantries, Gauri explained Sita’s situation as Dhriti and Ambika guided Sita onto the cot on the ground. Vikram adjusted his dhoti, the white cloth wrapped around the lower half of his body, contemplating. He selected a bottle of oil and handed it to Gauri, now seated on the ground with the other women, “Apply that to her stomach.”

He then began massaging Sita’s swollen belly, coaxing the baby from the current position. Sita wailed in pain, unable to stifle her screams. Ambika whispered encouragements, while Dhriti kept Sita’s hair out of her face and wiped her beading sweat. A few moments later, Gauri called out, “Stop!”

Vikram and the dais froze, following Gauri’s eyeline. Water had pooled underneath Sita, darkening the orange cloth draped over the cot.

***

Sita tried to sit up, but Ambika gently eased her back and ran her fingers through Sita’s hair soothingly, “You are going into labor right now.”

Sita nodded, “Did it work?”

Ambika smiled, “We don’t know yet, but everything will be alright.” Sita nodded uneasily. The vaidya and other dais were now moving quickly, speaking in harsh whispers. The pain left her exhausted and she struggled to see what was happening. After some time, Ambika and Dhriti flanked her as she moved to a squatting position, pointing her knees outward and keeping her center of gravity low.

Since finding out her labor would be complicated, Sita had found it difficult to hang on to hope. Like a candle resisting fire, she would light ever so slightly then extinguish completely at the slightest disturbance. Now—perhaps out of sheer desperation—the flame surged.

Every inch of her body ached as she pushed. Vikram-ji and Gauri mixed herbs, either applying them to her vulva or instructing her to drink the bitter concoctions. As her baby began to emerge, the pain became unbearable. She saw Dhriti holding a cloth red with her blood, the panic clear on the girl’s face. The oldest dai examined her stomach and looked grimly at the vaidya. The flame extinguished again.

“Save my baby!” Sita cried. “Please!”

The women eased her back to a lying position. Gauri kneeled beside her and caressed her cheek, “Sita, we were unable to turn your baby. You are bleeding too much and your baby is not moving. It is very likely we can save your baby by surgical removal, but this is very dangerous for you because you will lose more blood.” Sita could see the sadness in the woman’s eyes as she took a deep breath and added, “I am so sorry.”

Sita nodded, tasting the saltiness of her tears. In and out of consciousness, she saw Vikram-ji cutting into her stomach, felt the blood pouring down her body. She thought then of the women whose babies were born without breath. Did they wish they were in her position? Giving her final breaths to her baby, born without a mother—but alive.

She wondered who her child would grow up to be. Would they think of her? Or would she be forgotten, nothing more than the vessel that brought them here? A vessel. In pain, and fearful, Sita found some comfort in knowing that instead of being scorned as a woman who failed, she might be honored as a mother who died trying.

The final image she saw was her wailing baby girl wrapped in a bloodstained cloth, held by the young dai. As her eyes closed, Dhriti and her baby blurred into one.

Anisha Kumar is a graduate of Georgetown University, where she studied neurobiology and the medical humanities. Kumar, who has worked as a medical assistant, is now applying to medical school. She hopes to continue creative writing as she pursues her goal to become a physician as a way of exploring the patient-provider dynamic and communicating the humanistic themes she encounters in healthcare settings.

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