my corner

This year, I took an introductory course on religion, and I was so excited for the module on Hinduism. Hinduism is something I have always been curious about. It’s one of the world’s oldest religions with so many different practices and deities, and of course, the caste system. I’ve always wondered how caste discrimination can be reconciled with religious practices. I took this course as an opportunity to do some research on my own time about the caste system, while focusing my efforts within the specific context of the maternal health care system in India. I would like to preface that this is by no means a critique of the religion or its practices, but instead an overview of how the caste system impacts maternal care, and my opinion on how we can improve care while adhering to religious scriptures. I am not a Hindu myself and I would love to hear the perspective of different faiths in the discussion below. I’m looking forward to hearing your thoughts and starting a conversation.

India’s traditions have historically been marked by the hierarchical caste system. This religious structure classified individuals into categories, from the privileged Brahmins to the historically marginalized Shudras. Particularly significant is the concept of pollution associated with the Dalits and its implications for women within the group. These perceptions have profound repercussions. Among these, maternal health emerges as a critical concern. This post seeks to explore the ingrained perceptions of pollution within the caste system and their ramification on maternal health in India, positing that these longstanding biases have created significant health disparities for Dalit women. 

Firstly, the caste system must be put into the context of the religious beliefs held by Hindus. The caste system can be traced back to its origin in Hindu scriptures such as the Rig Veda, which introduces the cosmic being, Purusha. The castes emerged from his dismemberment: the Brahmins (priests) from his mouth, the Kshatriyas (warriors) from his arms, the Vaishyas (merchants) from his thighs, and the Shudras (servants) from his feet (Rig Veda 10.90). The story emphasized the theme of Dharma, that all social groups have their own individual obligations, and that fulfilling these obligations is necessary to maintain social and cosmic order. Fulfilling the caste obligations is considered a natural extension of the universe. 

Hence, the social structures were legitimized by revelation. As the caste framework evolved, so did notions of purity and pollution, pushing the Dalits, or the “Untouchables” outside of this fourfold system. “Pollution” refers to a deeply ingrained belief that lower castes, specific life events (menstruation, childbirth, etc.), and even occupations possess inherent impurities. It extends such that interactions with “polluted” individuals can contaminate others, leading to social customs aimed at avoiding these interactions. The Manusmriti is another Hindu scripture that codifies social rules about purity and pollution, for example, these instructions:

“A woman, during her monthly courses is not fit to be seen by other men; during that period she she should keep herself concealed and should not stay in her husband’s house.” (Manusmriti 5.66-67)

“If one (a member of the twice-born classes) has touched a Candala, a woman in her menses, an outcaste, a woman who has recently given birth, a corpse, or one who has touched any of these, he becomes purified by bathing.” (Manusmriti 5.85).

As the caste system evolved, the customs and norms further marginalized the Dalit women, cementing their association with pollution. 

These deep-rooted beliefs have adversely affected maternal healthcare access for Dalit women. Many healthcare workers (who are higher castes) fear contamination, often displaying an overt reluctance to treat those from lower castes. For example, 33% of public health workers refuse to enter lower caste homes (Khubchandani 163). Furthermore, there is a perception that the process of birth itself is polluting, but maternal care by nature relies on touch and proximity. As a result, upper caste healthcare providers prefer to care for only women of higher castes, while lower caste women seek care from traditional attendants to avoid embarrassment, or forgo care at all. Based on a 2008 study in Uttar Pradesh, 20% of upper caste women accessed prenatal care, while only 8% of lower caste women did (Saroha 10). Furthermore, upper caste women were five times more likely to deliver their babies with a skilled attendant than lower caste women are. The large number of women who do not receive adequate care in India due to caste customs has resulted in almost a quarter of maternal deaths worldwide. 

The caste discrimination faced by women in India has led to tangible ramifications of increased mortality. From the perspective of the Rig Veda and the Manusmriti, there are written commands that demonstrate that people of different castes must be treated in different ways, and that the fear of pollution is somewhat justified. In this case, how can we deal with the mortality and implications for women?

I believe that the key to resolving this issue is to have a holistic understanding of Hindu scripture. Yes, there are quotes which clearly dictate that there is a hierarchy, and that certain acts and events are impure. However, the essence of Dharma is righteousness, and by this definition, any effort to uplift the health of marginalized sections of society is aligned with the principles of Dharma. Crucial concepts in Hinduism include compassion, non-violence (ahisma), and universal equality.

“One should not do to another what one regards as injurious to oneself. This, in brief, is the rule of dharma. Other behavior is due to selfish desires” (Manusmriti 6.92).

This quote highlights the Golden Rule of Reciprocity. The principle of non-violence (ahimsa) and compassion (karuna) suggests that providing care to lower caste women, especially in vulnerable conditions such as childbirth, is a fundamental duty that transcends concerns of ritual purity. Neglecting to provide care would be a form of harm, which goes against these core principles.

“The humble sage, by virtue of true knowledge, sees with equal vision a learned and gentle Brahmana, a cow, an elephant, a dog, and a dog-eater (outcaste)” (Bhagavad Gita 5.18).

The recognition of the divine in all beings and the vision of equality espoused in the Bhagavad Gita emphasize that all individuals deserve equal treatment and care. This directly counters any justification for discrimination based on caste. A holistic understanding of Hindu literature means to not only focus on specific duties, but understand them in the context of the higher duties as well. By addressing these disparities, India not only upholds the principles of social justice but also strengthens its commitment to safeguarding the well-being of all its citizens.

Finally, the notion of certain events, acts, and people being considered impure can be reconciled with providing proper maternal care to women of lower castes. As the quote earlier mentioned, yes, birth is considered impure, but there are steps that can be taken to purify those in contact afterwards. The Manusmriti and other texts do mention purification rituals for those who come into contact with impure situations, suggesting that any perceived impurity can be addressed through these rituals. Hence, upper caste individuals with medical training can indeed provide maternal care to lower caste women. The provision of care aligns with the higher principles of Dharma, emphasizing duty, compassion, and the protection of life. After providing care, healthcare providers can follow the prescribed purification rituals to address any concerns about impurity. This approach allows them to fulfill their ethical and professional responsibilities while adhering to their religious practices.

Maternal care should be provided to all women, regardless of caste. Though the caste system is certainly ordained, that doesn’t mean caste discrimination is. In Hinduism, all creatures are divine, and fulfilling your Dharma is not just achieved by following your individual duties. Furthermore, there are steps to be taken to purify oneself. With this in mind, the crisis of inequality in maternal care can be resolved while adhering to religious beliefs. By addressing these disparities, India not only upholds the principles of social justice but also strengthens its commitment to safeguarding the well-being of all its citizens.

Works Cited

holybooks.com. Rig Veda. holybooks.com, 2018. holybooks.com, chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.holybooks.com/wp-content/uploads/RigVeda.pdf.

Khubchandani, Jasmine. “Caste Matters: Perceived Discrimination among Women in Rural India.” Archives of women’s mental health, vol. 21, no. 2, 2018, pp. 163-170. https://pubmed.ncbi.nlm.nih.gov/29034410/.

Saroha, Ekta. “Caste and maternal health care service use among rural Hindu women in Maitha, Uttar Pradesh, India.” Journal of midwifery & women’s health, vol. 53, no. 5, 2008. https://pubmed.ncbi.nlm.nih.gov/18761290/.