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An Indian couple embraces a new way to give birth—just in time

Mother and father with mother holding child.

Baby Depika was born safely thanks to the help of a village health worker and her parents’ wise choice.

“This was my first child,” says 25-year-old Ramsajeevan, remembering the difficult birth of his daughter Depika, “and I was scared senseless.”

Like other parents in his village, he’d assumed his wife, Archana, would give birth at home. The health center was far away. Just hiring a vehicle to take her there was more than the family could afford.

But not long after Archana became pregnant, she had a visit from the local community health worker, called an ASHA (for Accredited Social Health Activist). “She said, ‘Please come to the mothers’ group meeting,’” Archana remembers.

ASHAs are village women who teach best practices for safe pregnancy, childbirth, and infant care through mothers’ group meetings and in-home visits. They’re trained and mentored by PATH’s Sure Start project, which has reached 24.5 million people in India with information and support to make childbirth safer and children healthier.

“Because of all that we were taught, I knew that I could save my wife and child.”

In villages without doctors or health centers, the ASHAs are often the only source of this lifesaving information.

At the mothers’ group meeting, Archana sat with other pregnant village women and their family members, listening to instructive stories and playing games that reinforced new messages about safe pregnancy and childbirth. She can recite by heart what she learned: how to prepare for the birth (get a tetanus shot and adequate nutrition), how to take care of an infant (keep the baby warm, breastfeed within the first hour, vaccinate), and how to know when a pregnant woman or newborn might need help (high fever, redness around the naval).

Out of the mouths of babes

Meanwhile, Ramsajeevan was learning the same critical information from an unlikely source—a letter from his baby-to-be.

The letter, developed by the Sure Start project and delivered to all expectant fathers, is written from the point of view of the yet-to-be-born baby. In it, the “baby” told Ramsajeevan to watch for warning signs in her mother, like bleeding, blurred vision, and severe abdominal pain. “Do rush mom to the hospital immediately,” the letter read, “as these are critical danger signs.”

The letter also counseled Ramsajeevan to “save regularly for transportation and medical expenses so that you are prepared for my birth.”

Father holding a letter from his baby.

“What I read in that letter went right into my heart,” says Ramsajeevan.

“What I read in that letter went right into my heart, because it was from my child,” Ramsajeevan says. “Without the letters, I wouldn’t have even thought about it.”

A new tradition

Ramsajeevan agreed to break tradition and let Archana give birth at the health center. He also saved money to pay for transportation to get there.

And when Archana began bleeding in her ninth month of pregnancy, the couple didn’t ignore the warning sign as so many villagers had. They called the ASHA, arranged for transportation, and went to the health center, where an ultrasound showed that the baby was breech.

“It was very scary for all of the family,” Archana remembers. “We didn’t know if the baby or I would survive.”

If Archana had given birth at home, she and Depika might not have lived. But with her ASHA’s support and trained medical help the baby was born safely.

Photos: PATH/Gabe Bienczycki.