What does it take to save a life?

A mother-in-law

Older woman with a bright yellow sari, kneeling and holding her grandchild.

“The mother-in-law makes the decisions in the house,” Anjani says shyly as she peers out from a red and black sari pulled over her face. Like most Indian women, Anjani moved in with her husband’s family when she married. The decisions of her mother-in-law, Savita Rai, include where Anjani will give birth and how she’ll care for her baby.

Women like Savita are often midwives to their grandchildren, using practices they learned from their own mothers-in-law. And like Savita, they don’t know that many of the practices contribute to high infant and maternal death rates in India. Changing centuries of tradition requires engaging all members of a family, including mothers-in-law.

One place that engagement takes place is mothers’ group meetings organized through PATH’s Sure Start project. When Anjani was pregnant, the local community health worker invited her and Savita to the meetings. Savita went first to make sure Anjani wouldn’t be exposed to “any destructive teachings.”

“I didn’t know”

What Savita found instead was information—often communicated through games and stories—about how to make sure mothers and newborns survive childbirth and the critical days that follow. Years before, Savita had lost a baby of her own, a son who died after only 14 days.

“We used a dirty blade to cut the cord,” she says. “We gave the babies cow’s milk—we thought it was god’s milk. I didn’t know about covering the child to keep it warm. I didn’t know about giving birth at the health center or vaccinations. I didn’t know about any of it.”

Born in the health center

Savita brought Anjani to the next mothers’ group meeting, and she made sure that her grandson was born in a health center.

For Anjani, Savita’s support has been critical. “If she comes to the meetings and learns the good practices, she will follow them. And then my husband won’t resist doing the birth preparations or going to the health center.”

“I’ve learned how to take care of the mother and child,” Savita says. “Now I’m not so worried about my daughters-in-law or my grandchildren.”