Concealed pregnancies and protected postpartum periods: Defining critical periods of maternal health in Nepal

What counts as a critical period for action and intervention in improving maternal health? Using ethnographic interviews alongside descriptive data from the Nepal Demographic and Health Survey, I analyze two critical junctures for maternal health, the antepartum and postpartum periods, in the context of a particular peri-urban community of Nepal. The postpartum period is socially recognized as sutkeri for Hindu Nepalis, a forty-day period in which a woman who gave birth is considered ritually polluted, but also particularly susceptible to long-term health problems if proper care is not taken for her body in its vulnerable state. This perception of bodily vulnerability and mandated care while sutkeri exists in stark contrast to the absence of such notions and protective practices for the period of pregnancy. Pregnancy, an outwardly visible sign of sexual activity, is a state that one should hide or minimize in order to maintain one’s reputation and honour as a woman. Women worked to conceal their pregnancies, and typically no or little extra care was provided to women to meet their nutritional needs or to enable them to avoid hard physical labour. However, intersecting statuses, such as caste and class, and contexts, such as agricultural households and multi-generational households, crosscut any simple characterizations of the pregnancy and postpartum periods—even within the confines of a subgroup of the Nepali population (Parbatiya) in a single community and place.

Available in The Anthropological Demography of Health, Oxford University Press 2020