5.1 Purpose and Procedure
This Project RISE data collection effort occurred in April 2021, in the final phases of the analysis. We conducted two focus group discussions with five of the PCI investigators who collected qualitative and quantitative data for the Project. These PCI investigators have extensive expertise on the topic. They have directly collected most of the Project RISE data, including FGDs, KIIs, vignettes, and quantitative surveys. Furthermore, they are women and mothers from Bihar who have worked on many maternal and health projects over the last several years.
Their expert input was an invaluable way to make a ‘final check,’ of sorts, on our ritual description.
The discussions were conducted with video calls via Zoom, in two two-hour sessions, during the third week of March 2021. Each session consisted of the same five PCI investigators selected based on their experience and participation in the project. The insights generated through these interviews are synthesized as a perinatal narrative account that includes traditional, normative, and biomedical aspects of a ‘typical’ maternal experience in rural Bihar.
The specific questions asked were organized into groupings that follow the perinatal journey.
The following table gives the set of questions that were used to generate discussion. These were used as a kind of checklist, to ensure all the needed topics were covered. The questions were presented as a third-person narrative and based on other Project RISE findings to help steer the conversation. Ample followup questions and other clarifications were also given.
| Question number | Question |
|---|---|
| Pre-Pregnancy | |
| 1 | Roshni is a 21-year-old married woman living in Nayatoli village in Bihar. She is in her 2nd year of marriage and lives with her husband and in-laws. Roshni and her husband ‘Bablu’ are planning to have their 1st child. Are there any traditional/biomedical therapy or medicines Roshni would take to ensure pregnancy? What about other women in Bihar? When would other women in Rural Bihar have to start planning for their first child? |
| 2 | Are there any special pooja/rituals Roshni would perform to ensure pregnancy? What are the signs and indications of pregnancy commonly used in Rural Bihar? |
| Trimester one | |
| 3 | One day Roshni realizes that she missed her period for the month and wondering if she is pregnant. • What would be her first few steps? (how she becomes sure of her pregnancy) |
| 4 | When and how Roshni’s family is going to share the pregnancy news outside the household? When sharing news outside, is there going to be a different approach in sharing the information with various social groups like relatives, neighbors, other community members? What precautions would her family take in sharing the news beyond family, and what would be the reasons for these precautions? (like evil eye, risks associated with sharing the information) (Would Roshni be concerned about these risks if the pregnancy is not known to others. |
| 5 | What are the rituals and traditions Roshni and her family would follow once they are sure of the pregnancy? and why? |
| 6 | In Hindu traditions in Bihar, do pregnant women change prefer to pray to particular gods/goddesses, moreover others during the pregnancy? And what are the reasons for these preferences? Are there special pooja (prayers) prescribed for women in their early pregnancy? If yes, what are the reasons for these special prayers? |
| 7 | What are the dietary changes Roshni is supposed to follow & why? What other dietary changes have you have seen being followed by other women in Bihar (or by yourself) during their first few months of pregnancy? What other precautions should Roshni take in her first few months (related to work, movement, religious duties, intercourse, etc.)? & why? |
| 8 | In which month would Roshni meet ASHA for her pregnancy registration? How does ASHA come to know about Roshni’s pregnancy? How frequently is ASHA going to visit in the first few months of pregnancy? & why? |
| 9 | When would Roshni start receiving free Ration from the Anganwadi (ICDS scheme)? How is the process, and till how long would Roshni receive Ration? |
| 10 | When in the pregnancy, Roshni would visit the Primary Health Centre (PHC) or a doctor for the first time? Discuss the reasons? |
| 11 | Is Roshni or her family is going to call/consult Dai during the first trimester? What about other women in rural Bihar? What services Dai usually provide in the first few months of the pregnancy? |
| Trimester two | |
| 12 | Roshni is in her 5th month of pregnancy. The baby bump is becoming prominent. • Roshni’s mother suggested her to come home for the remaining few months of pregnancy. Is it common for pregnant women in Bihar to go to their parent’s place during pregnancy? Does such transition happen in every birth, or is it associated with particular birth order? Usually, for how long, the woman stays at her parent’s house? |
| 13 | If such transition happens, what is its implication for Roshni’s prenatal care, whether its about connecting with new ASHA, hospital selection, immunization, etc.? |
| 14 | Are there precautions/practices primarily associated with this pregnancy stage (2nd trimester) that Roshni should follow? Discuss along with the reasons. By the 2nd trimester, how many Antenatal check-ups would Roshni have gone for? Is it common for other women in rural Bihar to receive XX number of ANC check-ups in the 2nd trimester? In which month would Roshni get her 2nd Tetanus (TT) immunization? |
| 15 | Are there any dietary changes Roshni is supposed to follow during the 2nd trimester & why? What other dietary changes have you have seen being followed by other women in Bihar (or by yourself) during 2nd trimester months of pregnancy? |
| 16 | Are there any Rituals/ pooja Roshni should perform, especially during this stage of pregnancy? Are other women in rural Bihar perform any Ritual/prayers to particular deities) during the 2nd trimester? Discuss with Reasons. Frequency of the prayer/Rituals |
| 17 | Is Roshni or her family is going to call/consult Dai during the 2nd trimester? What about other women in rural Bihar? What services Dai usually provide in the middle of the pregnancy |
| Trimester three | |
| 18 | Roshni is in her 8th month of pregnancy, and the baby bump has become very prominent. • When would Roshni and her family start the birth preparedness (deciding the delivery place, who will accompany, transportation, setting aside money) for the delivery? For other women in Rural Bihar, when does birth preparedness starts in the pregnancy timeline? |
| 19 | Who in Roshni’s family (including Roshni) is going to decide on the place of delivery? Does ASHA get involved in this preparation (with how and when this happens) |
| 20 | Are there any common prescriptions for rest, household chores, sleep, etc., Roshni would take in the last few months of pregnancy? Who would give such advice? What are the associated risks and fears? |
| 21 | As the delivery date comes closer, are there any particular practices, rituals, or prayers Roshni/her family should do to eliminate the fear of delivery complications? Discuss the frequency and the reasons. |
| 22 | Are there any dietary changes Roshni is supposed to follow during the last few months & why? What other dietary changes have you have seen being followed by other women in Bihar (or by yourself) during 3rd trimester months of pregnancy and near the due date? |
| 23 | By the 3rd trimester, how many Antenatal check-ups would Roshni have gone for? Is it common for other women in rural Bihar to receive XX number of ANC check-ups in the 3rd trimester? |
| 24 | Its the 9th month of pregnancy. One day, Roshni feels intense pain in the lower abdomen, and she assumes that labor pain has begun. What are the steps Roshni/her family is going to take? Whom would they call? |
| 25 | What are the significant rituals/routines/traditions conducted when a woman goes for delivery (for the mother’s safety/well-being and the child she is giving birth to)? Are the same rituals followed when a woman gives birth at home? Who mainly performs these rituals? Do they have any connection with the health of the mother or the child to be born? |
| Delivery postpart | |
| 26 | What other processes would Roshni/her family go through while she is in the hospital? How long would Roshni stay in hospital if there are no such complications, and the delivery is normal? Is it similar to other women from rural Bihar? |
| 27 | What are the significant practices/rituals/prayers Roshni/her family would conduct immediately after the delivery – for the mother and the child? What are the significant risks these rituals and traditions target? |
| 28 | Do these rituals vary by the birth order, sex of the child, and place of delivery (at natal home Vs. in-law’s place) |
| 29 | When would Roshni start breastfeeding the child, and are there any prayers/rituals before initiating the breastfeeding? How common is it to feed newborns Pre Lacteals/early lacteals in Rural Bihar? Discuss with reasons |
| 30 | What the first few steps/processes taken once Roshni and her newborn child arrive at home? In Rural Bihar, what are other special rituals/prayers and traditions commonly followed once the new mother comes home with his child? |
| 31 | Would Roshni and her child go in a quarantine (separate room) once they arrive at home? Does it vary by the position of stars, birth order, sex of the child, community, and generation? When quarantined, would Roshni and her child sleep together or in a separate room? |
| 32 | Who all are allowed to enter the room where they are quarantined? |
| 33 | What foods are given or not given (prohibited) to Roshni during the quarantine period? Discuss with reasons in terms of risks prohibition/benefits. |
| 34 | When the quarantine is broken – ‘chatthi’ (6th day), ‘barahi’ (12th day), and ‘sataisa’ (27th day)? How are they different? Do people in your community still practice ‘sataisa?’ What all rituals involved in ‘sataisa?’ When does the child undergo the naming ceremony? Who all participate in the ceremony? Who decides the name? Is the priest or maulana involved? |
| 35 | Does Roshni’s husband conduct any special ritual between pregnancy and early infancy? What are those? |
| 36 | Is Roshni or her family is going to call/consult Dai during the first few days/weeks? What about other women in rural Bihar? What services Dai usually provides during this period? |
| 37 | Would Roshni get visits from the ASHA after delivery? how frequently these visits happen and what is the frequency of such visits? Would go for any routine medical checkups (if there are no known complications)? What about other women in Rural Bihar? |