[Reprinted from the American Gynecological and Obstetrical Journal 
for February, 1896.] 
MIDWIFERY IN GOA. 
By Viviato J. Pinto, M. D., 
Professor of Anatomy and Medical Jurisprudence in the Medical School of Goa, 
Portuguese India. 
Midwifery here is a profession which any woman takes up without 
suitable training. A woman who attends a few labor cases thinks she 
knows enough of the practice. Fortunately, such midwives are now 
falling into disrepute, and qualified practitioners are called in, chiefly 
by the better classes. 
A brief description of the old superstitious practice will be in- 
teresting because, notwithstanding its tyranny, the people appear to 
have resisted its ill effects by reason of their constitutions, which are 
stronger than ours. 
Pregnant women are not allowed to eat, for fear of abortive 
properties, of the cooked leaves and fruit of Guilandina moringa and 
Cucicrbita melopepo ; the ripe fruit of anonac, Cucumis melo, Ariocarpus 
integrifolia, Ananasa sativa, Anacatdium occidentale, and plantago (a 
species which produces large plantains) ; the tender shoots of Andro- 
pogon bambus and Brassica oleracea gcngiloides. 
The following are reputed to produce cold : Vinegar, the fruit of 
Cucurbita citrulus, Cucumis sativus, Eugenia jambulana, Punicagranaium, 
Garcinea purpurea, Averrhoa carambola, and Zizyphus jujuba, and they 
are accordingly prohibited. 
Pregnant women are allowed neither to live in the neighborhood 
of a confined woman nor to visit her from the third to the eighth 
day. They are enjoined to wear their dress somewhat tight lest the 
foetus should invade the thoracic cavity! 
Up to the sixth month of pregnancy, and not later, they may re- 
new the country bangles worn on the wrists. They must not do this 
later, lest the umbilical cord should twist round the neck or limbs of 
the child. 
Cold baths are prohibited and backaches are treated with conjee 
(gruel) of Trigonclla feenum-grcecum. 
They must not sit on the doorsteps nor on brooms (made of the 
midribs of cocoanut leaflets), tether cattle or do similar work ; and 
Copyright, i8g6, by J. D. Emmet, M. D. Viviato J. Pinto, M. D. 
during an eclipse they are strictly prohibited from pounding or crush- 
ing anything and handling a knife or other cutting instrument, be- 
cause it is believed that the cutting of the leg of a chicken, for 
instance, causes the amputation of the corresponding part of the 
child, and so on. 
During the sixth and the eighth months, crossing the limits of the 
village is supposed to be hurtful. 
From the seventh month of pregnancy to three months after the 
confinement cold water is not to be touched, and at the end of the 
second or third week of the seventh month two ounces of blood or 
more are withdrawn by venesection, regardless of the state of their 
health, and, two days after, a purgative dose of magnesia is given. 
The above are about all the hygienic and therapeutic measures 
taken by the midwives during pregnancy. 
When a woman has pains, whether true or lalse, the midwife, un- 
able to diagnose them, administers an infusion of onions, cumin seed, 
Trigonel/a foenum-grcecum and the bark of a mango tree (Mangifera 
indica) that has not produced fruit, to decrease them if false or to 
increase them if true. In the latter case the poor woman is imprisoned 
in a small, dark, ill-ventilated room, in which, to add to her misery, 
a number of female friends or neighbors gather and, by way of 
lightening her pains, recount, in all their details, cases of difficult 
labors they may have heard of; to make matters worse, some of 
them turn the small apartment into a smoking room. It may be 
imagined what an overwhelming depression must get hold of her, par- 
ticularly if she be a nervous primipara. 
When the os dilates so as to admit a couple of fingers the poor 
woman is seated on a rectangular wooden stool having a large open- 
ing in the center under which some cloth or a vessel is placed, and 
the midwife sits behind her to make the necessary manoeuvres : the 
woman’s head is tied with a common rough string across the forehead 
to prevent vertigo and a towel is coiled round at the level of the 
xyphoid cartilage to retain the child in the abdominal cavity. It is 
said that a child, in the absence of this precaution, once laid hold of 
the mother’s heart, which was only released by a quack timely 
puncturing the child’s hand through the cardiac region ! The ab- 
domen is rubbed with oil or the yolk of an egg to facilitate the labor, 
and the former is also applied to the sacral region to relieve the back- 
ache. The genital canal is oiled, irrespective of uterine contractions, 
and oil is also applied, even during a contraction, to the uterine 
cavity as far as it can be done. No matter what the stage of the labor Midwifery in Goa. 
3 
may be, expulsive efforts are urged. The perinaeum is supported by 
pressing upon it with a piece of cloth held in the hand, from below 
upward during contractions, and is oiled during the intervals. 
At the end of the second stage a metal vessel is beaten upon to 
make the child fearless, and the baby is not separated from the mother 
even if it cries lustily. After this they proceed to extract the placenta 
(either while the patient is seated or is upon her knees, kept wide 
apart), the retention of which, whether due to uterine fatigue or not, 
is appalling to them. Abdominal frictions with the juice of onions 
are then made, the hair of the confined woman is rubbed on her 
tongue, worms and the faecal matter of animals, draughts of wood 
ashes, or the raw juice of a chicken pounded to a pulp, are given to 
provoke nausea. Should these means fail to cause the expulsion, the 
midwife actually catches hold of the cord and keeps tugging at it, and 
some, more rash than others, introduce the hand and somehow or 
other extract the placenta, of the integrity of which they can not 
judge, and so rest satisfied with the feat. The placenta is then buried 
somewhere in the house. 
All this time the newborn child, quite unprotected, either remains 
on the ground, soiled with blood, or in the hands of some charitable 
woman. Under the umbilical cord a towel is laid for receiving, from 
the near relatives of the newborn, presents of money for the midwife ; 
after this ceremony the cord is ligatured, nine inches long, and divided, 
and the child is handed over to some one ; the knife, together with the 
worn-out broom used for sweeping the room, being placed under the 
mother’s pillow during the puerperium. 
Should there be haemorrhage after the third stage, the only haemo- 
static used is a stimulating fomentation, which sometimes, added to 
syncope, stops it. 
Regardless of the state of the uterus and the pulse, the midwife puts 
on the binder—a piece of cloth of extraordinary size, about a foot wide 
and twenty-four feet long, coiled round and round the abdomen—the 
poor patient standing up with or without support. This operation is 
repeated every day during the puerperal period. Thick folds of cloth, 
on which is poured a glass of Lisbon wine (or of country liquor, in the 
case of primiparae), are used for receiving the lochial discharge, being 
renewed only when soaked, no matter what time this takes. The 
genitals are washed by seating the patient on the aforementioned 
square stool—whether the lochial discharge is offensive or not—and 
the perinaeum, lacerated or not, is considered of no consequence. 
With this the parturient is marched off to her bed, generally spread 4 
Viviato /. Pinto, M. D. 
on the ground, in which she has to sit up, supported or not, for a 
couple of hours. This posture is warranted by the sage femmes to 
avoid vertigo, syncope and convulsions ; if it does not, all other means 
are tried but the position is not altered. While in the same position 
a glass of country spirits is served to whet the appetite, followed by a 
large quantity of coarse rice and curry, regardless of her digestive 
powers. Naturally she devours it, both on account of the stimulating 
effects of the liquor and of the long fast. This results in after-pains, 
which are treated with liberal doses of the same stimulants. It is also 
abundantly served to all present, whether they like it or not, so that 
the fumes of the drink pervade the whole house. This is the case 
especially when the firstborn is a male child. 
The child is violently rubbed with a mixture of tamarind pulp, 
yolk of an egg and rice flour, then with oil, and is finally washed in hot 
water mixed with Lisbon wine or country liquor, the poor little thing 
crying piteously all the while. During the inunction various parts of 
the head and face are, as it were, molded into proper shape—for in- 
stance, if the forehead bulges out it is pressed in, if the nose appears 
flat or short it is elevated or pulled down, and so on. The process of 
shaping is carried on for a couple of weeks or more, and to it alone is 
ascribed the regularity of the features. A foot bath in hot oil is given, 
and pieces of cloth soaked in oil are put on the head for curing any 
chill. The child is then wrapped in cotton stuffs and given insipid 
rice conjee or thin gruel, sometimes mixed with castor oil sweetened 
with jagghery, for two days; then it is put to the mother’s breast. A 
very hard experience for the poor creature at the very outset of life ! 
In the case of stillborn children an attempt at resuscitation is 
made by. as it were, breathing life into them, as follows : They are 
fomented with hot oil and treated with the smoke of country cigars 
(made by rolling tobacco in dry plantain leaf) held in the mouth by 
the lighted end, the smoke being blown through the other end into all 
the orifices of the body ; or with breath impregnated with garlic, crushed 
and held in the mouth. If these efforts be fruitless, the midwife has 
recourse to suction at the meatus urinarius and ostium vaginae. To 
conduct or maintain heat, the placenta with the cord intact is placed 
in a saucepan full of oil and left to boil over a charcoal fire—for many 
days in the case of prematurely born children and until signs of re- 
turning life are manifested in that of stillborn children. 
During the remainder of the first day the parturient woman lies 
down or sits up a while, but she is deprived of rest by the numerous 
female visitors ; from the second day she is at liberty to do either at Midwifery in Goa. 
5 
pleasure. On the fourth day fish enters into the dietary, as well as 
cakes made of rice flour and jagghery. Uncooked fish is never to be 
taken to the lying-in apartment, as it is supposed to be hurtful. The 
leaf of Piper biile, some of the nut of Areca catechu, and extract of 
Acacia catechu with a little lime are given to the lying-in woman, to be 
chewed, a little of the juice being sometimes given to the child. The 
umbilical cord, which was secured to the abdomen, is now tied to the 
groins or to the neck. Strings of black thread are tied round the 
waist, wrists and neck of the child. Lampblack mixed with oil is 
applied to the sclerotic conjunctivae of mother and child and to the 
latter’s navel. On the night of the sixth day the mother sits up, tak- 
ing the child, without a wink of sleep, and is roused immediately if 
she happens to dose. The friends and neighbors of either sex, pos- 
sessed of spirits (alcoholic), make merry in the house, singing to the 
sound of the batoque—a drum made out of a barrel-shaped earthen 
vessel, having two opposite openings, one about three inches in 
diameter and the other about twelve, the latter being closed with the 
distended, dried skin of lacerta iguana, which is tightly drawn over 
and secured to it—to drive away the so-called sotvee (tetanus ?), highly 
fatal both to mother and child, and which, it is believed, is carried 
away by the midwife on the next day. 
On the seventh day the patient, changing all her clothes but not 
the binder, shifts to another apartment prepared for her. 
On the eighth day a purgative is given and from the tenth, if the 
woman is all right, she takes a daily bath. All baths are given in the 
morning, preceded by massage with cocoanut oil, and followed by the 
administration of a glass of wine or spirits. Formerly the bath was 
given from the second day. 
During the puerperal period she changes her dress as often as she 
dreams, the clothes being previously washed, dried and subjected to 
aromatic vapors from burning incense or flowers of Lavandula vera. 
Those who have no spare clothes wear what they have on, after duly 
fumigating them. 
During the labor, liquor is given but no food except rice conjee, 
if needed. After-pains are treated with fomentations and carmina- 
tives, such as ginger, onions, etc. Any wound in the perinseum is 
treated by the application of irritants in the second week. Poor 
people reassume the household duties after the twelfth day and 
others keep their room, which always remains closed for a month. 
The binder is used for five weeks, in the case of the birth of a female 
child, and longer in that of a male.