Drawing on her fieldwork, Pragya Roy critically analysis the everyday embodied material realities of Dalit motherhood(s) through the nexus of caste, gender, and economic class.
Note: This is an individual case study, and all quotes are from Poonam, a Dalit woman participant who generously shared her experiences. All identifiable markers have been anonymised to protect participant privacy.
Poonam (34) and I met during my PhD fieldwork. She had recently undergone a ligation, a permanent surgical method of contraception that blocks/cuts the fallopian tubes to prevent future pregnancies. She had the procedure following the birth of her fourth daughter, who tragically died a few months later from a blood infection. In the morning of our interview, we sat in the local anganwadi (an integrated child development service centre) in Slum 1 (name changed), located next to one of Kolkata’s largest markets and several government welfare offices. Before starting fieldwork, I planned to study centrally-located, well-connected neighbourhoods near major medical facilities; the most ‘urbanised’ parts of the metropolis. Early scoping visits and conversations with frontline health and NGO (non-governmental organisation) workers revealed that urban-poor Dalits in central Kolkata largely live in (lower)caste-marked slums, tied to sanitation work. My research site thus emerged from these early encounters, rather than from a predetermined plan.
In Kolkata, caste and socioeconomic class are closely intertwined. The caste [জাত (jat in Bengali) / जाति (jati in Hindi)] system in India is an institution rooted in Hinduism and organised around birth and heredity. It has historically legitimised caste centred material inequalities through unequal access to land, income, and education, and assigned Dalits degrading, low-paying sanitation work. For Dalit women, gender further compounds these injustices. Yet, dominant upper-caste groups continue to deny caste’s contemporary relevance, invoking a rhetoric of urban castelessness (Deshpande 2013). They claim that caste no longer matters in big cities like Kolkata, with its meritocratic labour markets and liberal values. This denial is strategic, allowing them to benefit from the very system they claim no longer exists. Dalit women’s maternal health experiences expose this contradiction, showing that denying caste’s urban presence does not end its impact. It only obscures and sustains it.
Available data on caste, although limited, shows how it is structurally embedded in urban life, through the overrepresentation of Dalit communities among sanitation workers who manually clean and maintain rapidly urbanising and increasingly polluted Indian cities (WaterAid India, Centre for Equity Studies and ARUN, 2018). Despite being the ‘labouring backbone of urban India’ (Ranganathan 2022), Dalit families often live in unsanitary and under-resourced urban environments. Yet, the impact of these conditions on Dalit (outcaste) women’s lives, particularly their maternal and reproductive experiences, remains underexplored. Existing caste-health research is heavily rural-focused (Yadav and Jena 2020; George 2015), overlooking distinct, urban, caste-centred health inequalities. And wherever Dalit women’s health is addressed, it is typically treated as an afterthought or as an add-on to broader inquiry. Poonam’s story intervenes this gap by foregrounding the everyday, embodied maternal realities of Dalit women like her, who find themselves subordinated within a nexus of caste, gender and economic class-based marginalisation.
Dalit women continue navigating (often multiple) pregnancies, childbirth, abortions, miscarriages, and management of contraception in extremely resource-deprived settings. In spite of its central location, Poonam’s slum, for instance, has 934 registered residents who share just eight common toilets; four for women and four for men, undermining reproductive health, hygiene and privacy. Families of three or four, sometimes even seven or eight, across generations, live, cook and sleep together in one-room houses. Such housing conditions leave no space for privacy and rest, both of which are essential during pregnancy and postpartum recovery. Poonam, who has experienced four pregnancies in her one-room house, shares her reality,
“We do not have any personal rooms. The houses here are so small, everyone adjusts in them. Our house is very small, but our family is very big. I have three kids, a brother-in-law and a sister-in-law. They again have two kids. And I have my mother-in-law. She is always sick. She has a pacemaker in her heart. My mother-in-law sleeps on the bed, with two of my daughters and my husband. And besides the bed, on the floor, my sister-in-law and her two kids, one of my daughters and I sleep. My brother-in-law goes to sleep outside in the streets.”
Gender norms around domestic labour intensify these material hardships. Women like Poonam are expected to perform physically demanding tasks, such as queuing in line to fetch water twice a day in large drums (see image 3) from communal taps for daily household chores, even during their maternal health conditions. Though rooted in dominant, brahmin (upper-caste) patriarchal structures, other gender-based restrictions such as early caste endogamous marriage and childbirth, control over movement, obedience, chastity, domesticity, and patrilocality are imposed, internalised and enacted even within lower caste communities (Paik 2016; Omvedt 2000; Rege 1998; Guru 1995). Political scientist Gopal Guru (1995) terms this as ‘Dalit patriarchy’ and insists that Dalit men reproduce “…the same mechanisms against their women which their high caste adversaries had used to dominate them.” (pp. 2549). As a result, many Dalit women remain confined within these resource-deprived slum conditions and end up spending the most time within the slum boundaries. Women like Poonam struggle to escape such circumstances due to a lack of socioeconomic independence, as they endure interrupted education, early marriage and pregnancy, and limited access to skills training that could lead to better paying and more dignified employment opportunities. Their roles as wives and mothers further tie them to these conditions, as they feel obligated to fulfil their marital and maternal responsibilities.
Despite such constraints, Poonam has defied a few of these norms, even though her act of defiance reveals her financial and social precarity. She works informally as a sanitation worker in a nearby public hospital for a meagre INR 9000 (£75.5) per month. She was compelled to take up this job during the COVID-19 pandemic when her husband refused to financially contribute and share parental responsibilities for their three children. She recalled the risk she took working in a medical setting at the peak of the pandemic,
“During COVID, there were a lot of problems in my home because my husband is not well. He drinks excessively. He doesn’t care about me. I have three children. How am I supposed to feed them? If today I had someone who would support me, if my husband was a good person, I would never do that work. That was a risky job. I did that work risking my life.”
Oddly enough, for Poonam, her workplace, despite being underpaid and insecure, offers her emotional relief from the stress of domestic life in the slum,
“When I go to my workplace, I feel relaxed. I feel better there than at home. I always feel tense here. My husband drinks alcohol and comes home. I cannot tolerate alcoholics. That is why I never want to be absent from my duty in the workplace. It is the duty there that gives me life.”
Her husband, also an informal sanitation worker, earned roughly the same INR 9000-10000 (£75.5 – £83.9) per month. Poonam shared how he had become increasingly abusive after the birth of their second child and would spend most of his income on alcohol.
Reflecting on her four childbirths, she further added,
“Nowadays, having four children is too much. People now have just one child. And it was a mistake that I ended up having four. Why did it happen? Because all four were girls. In the hope of having a boy, I had four daughters.”
Son preference is a common social issue among South Asian communities. Rooted in dominant, brahmanical patriarchal ideology, girls are seen as economic burdens (Jensen and Thornton 2003) across all caste groups (Mahalingam 2007), and women are compelled to continue childbearing until they birth a male child. Her story, however, is not uncommon. She observed that many women in her family and community endured similar realities, trapped in cycles of alcoholism, neglect, and domestic abuse, amid chronic material deprivation.
As the research interview progressed, Poonam again expressed her regrets about giving birth to four children, this time in the context of contraception management. While she planned the first two, the other two, she says, were a mistake. For most of her married life, she took Mala N tablets (a local oral contraceptive) as her husband refused to use any form of contraception. However, due to side effects, including a gall bladder condition, she was told by her doctor to discontinue it. Each time she discontinued, she got pregnant, until the last childbirth, where she decided to get a ligation,
“I was thinking, if I stop taking contraceptives, I will become pregnant again. This man is an alcoholic. You can’t really trust him. I can try to keep myself safe, I take medicines for my safety. But that man doesn’t use anything, right? He drinks and comes back home. That’s why I got the ligation procedure done eight months back. After the procedure, I am better now.”
In marginalised communities like Dalits, limited use of and access to contraceptives increases the risk of unwanted pregnancies, often pushing Dalit women towards ligation more frequently than upper-caste women (Sharma and Gupta 2024). While public health systems recognise this disparity, they tend to focus on medical solutions without addressing the social realities shaping contraceptive choices. In Poonam’s case, she was advised to stop using contraceptives without considering her vulnerabilities. Ultimately, her decision to undergo ligation, though made under dire circumstances, became her act of resistance against forced pregnancies in the face of scarce resources and partner abuse.
Poonam, just 34 years old, had also recently become a grandmother. Her eldest daughter, Priti (name changed), gave birth prematurely at 16, a year after eloping with her unemployed teenage husband, who depends on his parents (also sanitation workers) for financial support. Poonam had hoped for a different future for Priti, wanting to rewrite her life’s trajectory through her. Poonam herself was married off against her wishes at 18 and became pregnant immediately. After her father died during her childhood, financial hardships forced her to leave school. As her mother grew increasingly worried, Poonam was married off quietly, without celebration. Yet today, despite a generation between them, both Priti and Poonam live in the same Dalit slum. Like her mother, Priti’s education was cut short by early marriage, and she is now navigating pregnancy, childbirth, and postpartum struggles at a young age amid similar material deprivation and lack of kin and partner support.
Their testimonios are not isolated events but rather reflect a systemic pattern that shapes the lives of many Dalit women in India. In communities where caste, class, and gender intersect to marginalise, reproductive health becomes an individualised, lifelong task, especially burdensome during reproductive years. Maternal health is conventionally dismissed as ‘women’s work’, left to be predominantly managed by women themselves with minimal state and social support. Women like Poonam are expected to maintain their own health (and that of the foetus), navigate complex social relationships with family and health workers, manage emotional stress, physical pain, and perform everyday housework and informal underpaid work, during and beyond their maternal health journeys. In this way, Dalit motherhood(s) become physically and mentally demanding, undervalued (re)productive labour. This embodied labour becomes a critical site for reproducing, and at times resisting, caste and future generations of caste-based, exploited labour power.
The Indian state and its public health system have historically been ignorant towards caste inequalities, especially in urban contexts. For decades, empirical caste data, through a comprehensive caste census, have not been collected. As a result, current affirmative policies in education, health and employment are outdated, and caste-based inequalities remain hidden and ignored from the mainstream, urban public imagination. Upper caste groups continue to dominate urban spaces and institutions, while Dalits are forced to live in segregated, resource-deprived conditions. Political mobilisation, specifically for Dalit women’s issues, has also been challenging as Dalit women have been structurally excluded from both upper-caste feminist movements and male-dominated anti-caste politics in India (Guru, 1995).
In reproductive healthcare, the state continues to prioritise narrow biomedical models, technological developments and clinical diagnoses, without addressing the intersecting social determinants of maternal health, including caste and gender inequalities. Poonam’s lived experiences challenge these limited frameworks, compelling us to rethink maternal health. Centring Dalit women’s voices highlights intersecting oppressions, a perspective that remains underrepresented in existing public health paradigms in India. Importantly, global health frameworks also employ simple class-based analysis and binaries of the Global North versus the Global South, which homogenise the South and disregard caste from their view. Such frameworks risk masking internal inequalities, where upliftment of the country’s (Indian) maternal health metrics potentially obscures existing inequalities between and within caste groups.
A closer look at the everyday lives of urban-poor, Dalit women reveals how caste continues to be materially relevant in urban India, through their segregated slum life, historically imposed, exploitative and defiling caste-based occupations, imposition and internalisation of brahmanical patriarchy, and intergenerational poverty. This prompts us to confront structural inequalities, family dynamics, and community relationships. They push us to politicise reproductive health by holding our state and governance institutions accountable, and reframe health as a shared responsibility, as opposed to an individual one. If maternal health is to become truly inclusive, policy must shift from universalist biomedical models to intersectional frameworks that account for caste, gender, and urban poverty. This means investing not only in maternal clinics but also in Dalit women’s autonomy, respectable housing, toilets and water access, and freedom from patriarchal violence.
As for Poonam, she finishes the interview by saying she’s planning to leave soon,
“I am waiting for the day when all my daughters will be married. One of them is already married. The other two will also be married, and then I will not live here anymore. I will run away.”
About the author
Pragya is a Postgraduate Researcher at the University of Sheffield, UK. Her PhD, funded by the Faculty of Social Sciences, UoS, explores the intersection of caste and maternal health in urban India. Holding a BA and MA in Sociology, and an MA in Social Research, her research interest lies on reproductive experiences and social inequalities in South Asia and among South Asian communities. Informed by her lived experience of caste and casteism, Pragya’s scholar-activism aligns with transnational anti-caste, anti-racist, and Marxist-feminist movements. For more information, contact proy3@sheffield.ac.uk or roypragya35@gmail.com.
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