The erasure of Maya’s death also sheds light on the silence that still surrounds maternal death in India today. I first learned how death in childbirth can be oddly silenced in a modern Buddhist context in 1994. I was working as an anthropologist in the Indian Himalayan region of Ladakh, which has been Buddhist since the first century CE. One of my peers, a twenty-nine-year-old named Angmo, was unmarried when she was raped by Phuntsog, a married neighbor with three sons, who served as an assistant (khotwal) to her father, the village headman. Like many women in Ladakh and elsewhere around the world, Angmo was so ashamed of the rape that she told nobody. She kept her subsequent pregnancy hidden from her family and community. Like most pregnant women in Ladakh, she kept working until the day she went into labor, but, unlike married pregnant women, she did not have the benefit of extra meals or respite from some of the most backbreaking chores, given that her family was unaware she was pregnant. After her water broke precipitously one evening, she strained through ten hours of labor before giving birth to a stillborn son. Two local Tibetan doctors were called when she failed to expel her placenta, but they did not have the critical midwifery skills to manually remove the retained placenta, which was gushing blood in dangerous quantities. In my mind, Angmo’s retention of the placenta stood for the painful secret that she had kept hidden so long.

Although Angmo named the rapist shortly before her death at midday, her father refused to fire the assistant who had raped his daughter. In the wake of his daughter’s death, her father enforced the customary fine for rape that Phuntsog needed to pay, namely, an offering at the village altar to purify the village god and a set of clothes and butter for the future infant, which the rapist owes the pregnant woman’s family as payment. While Angmo’s father immediately sent the butter and clothes on to the monastery, as an offering of merit for his daughter’s rebirth, he seemed to bring an almost unimaginable equanimity to the situation of working with Phuntsog. I will never forget observing father and rapist working side by side at the very festival where Angmo had been raped a year earlier. Angmo’s father showed no trace of malice toward Phuntsog as he worked distributing village offerings at the annual rite to remember villagers who had died that winter, including his daughter. The lessons of Buddhist compassion and impermanence were on vivid display, even as the silence of Angmo’s father about his daughter’s death perpetuated a deeper cultural silence around unwanted pregnancies and rapes.

In the past two decades, I have heard many more stories in Ladakh about unwanted pregnancies and maternal death. Slowly, I began to understand how the silence around maternal death could reflect an unconscious scapegoating of the victim, whose death could be blamed on her karma. Similarly, the silence on rape or illegitimate pregnancies also reflects a blaming of women whose “improper” actions brought about these unfortunate incidents. As happens elsewhere in the world, the blame falls on the woman—for her actions, dress, or comportment—rather than on the rapist. When it comes to gender-based violence in many traditional Buddhist communities, women’s karmic guilt is placed front and center while men’s karma is largely occluded. The silent stigmatizing of maternal death in the Buddhist and Indian context is related to a deeper view of the unfortunate and often passive female body. Maya’s death can help us to better understand this ideology.

The earliest accounts of Maya’s delivery and death evolve in tandem with Buddhism’s growth as a major religion. The Buddhacarita, an epic poem composed in Sanskrit in the second century CE by Ashvaghosha, a Brahmin poet who had converted to Buddhism, offers one of the earliest descriptions of Buddha’s conception and birth:

That ruler of men, sporting with his queen,
Enjoyed as it were, Vaishravana’s sovereign might,
Free from sin, then, she produced the fruit of her womb,
As knowledge does, when united with trance.

Before she conceived she saw in a dream
A white elephant king
Entering her body, yet she did not
Thereby feel any pain.⁵

The Buddhacarita clearly implies that Maya conceived while “sporting” with the king after the dream of an elephant entering her side. In contrast, fifth- and sixth-century biographies of the Buddha imply her pregnancy began with an immaculate conception. Later biographies of the Buddha, such as the Lalitavistara and the Mahavastu, suggest that Maya conceived during a dream she had while keeping ten virtues, including chastity.⁶ This increased emphasis on Maya’s chastity and purity in the later texts may correlate with the heightened Brahmanic critique of Buddhist stances on purity and pollution. In Brahmanic discourse, then as now, birth and menstruation are considered highly polluting, although this is an ironic inversion of a Vedic emphasis on fertility, female power, and creation that is embodied in the feminine concept of Shakti.

The canonical Acchariya-abbhuta Sutta offers an explicit litany of Maya’s purity and virtue during her pregnancy:

When the Bodhisatta [future Buddha] had descended into his mother’s womb, four young deities came to guard him at the quarters so that no humans or non-humans or anyone at all could harm the Bodhisatta or his mother. . . .

When the Bodhisatta had descended into his mother’s womb, she became intrinsically virtuous, refraining from killing living beings, from taking what is not given, from misconduct in sensual pleasures, from false speech, and from wines, liquors, and intoxicants,
which are the basis of negligence. . . .

When the Bodhisatta had descended into his mother’s womb, no sensual thought arose in her concerning men, and she was inaccessible to any man having a lustful mind. . . .

When the Bodhisatta had descended into his mother’s womb, no kind of affliction arose in her; she was blissful and free from bodily fatigue. . . . She saw the Bodhisatta within her womb with all his limbs, lacking no faculty. . . .⁷

These stanzas affirm the virtuousness of the Buddha’s mother during her pregnancy, which in turn is supposed to safeguard the Buddha’s health and her own. The Buddha’s mother is blissful and free from affliction or bodily fatigue. The recitation of Maya’s virtues—that she kept the five precepts of no killing, no stealing, no lying, no sexual misconduct, and no intoxicants—could be read as a rhetorical attempt to ward off suspicions that her own actions caused her death. Her lack of sensual thought might be read as an assurance that her womb and body remained unsullied after the Buddha’s conception.

The Lalitavistara goes even further, endowing the pregnant Maya with the power to heal all kinds of diseases and disorders through her touch or by using healing plants, stating that “women and maidens, who happened to be afflicted by being possessed by demons or by insanity” were cured by Maya.⁸ Both the Mahavastu and the Lalitavistara record a lengthy discussion in which the gods in Tushita Heaven discuss the type of womb into which the Buddha will be born, specifying the era, continent (jambudvipa), country (magadha), caste (kshatriya), and queen. The gods decide that the Bodhisatta must descend into Maya’s womb because she is the only queen endowed with the thirty-two favorable qualities a Bodhisatta’s mother must have—including being free from defects, well-born, well-proportioned, childless, free of inherited defects from her mother’s side, and endowed with noble qualities. The Lalitavistara is at pains to highlight the fact that Maya has the ideal physical, psychological, emotional, and spiritual qualities to host a Bodhisatta in her womb.

Yet shortly after assuring the reader that no harm could befall Maya during her pregnancy, the Acchariya-abbhuta Sutta abruptly declares that Maya died shortly after the Buddha’s birth, but does not elaborate further:

Seven days after the birth of the Bodhisatta, his mother died and reappeared in the Tusita heaven. . . .

Other women give birth after carrying the child in the womb for nine or ten months, but not so the Bodhisatta’s mother. The Bodhisatta’s mother gave birth to him after carrying him in her womb for exactly ten months. . . .

Other women give birth seated or lying down, but not so the Bodhisatta’s mother. The Bodhisatta’s mother gave birth to him standing up. . . .

When the Bodhisatta came forth from his mother’s womb, he came forth unsullied, unsmeared by water or humours or blood or any kind of impurity, clean, and unsullied. . . .⁹

The precise details used to describe Maya’s pregnancy and delivery—that the Buddha’s mother was protected by deities from any harm, was virtuous, kept the five precepts, refrained from lustful thoughts, had no sickness or fatigue during pregnancy, saw the Bodhisatta intact inside her womb, carried him ten months rather than nine, gave birth standing up, died seven days after delivery, and finally that the Buddha emerged unsullied by water, blood, or other impurities—are repeated verbatim in another canonical source, the Mahapadana Sutta. In this sutta, however, the subject is the Bodhisatta in a prior incarnation as Prince Vipassi. The text explains that these details held true for all of the Bodhisatta’s prior births. This textual sleight of hand—transforming Maya’s experiences of pregnancy and delivery into ritualized rules for all of the Bodhisatta’s previous births—turns Maya’s tragic death into a paradigmatic necessity. This textual “god trick,” to use Donna Haraway’s phrase, justifies Maya’s death from the perspective of an omniscient and omnipotent Buddhist narrator who links Maya’s death to all the Buddha’s previous births, without further comment.¹⁰ However, this still leaves some doubts about what Maya’s death meant and why it was necessary.

Rather significantly, the obstetric details in the Acchariya-abbhuta Sutta passage—that Maya carried the Buddha ten months, that she gave birth standing up, and that he came forth unsullied by water, humors, or blood—could be read as a list of averted maternal complications. The ten months suggests that the Buddha was not born too early or precipitously; the description of Maya standing up may imply an easy, unobstructed labor; finally, a delivery “unsullied” by blood or water suggests that Maya did not experience a hemorrhage or premature rupture of her membranes. Premature labor can cause maternal complications even today and the other two conditions—obstructed labor and hemorrhage—remain leading causes of maternal deaths.¹¹ The detailed description of Maya’s gestation, delivery, and death could be intended to ward off suspicions that Maya’s death was accidental rather than spiritually significant.

Both the listing of Maya’s virtues and the depiction of the Buddha as unsullied by birth may have served as a bulwark against fears that Maya’s death was due to her being unworthy. By making Maya’s death necessary and Maya’s character faultless, the narrative appears to dispel doubts about why a benevolent and nonviolent Buddha would be born through a process that killed his mother. The text’s lengthy litany of Maya’s faultless actions during pregnancy and her perfect delivery of an unsullied Buddha could be read as an attempt to ward off confusion about her sudden and inexplicable death.¹²

A current of deep unease about birth and mortality runs beneath these descriptions of Maya’s exemplary pregnancy and death. In the early Buddhacarita, Maya’s delivery is described as an occasion that causes not only delight but also fear and apprehension:

When he saw the wondrous birth of his son,
the king, although steadfast, was much perturbed,
and from his love two streams of tears surged forth,
rising from apprehension and delight.
The queen was overcome with fear and joy,
like a mixed stream of water, hot and cold,
both because her son’s power was other than human,
and because of a mother’s natural weakness.

The pious old women failed to comprehend,
seeing only reasons for alarm,
cleansing themselves and doing rites for good luck,
they petitioned the gods for good fortune.¹³

There are two important points here. First, the need for purification implies that birth was seen as polluted, even for the divine Buddha. Second, the need for blessing rites implies imminent danger, possibly to Maya or the Buddha. The “pious old women” who began doing rites for good luck after being alarmed by Maya’s condition may have been a precursor of modern dais, the postpartum workers and midwives who conduct many home deliveries across North India today. As outcaste women at the bottom of both caste and gender hierarchies in Indian society, dais cut the umbilical cord and perform the obligatory disposal of the placenta and other purificatory rites that reintegrate the woman and newborn into caste and society.¹⁴

While it is unclear what is meant by a “mother’s natural weakness,” it could refer to Maya’s or the newborn Buddha’s vulnerable condition after birth. It is well known that both mother and newborn face the highest risk of mortality and morbidity in the first hours and days after delivery.¹⁵ The Buddhacarita further elaborates on danger in childbirth, calling birth a “time of danger to the body” and likening it to a “period of armed conflict”—language that clearly signals the mortal threat that pregnant women face. Although the Buddha’s birth is described as resulting in a period when women across the kingdom could deliver safely—“with great ease and on the due date . . . healthy and free of disease”—the anxiety around birth is palpable.¹⁶ There is a sense of both hope and fear when the great sage Asita comes to inspect the newborn Buddha, remarking on the promising significance of some of his traits (webbed feet and toes, wheel marks on the soles of his feet, and a sheath around his genitals). When Asita begins to weep, the king assumes that the newborn Buddha is fated for death. However, the sage explains that he is crying because he will not live to hear the Buddha’s teachings. The relieved king performs the proper purificatory rites for the Buddha’s birth after which the entire family (king, queen, and newborn Buddha) returns to the palace in Kapilavastu from Maya’s family home in Lumbini.

But Queen Maya does not live much longer. The Buddhacarita describes Maya’s death after the return to Kapilavastu in a brief, elliptical stanza:

But when queen Maya saw the immense might
Of her son, like that of a seer divine,
She could not bear the delight it caused her;
So she departed to dwell in heaven.¹⁷

Here, the Buddhacarita offers a possible motive for Maya’s death: that Maya chose death over the unbearable joy that her son’s spiritual power would bring her. Modern scholars imply that Maya preferred death to seeing her son renounce home to become a monk.¹⁸ However, this interpretation seems odd, given the universal experience most mothers have of children growing up and leaving home, which rarely drives them—especially those as enlightened as Maya—to suicide. If Maya’s temperament is indeed such that she is full of benevolence and devotion and is free from all envy, jealousy, intrigue, fault, and deceit, why would she choose death over seeing her son become a Buddha? Later textual sources inform us that Maya heard the Buddha’s teachings in Tushita Heaven, yet it is unclear why Maya would prefer to hear her son’s teachings after her death rather than live to see her son become a Buddha.¹⁹ The lack of mention of Maya’s funeral rites suggests a silencing of an unfortunate event rather than one preordained by an omniscient Buddha, as the later Lalitavistara would have us believe. As Vishvapani Blomfield notes, the brief mention of Maya’s death “strikes a dissonant note, as if an uncomfortable but important fact has somehow survived within the litany of marvels.”²⁰

The Buddhacarita tells us that Maya was en route to her natal family when “sorrow and fatigue set her mind [o]n visiting that faultless [Lumbini] grove.”²¹ The text recounts how Maya was overcome with labor pains while in the grove, where she gave birth to the Buddha standing up, holding onto the branch of a sacred sal tree. Modern authors like André Bareau have argued that mention of the Lumbini grove reflects a desire to incorporate indigenous goddess cults into the early and still fragile Buddhist religion. Yet much contemporary Buddhist scholarship has overlooked the significance of Maya’s wish to travel home late in pregnancy.

Like Maya, some women in the Buddhist Himalayas and in North India still travel to their natal homes during their first pregnancy, where they will be pampered with better food and care than they would receive at their in-laws’ house. Beyond the critical gaze of their mothers-in-law, these daughters earn a respite from agrarian chores and receive care from their own females relatives when they deliver. However, Buddhist and Brahmanic ideologies often blame women for adverse outcomes if they deliver outside the marital home.

In the Buddhist Himalayas and in North India, birth and menstruation are considered to be polluting events that symbolically disempower the birthing woman while requiring ritual management by male Buddhist monks or Brahmans. Both Buddhist and Brahmanic beliefs identify birth and female fertility as threatening to a process of purification managed by men putatively tending to local deities. In the Buddhist Himalayas, childbirth is considered polluting to the local protective deities, including clan/guardian deities (pha lha), village gods (yul lha), hearth gods (thab lha), and fertility deities (klu).²² This pollution can be contained as long as a woman remains secluded within her husband’s home and as long as Buddhist monks perform the necessary purification rites in the first weeks after delivery. If a woman delivers in a hospital or her natal home, her lack of seclusion in her marital home threatens local protective deities who can harm mother, baby, and household prosperity. From a feminist perspective, patriarchal practices and traditions oppress women by treating female fertility and birth as highly polluting events in need of male ritual management. In Ladakh, these traditions can make women reluctant to deliver in hospitals, even as they scapegoat those women who have bad outcomes, using karma as an ultimate and unfalsifiable explanation.

The Buddhist discourse about birth pollution can reproduce a culture of blame in which women are held accountable for their deaths, rather than placing the cause within the structural violence—corruption, poverty, and lack of access to good health care—that makes birth so dangerous in India today. For a woman named Tendzin, whose story I heard in 2006, the discourse of birth pollution proved fatal. Tendzin was seven months pregnant when she first started bleeding at her natal home in the Zangskar region of Ladakh. She went to a nearby community health center (CHC), where she was put on bed rest for several weeks due to a placental abruption misdiagnosed as placenta previa. Although the head doctor and two midwives urged her to stay near the CHC at an apartment with her father, her mother begged her to return home so she could care for her. When Tendzin started bleeding again a few days after returning home, her mother was convinced that she had offended her natal guardian deity, rather than realizing that her daughter should not have been hauling water from the village pump. Under advice from her mother, Tendzin decided not to return to the clinic. Instead, she walked up the steep cliff to her in-laws’ house, believing that she would be protected by her husband’s guardian deity. Tendzin delivered a stillborn son and bled to death soon after reaching her in-laws’ house. Like other maternal deaths across Ladakh, Tendzin’s death was blamed on her karma rather than on the mismanaged care she received.

I was deeply affected by Tendzin’s story because two years earlier my own first pregnancy had ended with an antepartum hemorrhage caused by placental abruption, a condition in which the placenta prematurely separates from the uterus. Like Tendzin, I wanted to believe everything would be fine, and like Tendzin, I was not in my marital home but visiting my mother’s home in Vermont when I started bleeding. Unlike Tendzin, I had a sister who had worked in a maternity ward during her Peace Corps stint in Uzbekistan and who suspected that my bleeding was serious, thus saving my twins’ lives and possibly my own. I would later learn that the medium time from onset to death for an untreated intrapartum hemorrhage is six hours. Whereas Tendzin quietly bled to death in her in-laws home, my sister drove me through the night to Dartmouth-Hitchcock, the nearest major hospital, where I was mistakenly given magnesium to slow my labor before the attending obstetrician realized that I was leaking amniotic fluid. One doctor cautioned me that mortality and morbidity outcomes vary widely among newborns with extremely low birth weight, a group my twins would shortly join. Suddenly, I realized that their chances of survival were hardly certain and that it would be months before they came home from the intensive care nursery at the hospital.

My eyes blurred as I thought about what one of my Buddhist teachers in India once told me: “tears were of no use to the dead.” He explained that excessive grief can draw the deceased person’s consciousness back into the very world it seeks to transcend. Consciousness links each moment to the next, as well as death to rebirth, two stages in the Buddhist continuum of dependent origination. I began to recite a Tibetan mantra I’d learned to ward off fear: “Omniscient, noble Tara, protect me from all kinds of fear and suffering.”

I had used this prayer only a handful of times in my life—usually in moments of extreme danger such as traversing thin ledges or cliffs in the Indian Himalayas, where a fall could be fatal. I repeated the prayer often during the second and the third day of my hospital stay. My bleeding slowed but the contractions continued unabated. After an even more egregious medical error—a speculum exam while I was on bed rest, introducing bacteria that caused my labor to speed up rather than slow down—my twins were born vaginally at twenty-six weeks. Though my labor was mismanaged—like Tendzin’s and like Angmo’s—in my case the medical errors were hardly fatal, although they did contribute to the early delivery of my twins. My bleeding was closely monitored and it never became life threatening and my twins received life-saving care in a neonatal intensive care unit. They would never have survived if they had been born in Ladakh at that early date.

We will never know if Maya bled during or after her delivery. But what we can suspect is that Maya, like Tendzin, was partly blamed for her own death. The local midwives and doctors in Ladakh blamed Tendzin for refusing to stay at the clinic, even as they failed to admit their mistaken diagnosis. The silence around maternal deaths and their accompanying errors has ramifications in the United States as well as in India, something I became acutely aware of after my experience of a nearly missed diagnosis of leaking amniotic fluid. The United States currently has one of the highest maternal mortality ratios in the industrialized world and more than half of all maternal deaths are preventable errors, according to the Centers for Disease Control and Prevention. Yet we do not have complete review of every maternal death, as occurs in the United Kingdom and the Netherlands, for instance.

While Tendzin’s family sought solace in the ideology of karma as a way to make sense of her death, I have spent the subsequent decade reading more deeply into obstetrics, maternal-fetal medicine, and neonatology in order to better understand how and why women and newborns die in the United States and India today. Although a Buddhist discourse seeks the meaning of karma, ritual, and offended local deities, I am more interested in the medical causality that fails to provide appropriate, life-saving care when needed. In theory, these two discourses are not mutually exclusive. But in practice, the Buddhist ideology of birth pollution in India can obscure ongoing failures of medical care. Silence and grief around maternal death are universal, but discussing and remembering these deaths can help improve maternal care as well as contribute to the Buddhist discourse of dependent origination, in which all actions are connected. While the recording of maternal deaths cannot bring Maya or Tendzin back to life, they can provide solace to the relatives who mourn their lost mothers.²³

Kim Gutschow is an associate professor at the Center for Modern Indian Studies and Institute of Anthropology at Goettingen University in Germany and a lecturer in the anthropology and religion departments at Williams College. She is the author of an award-winning ethnography, Being a Buddhist Nun (Harvard University Press, 2004), and twenty essays on Buddhism, birth, maternal health, and social power in the Himalayas.