Indian midwives, or dais, from Rajasthan, Bihar, and Delhi tend to their patients, dispense traditional knowledge, and reflect on changing childbirth practices. Usually of low caste and rarely paid for their work, dais provide a service that is considered by some to be unhygienic and sinful but is nonetheless essential in areas where medical assistance is distant and expensive. These attitudes are contrasted with evidence of the increasing popularity of such practices in the West.