Casual laborers often work throughout their pregnancy and rarely attend hospital appointments because they cannot afford to give up even a day's wages. "It is difficult, but work is work, I have to do it," said Rama, adding that taking breaks is frowned upon and often results in a scolding from her supervisor. She explained how she walks slowly to work these days, but with caution. "When they see us resting, they ask, 'who will pay for your wages?'"