WUNRN
GUATEMALA - INDIGENOUS MIDWIVES
HAVE KEY HEALTH & SOCIAL ROLES
CHIMALTENANGO,
Xinico,
a member of the Cakchiquel indigenous community, told IPS that the midwives
“are treated as part of the family; they give people advice about how to solve
their difficulties.” They are also called on when there is a health problem in
the community.
The important role played by
local midwives is reflected in the official statistics, which show that nearly
half of all births in this Central American country are attended by midwives.
The 2008-2009 National
Maternal-Infant Health Survey reported that 48 percent of pregnancies in the
country were attended in the homes of the expectant mother or the midwife. But
in departments (provinces) where most of the population is indigenous, the
proportion reached almost 80 percent.
The survey also indicated that
43 percent of births took place in public hospitals and clinics, and just under
eight percent in private health facilities.
The Health Ministry reported
that midwives attended 45.7 percent of the 115,997 births registered in the
country from January to October 2011.
The National Survey on Living
Conditions carried out last year reported that 54 percent of
The worst poverty and lack of
public services, healthcare and education are concentrated in indigenous
provinces. (According to official statistics, 40 percent of
Despite the important role they
play in providing healthcare,
“The doctors don’t let us go in
the hospital, they only let the patient in, which makes us feel bad,” said
Regina Patzán, a native midwife from San Juan Comalapa in the central
department of Chimaltenango.
This happens even though many
of the expectant mothers do not speak Spanish, only their native language, she
told IPS.
Patzán, who has been a midwife
for 16 years, says her skills are a gift from God.
“When I was just a little girl
I wanted to know how babies came into the world. My great-grandmothers and my
grandparents would get angry when I asked them,” she said, adding that she was
even whipped a couple of times for asking about “adult things.”
But she was determined to know.
“I wanted to receive the children when they were born,” she said. So she got
involved in a non-governmental organisation, and was trained as a midwife,
seeing her dream come true.
“When women come with
complications, we immediately send them to the hospital. We are also visited by
14- or 15-year-old girls who come in with a stomach ache and we explain that
it’s menstruation,” she said.
Her hunger for knowledge
remains intact. “We would like to learn how to detect haemorrhaging when we are
in the village and how we can help the women,” she said.
María Clara Mux, 55, another
midwife from Chimaltenango, inherited her craft from her grandmother. “The
first birth I attended was my daughter-in-law’s, because I had seen how my
grandmother did it. Thank God everything went well. My grandson is now 13 years
old,” she told IPS.
She strongly emphasises the
need for family planning. “Now there are many planning methods to use. It’s not
like before, when families had 16 kids. Things are difficult and we have to pay
for school, clothing and food,” she said.
Mux is now receiving training
at the local health centre and continues to help pregnant women and attend
births, although she does so in precarious conditions.
“We need equipment – gloves,
scissors and a syringe. The Health Ministry gave us some, but they eventually
wear out. We also need a lantern, because some people don’t even have
electricity and we can’t see a thing.”
The absence of health services
in the most remote parts of the country means midwives play a key role in
preventing maternal deaths.
Aracely Tórtola with the
Asociación Pro Bienestar de la Familia de
“These women also face economic
and cultural hurdles to gaining access to hospitals,” the expert said.
Tórtola said midwives should
receive training and education in the rights of women, family planning methods,
prevention of sexually transmitted diseases, prevention of risks, and
breastfeeding.
“If the midwife provides good
advice and information, if she tells women that they have a right to family planning,
if she takes them to the hospital when the pregnancy is at risk, she is helping
bring down the maternal mortality rate,” she said.
The latest available
statistics, from the national survey on maternal mortality published in
December 2011, indicate that the maternal mortality rate fell from 153 deaths
per 100,000 live births in 2000 to 139 deaths in 2007.
But the ratio is three times
higher among indigenous women, the Observatory on Sexual and Reproductive
Health reports.
Leonor Calderón, the delegate
of the United Nations Population Fund (UNFPA) in
Calderón described traditional
midwives as “agents of development” because of the social role they play in
attending births, reducing maternal mortality and encouraging family planning.