A Midwife Is Changing How Women Give Birth in Mexico, One Baby at a Time Carolina Menchu - STAT
go to original July 31, 2017

Obstetric nurses Maria Dolores Macias Bernal and Adriana Estrada Lomeli comfort Juana Lopez. Laboring on a ball and back massage are pain management techniques often employed by midwives and not typically used in Mexican maternity wards. (Alice Proujansky)

Bringing a new life into the world should be a calm, natural experience, not one accompanied by the subtle violence of unnecessary surgery. Because every woman’s birth experience is indelibly stamped into her memory, in my work as a midwife I try to help my patients make outstanding memories.

Before I started out on a career in midwifery in 2011, I thought that delivery by caesarean section was best for the mother and the baby. That is what I had seen and heard growing up in Guatemala and then saw in Mexico, where caesarean sections are common. While this procedure can save lives, it can also lead to infection, bleeding, complications in future pregnancies, and breathing problems in newborns. I started changing my mind during midwifery school in Mexico. There I learned that natural childbirth is a much better option for most births and became determined to transform the way women in Mexico give birth from an interventional procedure to a natural one in which women are given the voice they deserve. During my año de servicio, my mandatory year of service working as a midwife in a rural town called Revolución, I saw how this approach could succeed.

Revolución is in Chiapas, the southernmost state of Mexico. It is a rural, rugged part of the country with very few health professionals to care for its more than 3 million inhabitants. That may help explain the high rate of maternal deaths, more than 60 per 100,000 live births, which is about four times higher than in the United States and 20 times higher than in Finland and Iceland. But Chiapas also has one of the highest caesarean section rates in Latin America — almost 50 percent — which doesn’t make sense given the shortage of doctors.

Some women brave the two-to three-hour journey from their homes to hospitals or birth centers, where the caesarean section rate is quite high. But many women in Chiapas deliver their babies at home, often with the help of one or more parteras. These are local women who help others in the community during their pregnancies and births. Although these women generally have not had any formal training about how to care for pregnant women or deliver babies — they use the skills they learned from parteras who came before them — many times they are the only and best source of assistance for pregnant women.

Parteras offer advice during pregnancy. They stay with women during labor and birth, encouraging them to move or squat or push as needed. Some prepare medicines from plants to ease or accelerate labor. Above all, they support the women they care for. If a partera is worried that something is not right, she helps a woman go to the hospital.

Read the rest at STAT | Español

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