A Tale of Three Midwives: Inconsistent Policies and the Marginalization of Midwifery in Mexico (original) (raw)
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Midwives in Mexico: Situated Politics and Politically Situated
2021
This book presents the contemporary history and dynamics of Mexican midwifery - professional, (post)modern or autonomous, traditional and Indigenous - as profoundly political and embedded in differing societal stratifications. By situated politics, the authors refer to various networks, spaces and territories, which are also constructed by the midwives. By politically situated, the authors refer to various intersections, unsettled relations and contexts in which Mexican midwives are positioned. Examining Mexican midwiferies in depth, the volume sharpens the focus on the worlds in which midwives are profoundly immersed as agents in generating and participating in movements, alliances, health professions, communities, homes, territories and knowledges. The chapters provide a complex panorama of midwives in Mexico with an array of insights into their professional and political autonomy, (post)coloniality, body-territoriality, the challenges of defining midwifery, and above all, into the ways in which contemporary Mexican midwiferies relate to a complex set of human rights. The book will be of interest to a range of scholars from anthropology, sociology, politics, global health, gender studies, development studies, and Latin American studies, as well as to midwives and other professionals involved in childbirth policy and practice.
Midwives in the Mexican health system
Social Science & Medicine, 1993
The health care system in Mexico was built upon a western model in which curative rather than preventive medicine is emphasized. However, the incorporation of indigenous midwives into maternal and child care and family planning programs by several public health agencies is an exception to the governmental health policies. An analysis of midwife preferences among rural women indicates that primarily poor illiterate women with children, living in remote areas with difficult access, rely on midwives. The continued reliance on midwives by this sector of the population makes the government programs most important.
Medical Anthropology Quarterly, 1996
Physiological and anatomical concepts about reproduction held by traditional midwives in Southern Oaxaca differ considerably from those of biomedicine. Government training courses for traditional midwives disregard these deep-seated differences, and also the underlying conceptual rationale of ethno-obstetrics. These courses constantly reinforce and actively promote the biomedical model of care. But rural midwives, despite these training courses, do not substantially change their obstetrical vision and ways. The strength of their own authoritative knowledge, fully shared by the women and men of their communities, allows them to continue their traditional style of care, despite pressures to conform to biomedical values, beliefs, and practices. Suggestions for a mutual accommodation of biomedical and midwifery approaches to prenatal care include training medical personnel in ethno-obstetric techniques and rationales, teaching midwives basic medical interventions, addressing in intervention programs all social actors participating in reproductive decision making, and adopting an interdisciplinary approach that includes nonmedical aspects of maternal care. [authoritative knowledge, ethno-obstetrics, traditional midwives, prenatal care, maternal health, Mexico] n the state of Oaxaca, as in many other Mesoamerican regions, traditional and empirical parteras (midwives) continue to attend the great majority of births (
BMJ Open, 2021
ObjectivesCollate published evidence of factors that affect maternal health in Indigenous communities and contextualise the findings with stakeholder perspectives in the Mexican State of Guerrero.DesignScoping review and stakeholder fuzzy cognitive mapping.Inclusion and exclusionThe scoping review included empirical studies (quantitative, qualitative or mixed methods) that addressed maternal health issues among Indigenous communities in the Americas and reported on the role or influence of traditional midwives before June 2020. The contextualisation drew on two previous studies of traditional midwife and researcher perspectives in southern Mexico.ResultsThe initial search identified 4461 references. Of 87 selected studies, 63 came from Guatemala and Mexico. Three small randomised trials involved traditional midwives. One addressed the practice of traditional midwifery. With diverse approaches to cultural differences, the studies used contrasting definitions of traditional midwives. ...
The Journal of Latin American and Caribbean Anthropology, 2020
Rosalynn A. Vega's No Alternative: Childbirth, Citizenship, and Indigenous Culture in Mexico is a deeply theoretical and richly ethnographic critique of the relationship between traditional midwifery and the humanized birth movement in Mexico. It is important to note that my own research overlaps geographically and temporally with Vega's, although our specific interests and conclusions diverged in significant ways. A central strength of Vega's work is the breadth of her data and the range of her field sites and informants. Her commitment to multi-sited ethnography is evident throughout each of her chapters, as she weaves together cases from across Mexico and from varying kinds of practitioners and advocates. She spent 28 months in the field, during which time she clearly formed deep connections with many of her key informants. She also followed leads to track down practitioners and attend events across Mexico and beyond. She describes visiting an upscale
Strengthening Midwifery in Mexico: Evaluation of Progress 2015-2018
2019
MacArthur Foundation's Population and Reproductive Health Program in Mexico entered a final phase from 2015 – 2019. Since entering the field in 1986, the program aimed to contribute to Mexico's progress in reducing the national maternal mortality ratio. In the 1990s, it helped create and strengthen a national movement that followed two of the field's most important international conferences for reproductive health: the International Conference on Population and Development (1994) and the Fourth World Conference on Women (1995).The Foundation contracted with Consultores Colibrí an external evaluator, to conduct the evaluation of its midwifery initiative. A baseline evaluation was completed in February 2016. It explores the landscape and baseline information related to the four thematic areas of the final phase of our work: legal and normative framework, recognition and demand, education, deployment and quality of care. And a progress report was completed in 2018. The prog...
Important advances have taken place since baseline to expand the presence of professional midwives providing high-quality obstetric and neonatal care as part of Mexico’s public health system. The potential for midwifery to become a permanent feature in the country’s public health system seems greater today because of the growing number of students, midwives and midwifery sites throughout the country; a larger and more influential community of midwifery proponents or champions; multiple collaborative efforts to disseminate information and sensitize health personnel to midwifery models of care; increased awareness and action by public authorities; and an emerging dialogue among innovative state-level actors about what works. These advances contribute to momentum around the country, with the most significant progress seen in locations where the Initiative’s four thematic areas, and the corresponding efforts of its partners, have converged. In addition to confirming the importance of synergy among the four areas of support, as envisioned in the Theory of Change, the findings point to several factors or elements that may enhance success: • A few states invested significant effort in preparing the terrain through sensitization of health care officials and medical personnel to foster greater acceptance of their midwifery programs. As a result, they encountered fewer difficulties related to referrals and collaboration with other providers. The Initiative recognized the importance of sensitization and supported numerous efforts to enhance acceptance among public officials and health system personnel in targeted states. • The best maternal health outcomes are seen in integrated models where midwives are part of a larger team of practice with clear and complementary roles, and they are also best in primary and intermediate levels of care. In addition, the data show that quality of care is highest in midwifery sites where there is an enabling clinical setting, meaning committed leadership, commitment to evidence-based practices, good training, supportive staff, and continuing education. The Initiative did not prioritize a particular model of practice or health care level. Rather, it encouraged emerging models through support for learning, information exchange, and recognition of best practices. • Mexico is a highly diverse nation both culturally and geographically. This diversity is marked, however, by extreme inequality of income and education linked to ethnicity, gender, and geography. In order for midwifery to be accepted in regions that need it most, this asset of diversity—in the context of inequality—needs to be honored by training diverse midwives who are prepared to work where they are most needed. The Initiative recognized the importance of diversity and fostered this through grants to organizations representing multiple approaches and voices.