The changing role of indigenous lay midwives in Guatemala: New frameworks for analysis (original) (raw)
Objectives: to examine the present-day knowledge formation and practice of indigenous Kaqchikel-speaking midwives, with special attention to their interactions with the Guatemalan medical community, training models, and allopathic knowledge in general. Design/participants: a qualitative study consisting of participant-observation in lay midwife training programs; in-depth interviews with 44 practicing indigenous midwives; and three focus groups with midwives of a local non-governmental organization. Setting: Kaqchikel Maya-speaking communities in the Guatemalan highlands. Findings: the cumulative undermining effects of marginalization, cultural and linguistic barriers, and poorly designed training programs contribute to the failure of lay midwife-focused initiatives in Guatemala to improve maternal-child health outcomes. Furthermore, in contrast to prevailing assumptions, Kaqchikel Maya midwives integrate allopathic obstetrical knowledge into their practice at a high level. Conclusions and implications: as indigenous midwives in Guatemala will continue to provide a large fraction of the obstetrical services among rural populations for many years to come, maternal-child policy initiatives must take into account that: (1) Guatemalan midwife training programs can be significantly improved when instruction occurs in local languages, such as Kaqchikel, and (2) indigenous midwives' increasing allopathic repertoire may serve as a productive ground for synergistic collaborations between lay midwives and the allopathic medical community.
Related papers
The Changing Roles of Indigenous lay midwives in Guatemala: New frameworks for analysis
2013
Objectives: to examine the present-day knowledge formation and practice of indigenous Kaqchikel-speaking midwives, with special attention to their interactions with the Guatemalan medical community, training models, and allopathic knowledge in general. Design/participants: a qualitative study consisting of participant-observation in lay midwife training programs; in-depth interviews with 44 practicing indigenous midwives; and three focus groups with midwives of a local non-governmental organization. Setting: Kaqchikel Maya-speaking communities in the Guatemalan highlands. Findings: the cumulative undermining effects of marginalization, cultural and linguistic barriers, and poorly designed training programs contribute to the failure of lay midwife-focused initiatives in Guatemala to improve maternal-child health outcomes. Furthermore, in contrast to prevailing assumptions, Kaqchikel Maya midwives integrate allopathic obstetrical knowledge into their practice at a high level. Conclusions and implications: as indigenous midwives in Guatemala will continue to provide a large fraction of the obstetrical services among rural populations for many years to come, maternal-child policy initiatives must take into account that: (1) Guatemalan midwife training programs can be significantly improved when instruction occurs in local languages, such as Kaqchikel, and (2) indigenous midwives' increasing allopathic repertoire may serve as a productive ground for synergistic collaborations between lay midwives and the allopathic medical community.
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. ...
Fighting for respect: Midwives and the medicalization of childbirth in Guatemala
PsycCRITIQUES
Although birth is considered one of the few universals of the human experience, Sheila Cosminsky illustrates through its rituals and traditions how childbirth is culturally informed. Drawing on decades of fieldwork in a Guatemalan finca (plantation) and close connections with the two main comadronas (midwives) on that plantation, Cosminsky provides vivid examples of how pregnancy, childbirth, and to some extent motherhood are experienced by those who call the finca home. A central theme of the book is how the medicalization of childbirth-the promotion of hospital deliveries and medical intervention-has left both comadronas and mothers disempowered.
Authorizing Tradition: Vectors of Contention in Highland Maya Midwifery.
Social Science & Medicine, 2004
In Guatemala, midwives deliver the majority of children and play an important health care role in rural areas. Maya midwives, using time-proven methods, are the chief providers of care for mothers and infants in these areas. In recent decades, however, the medical establishment has become interested in Maya midwives, and is currently engaged in training and certifying many of them. This study examines how Guatemalan health authorities have sought to change Maya midwifery, refashioning its vocational framework and retooling it in accordance with Western medical principles. I focus on the place of obligatory formal training and the use of biomedical materials in the experience of Kaqchikel Maya midwives, and consider how the health officials employ these means to undermine the midwives’ knowledge base. Encounters between midwives and formal health personnel reveal an ongoing privileging of biomedical knowledge, one that preserves asymmetrical relationships between these practitioners. This creates an environment favorable to health personnel, and helps them to extend their influence through the midwives into the community. Given this, I contend that health personnel value local Maya midwives primarily for their role in furthering the goals of biomedicine. 2003 Elsevier Ltd. All rights reserved. Keywords: Guatemala; Maya midwifery; Biomedical change; Maternal health; Child care
Teaching Guatemalan traditional birth attendants about obstetrical emergencies
Midwifery, 2018
Guatemala's Maternal Mortality Rate is 65th highest in the world at 120 deaths per 100,000 births. Contributing to the problem is traditional birth attendants (TBAs) attend most births yet lack knowledge about obstetrical emergencies. Government trainings in existence since 1955 have not changed TBA knowledge. Government trainings are culturally insensitive because they are taught in Spanish with written material, even though most TBAs are illiterate and speak Mayan dialects. The purpose of the observational study was to evaluate the effect of an oral training, that was designed to be culturally sensitive in TBAs' native language, on TBAs' knowledge of obstetrical emergencies. one hundred ninety-one TBAs participated. The study employed a pretest-posttest design. A checklist was used to compare TBAs' knowledge of obstetrical emergencies before and after the training. the mean pretest score was 5.006±SD 0.291 compared to the mean posttest score of 8.549±SD 0.201. Chan...
Loading Preview
Sorry, preview is currently unavailable. You can download the paper by clicking the button above.