Traditional Midwifery

My Spanish Class went to visit with a partera y curandera (traditional midwife and healer.) In Mexico, the practice of midwifery has long fallen to one or two women in a village who help the others give birth the women are called parteras or midwives. Likewise, there has usually been several people who developed skills in recommending herbs, in massage, and who know when cooling or warming a person would help most. These people are called curanderos or healers. Our teacher explained that we were going to meet a woman who learned her skills from another midwife (in this case her grandmother) but who took classes in basic health care from the government and became certified as a 'traditional midwife,' about 20 years ago. With this certificate, this midwife can also complete the paperwork needed to register the birth with the government and create the birth certificate and is able to provide ongoing birth control services to her clients.

We visited a Gertrudis, who has been living in Barra de Colotopec for about 70 years. She has been practicing midwifery that entire time. She is now in her 90s and continues her work as a midwife, having had four births in the month of June, 2009. She also has 35 women who come to her monthly to receive birth control injections (the most commonly used form of hormonal birth control used in Mexico.) Gertrudis was recently ill and is now recovering from a stomach ailment and her daughter from South Carolina was visting to help her mother recuperate.

Gertrudis greeted us and invited us to sit on chairs with her in her patio. Her family came and went, while she patiently answered our questions. She was bright and enthusiastic. She shared a good sense of humor with her daughter. The both frequently laughed when remembering different things that had happened in their lives. Our discussion was frequently interrupted by roosters crowing and she explained that her very nearby neighbors raised fighting cocks.

Her house was one of the more humble houses I have seen. It has openings for doors and windows, but no way to shut them. The roof is corrugated tin. The walls are either wood or a mixture of wood and mud wattle. The kitchen is on the porch and the stove is fueled by wood. Some of the floors are cement, others are dirt. There is no plumbing, but there is a separate building with shower and toilet. Gertrudis has a special room for births, with a bed with mosquito netting and a single light bulb hanging in the center of the ceiling.

She explained that she handled many different types of births with success in her birthing room. Sometimes she would go to the home of the laboring woman, but she preferred to that they come to her home. She does not use any kind of instrument nor does she use any medications during birth but does use herbs during labor. If she encountered problems now, she could refer the woman to the local health center or to a nearby private doctor or to the hospital which is a hour's drive away. Previously, she did not have these options.

We tried to get Gertrudis to explain the process to us. That is, to talk about how long labors last, how much women hurt and what she would do to relieve the pain, how she could tell that there was a difficulty about to occur, what she would do if a specific problem occurred. Gertrudis does not work in a world of dates, times, and facts. She was not able to state how long most labors last or how long the longest one lasted. She said that she provided massage to ease labor pains, an herbal tea and sometimes bathes the laboring mother. I feel certain if she was with a woman birthing, she would know that a contraction was about to begin, but she wouldn't be able to explain how she knew this. That's just how life is for Gertrudis.

Her patients come to her for prenatal checks with a focus on checking the unborn's size and location in the womb. If the baby was not in the preferred position (head down) she would treat the woman with massage to encourage the baby to change before the due date. She encourages women to take vitamins and iron during pregnancy. She said she had different herbs that she recommended to become pregnant, during pregnancy and during birth. Most she recommends in the form of a tea. Not all of the herbs she uses grow locally and she has friends living elsewhere who provide her with those she needs from the mountains.

Gertrudis´s daughter has lived in South Carolina with her children, grandchildren and great grandchildren for years. The daughter explained that she does continue the work as a curandera (healer)-providing herbs and massage-but does NOT do midwifery in the US. She was cooking beans in a ceramic pot over an open fire and said she also has a stove like this outside of her trailer in South Carolina.

Mexico has many more births than can be accomodated in the existing health centers or hospitals. The government has chosen to recognize and to provide support to the traditional midwives who have worked this land for centuries. So, we find a woman in her nineties providing modern birth control to women. Although she does charge for births, she does not charge for birth control as she receives it from the government with this understanding. And even though this midwife stated that she did not really trust modern medicine or it´s doctors, she is implicitly a part of the modern medical system. I wonder what the next step is for midwifery in Mexico. There is not yet a formal education for midwives in Mexico, like for nursing and medicine.