After chatting with DESGUA in the hotel lobby, our delegation along with Jenny and Jhonathan from DESGUA, met with The Association of midwives in the Maya Mam Region (ACAM).
The midwives welcomed us with hot punch and sweet rolls, and as we sat in a circle, they explained the formation of their Association. In 2002, a group of Mayan midwives formed an association to preserve the traditional practices of Maya midwifery, and promote traditional healing practices that advance maternal, infant, and community health. They did not have any financial resources when they formed the Association, so they traveled from door-to-door in the nine municipalities where they worked to raise funds. Eventually, they were able to find a space for their Association, and attain support from the Global Fund, two International Organizations, and midwives in the United States.
A significant barrier to the formation of the Association was discrimination from Guatemalan men. Some of the midwives’ husbands opposed the decision to form the Association, and the indigenous K’iche Mayor was unable to provide financial support. Although the Mayor did sign an agreement that would allow the midwives to build the Association in 2005, the Minister of Finance disapproved of the project, and reduced the allocated funding for building the Association.
One of the midwives commented on how the Minister of Finance’s decision revealed his opinion that midwifery “lacks value.” Members of the Association met with Directors from Guatemala’s Civil Society to learn why the funding for construction was reduced. At the meeting, one of the directors told the midwives, “you should get it through your stupid heads that the project is not yours.” This nasty comment stood in contrast to a $30,000 study the midwives had conducted to demonstrate the benefits of building the Association. Furthermore, even women representatives on the local Development Council voted against funding the Association’s construction. The Association reached out to Human Rights Ombudsman Office, who told the midwives to put in complaint that state funds were misused.
Eventually, the case was resolved, and the physical space for the Association was constructed. Since 2007, the midwives have provided: pre-and-post birthing services and massage therapy to women as well as post-natal health services to infants. The Association has also been training new midwives since 2007, and explained that midwifery is a vocation, and to become a midwife a woman must be the daughter or niece of a midwife and have a Nahwal (Mayan horoscope) that is designated for the midwife in Mam culture.
The Association blends traditional practices with modern medical care, and teaches midwives how to work with pregnant women to identify potential complications and risks during pregnancy and birth. The Association encourages midwives to take their patients to hospital if necessary. Although the Association has coordinated with hospitals since 2007, and has recently set up a program where women training to be midwives can undergo a “practicum” to learn from medical practices in hospitals, tensions between the Association and hospitals exist.
Indigenous women often experience discrimination in hospitals–midwives are forbidden to accompany their patients and provide traditional foods and ceremonial baths. In addition to prohibiting familiar food and rituals, the hospital is made further inhospitable to indigenous women because they must give birth in a “Western position” with their feet in stirrups. Often midwives must act as the patients’ advocate and work to overcome the “cultural collision” that occurs between the hospital’s method of care and traditional midwifery.
The midwives wrapped up their talk with a description of their plans to bring in a new generation of midwives who bridge traditional and modern theories and practices of health and healing. Their next steps include educating local health centers about midwifery, and continuing to address the pervasive discrimination against midwives. Recently, the hospitals established a new rule that if a midwife brings a woman to the hospital who then dies during labor, the midwife is deemed to be a fault if the death occurs within the first 24 hours.
Our meeting with ACAM concluded with a tour of the grounds, which include a birth center and Temescal, a traditional Mayan sweat lodge, which eases the birthing process. The midwives define their vision of health as “holistic”–their services encompass caring for a woman’s psyche and working in alignment with the Mayan Cosmo-vision.
Learn more about ACAM Midwifery Project
1. Maya Midwifery A.C.A.M. February 18, 2013. http://www.mayamidwifery-acam-imlusa.org/index.php?option=com_content&task=view&id=31&Itemid=81 This is the official website written in English for ACAM.