The Rituals of Life: Indigenous Midwifery In Guatemala

Nicolle L Gonzales, CNM, Executive Director/Founder, Changing Woman Initiative

Stepping off the plane in Guatemala City, my eyes were immediately drawn to the array people of different shades of brown speedily walking past me to get through customs. Up to this point, my knowledge of Guatemala had been very minimal. I was aware that I was a Native woman traveling alone with my 14 year old son, my respect for the territories we would be traveling through grew from the knowledge that we were visitors. We also were not entirely alone, we would be traveling with Every Mother Counts to visit two of their grantees in parts of Guatemala.

Nicolle at ACAM

As we traveled from one community to the next, our guide educated us on the history of his homelands. Guatemala is home to 23 different Indigenous Mayan tribes, like New Mexico, it was colonized by the Spaniards and the primary language spoken is Spanish. If you listen closely enough you can hear people talking to each other in Spanish and then switching to one of their native dialects mid-sentence. Like indigenous communities here in the United States, clothing, shoes, and hairstyles represent indigenous regions and tribal affiliations.

As a Navajo midwife traveling to another indigenous community, my mind was already making comparisons in our cultures and my ears perked up listening to the history of colonization, resilience, power dynamics, women’s rights and the role indigenous midwives played in their communities. In the United States, Indigenous midwifery is slowly being revived after 50 years of colonization through the medicalization of birth. In Guatemala, where indigenous people are the majority, internal colonization and North American collusion dominate power shifts, in many ways this mimicked the struggles we as American Indians face in the U.S., as we are the minority and the predominantly white culture has absolute power.

It is clear to see how these dynamics play out in the United States where midwifery is highly regulated, discriminatory, and there is a real debate around who is practicing medical midwifery vs. traditional midwifery. These very ideas are what has divided the progress of indigenous midwifery in the United States and it was about to be challenged by our meetings with the “comadronas” of ACAM-Association of Midwives of the Mam Speaking Area.

After traveling 3 hrs. on narrow winding roads weaving through the sometimes-mountainous country side, we finally made it to the birth center of ACAM. The ACAM Midwifery and Birth Center is the only medical facility owned and operated by in Indigenous midwives in Guatemala. Soon after we stepped of the bus, we were greeted with hugs, kisses, and herb tea the comadronas had prepared for us.

Traditional herbs at ACAM

Following introductions, we were lead up to the roof of the birth center where they grew their own herbs. Details of the herbs purposes were explained in Spanish, our interpretor pointed to the plants explaining how one treated diabetes if dried and made into a tea and another one was used in their postpartum sweat lodge or “chuj” in their Mayan language.

As our guides took us to other parts of the birth center, I was surprised to see a room with shelves of pharmaceuticals and an ultrasound machine, as well as a room full of dried herbs. Six of the comadronas were trained to do early dating and growth ultrasounds. This in itself blew my mind, they were not only using their own traditional medicines and teachings to care for women, but they were integrating aspects of western medicine too. They were pulling aspects of training and skill to serve their communities, on their terms.

Over 2,500 women have been served since 2016 and over 50 comadronas have received training and support through ACAM. The comadronas also run a mobile clinic where they go to communities further away to provide prenatal and women’s health care.

To date there has not been a single maternal death in the history of the birth center.

Nicolle at Corazon del Agua

This one encounter solidified my own thoughts on how Indigenous midwives are not being used to their fullest potential in the United States to address maternal and infant health in and around reservations. Indigenous midwives are protectors and right now in the United States, our collective rights are not being honored or represented on a national level. There is mounting research and evidence that providing prenatal care and birth services that is indigenous-led from an indigenous space-does in fact prevent maternal and infant death.

Even in the most far reaching and remote locations, Indigenous midwives save lives, relying on centuries of cultural knowledge passed on through storytelling and apprenticeship. Our legacy lives on like seeds in each of us, no matter where we are planted. Having the opportunity to see the possibilities through this experience has expanded my own thinking on where to go from here. Re-establishing indigenous midwifery roles within our communities is reconciliation work.

Topics: Childbirth, Maternal Health, Pregnancy