Long live the midwife!

22. Juli 2010

Dona Ambrosia (109 years old), Traditional Midwife

The following essay was written by Anna Blankenberger, a young women from Chicago. Anna had contacted  me because she  was doing a study about traditional midwives working around the Rio Cangrejal Valley in Northern Honduras.
The Rio Cangrejal Valley is a beautiful area and very close to La Ceiba, where I live. During Anna’s research she identified twenty traditional midwives. All but one older women. I knew a few of them already. The oldest traditional midwife, Dona Ambrosia celebrated her 108 birthday in December of 2009.

Next Sunday we are holding a workshop for younger women who live in the Cangrejal Valley about the tradition of midwifery and maternal healthcare together with some local nurses.We hope this will encourage young women to work in maternal health care.

Now here is Anna’s article:

Viva La Partera! (Long-live the midwife!)

One of the greatest gifts about learning another language is that it provides key insights and perspective into one’s culture.  For example, dar a luz, (literal translation “to give light”) is the expression used in Spanish when referring to a woman giving birth. What an exemplary phrase to describe one of the most precious moments in a woman’s life! Up until a few months ago, I was quite unconscious of the true potential of a woman’s body and even more so, the connection that is made between woman and child in those moments.  Through the last couple of weeks, my respect for midwifery has also deepened, knowing that one of their key roles is to preserve the purity of this process.  They facilitate the birth experience in such a way that women become more conscious of one of their greatest assets: to bear life.

For those of you who know little about midwifery, the term midwife comes from the Old English language which literally means, ‘with women’ and refers to the responsibility of assisting a mother during her labor and deliver.  Traditional midwives (women and men who have not had any formalized training) have played an instrumental role in the births of many historically and they remain an essential aspect to maternal child health systems throughout several regions throughout the world.  I have been met several midwives who have assisted in hundreds of births and continue to assist in deliveries; however, unfortunately in this particular region of Honduras, the profession is fading.  All of the midwives I have met are on average 70-80 years old and most express concern that there are no young women interested in continuing this traditional form of healthcare. Though my interviews with nurses and doctors at the local clinics and hospitals claim to be willing and eager to incorporate midwifery more formally into the health system, however there hasn’t been a training for midwives since 1996 (according to one of the public health nurses at the local hospital). That key informant interview, along with a few other health professionals, believe the local government is trying to phase out midwifery all together in this region.  The controversy is that the communities continue to utilize midwives, in emergency situations, those unable to afford a hospital birth as well as for women who live hours away from the closest hospital.  In order for these births to continue to be safe, sanitary, and healthy, the local clinics, public hospitals and government must begin working again and supporting the midwives.

My role in all this? Over the next several months, I will continue to meet with the midwives, local clinics and health providers as well as get in touch with the public officials in La Ceiba to further understand how the conversation can be put into action.  Yet the activity I am most excited about is the planning of the main event: Viva Las Parteras (Long live the midwives)! The idea is to throw a celebration (I know all of you who are reading this can see the smile – I do like to plan parties) to recognize all the midwives in the valley as well as invite younger women to come and learn more about the practice of midwifery. We will also be inviting local health providers to begin the conversation with midwives on how they can begin to organize capitaciones (trainings) in order to better integrate them in the health system.

And….guess what! I was able to see my first live birth! Que suerte tengo! (How lucky I am!) I was fortunate enough to be put in contact with Sylvia, a German doula/traditional midwife who has been working for over four years with women’s birth rights throughout the coastal region of Honduras.  Immediately after our first meeting, I knew Sylvia would be essential in connecting me to the local and city healthcare providers.  Sylvia has spent the last three and a half years, for 60+ hours a week in the Maternity/Labor and Delivery room at Hospital Atlantida (one of the public hospitals en La Ceiba). Though Sylvia does not receive financial compensation for providing women with emotional, physical support through their birthing process, she admits how lucky she is to take part in such extraordinary moments in these women’s lives. She never takes the experience for granted, nor does she ever ware in front of the woman despite the poor treatment they are provided. She continues to be a ray of hope and encouragement for these women, giving them a sense of dignity and respect.

Last Monday morning, Sylvia managed to get me clearance into the hospital past the guards, as well as on-the-spot permission from the Chief Doctor to accompany her on her ‘rounds’ in the Labor and Delivery room at Hospital Atlantida.  After a few quick questions about where I was from and why I was here, he agreed. After I put on some scrubs and covered my flip flops with hair nets, I entered the L&D room, were 10 beds lined in a row full of mommies in labor. Sylvia quickly escorted me over to Cindy (24) who was dilated at 5 cm and in labor with her first baby.  As Cindy held my hand she told me ¨Dios me mando, Anita (God sent you, Anita) to be here for me.¨ I told her this was my first as well and I would give it my best shot! I sat with Cindy for almost four hours coaching her breathes, holding her hand during and throughout contractions, fetching her bed pan (since she was unable to walk around) and wiping the sweat from her forehead.  Privileged to have been at her side, I witnessed Cindy give birth to a beautiful baby girl, Ivanna Carolina, 7lbs, 5 oz! Cindy began breastfeeding immediately, and after thanking her for allowing me to be a part of the experience, I left Cindy and Ivanna to enjoy their first mother-child moments.

As I returned to the delivery room to hold another hand or wipe another drip of sweat, a young girl with big round brown eyes, impeccable dark skin and thick curly afro hair entered with contractions.  Her youth (age 15), fear and inexperience was revealed through her ghost-like facial expression.  Sylvia rushed immediately over to comfort her, but she was quite restless and clearly in excruciating pain.  The nurses attempted to help her put on a gown, but she refused and began to pace the entire room. The nurses kept telling her to lie down, but she insisted it felt better to walk around. They demanded she lay down, stop screaming and even threatened how much her behavior was harming the baby.  Eventually, one doctor calmly took her aside, injected a sedative in her arm and after a few minutes the girl lay down and fell asleep.  A few moments later she awoke and began screaming. I looked over and the nurses had apparently tied up her hands and legs to the bed frame. “No soy un animal! Quita estos ahora! I am not an animal! Take these off at once” No one listened.

After struggling for about 15 minutes, she was able to break free of the cloth chains they had wrapped around her wrist and ankles. Naked, tears rolling down her cheeks, blood gushing from her arm and urine seeping between her legs, she demanded they give her clothes back and she was to leave at once. The head nurse informed her that her husband had called and told her she must stay in the hospital.  “Fine,” she said, “but you are not tying me up! I will not be treated this way.”  Sylvia brought over a towel to wipe off the blood and urine, pulled the patient gown over her head and helped her lay in the bed. We had to leave to catch the bus, but we found out a week later from one of the doctors that the baby was sent to social services.

We must continue to share these stories and fight for woman’s rights to a safe, supportive birth, where they are treated with respect and dignity. I hope to have more information in my next update on how you can help.

Un abrazo, Anita

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