Contemporary Issues in the Training, Practice, and Implementation of Midwifery for Indigenous Women in Mexico
Midwifery care in Mexico is currently not understood to be a profession, nor is there acceptance of the midwifery model of care as a desirable norm for most women. While there has been a commitment to integrated medicine in the public sector, such as the Intercultural Hospital in San Cristobal de Las Casas, and recently “humanized birth” areas in maternity hospitals in Tula, Hidalgo, and Tlaxcala, there are different and conflicting opinions and visions how to achieve “integrated medicine,” which includes midwifery care. The following chapter examines the current state of maternal health, professional and traditional midwifery in Mexico, its effect on health outcomes for women, and its interface with publicly funded care. We review the state of maternal health in Mexico and explore the cultural worldview of Mesoamerican birth ways, which remains an important influence among the various indigenous groups in contemporary Mexico. We argue that professional midwifery is the bridge between the two worlds of contemporary Western obstetric care with its evidence base in addressing the physical complications of pregnancy and childbearing and the more spiritual and holistically driven orientation of indigenous traditional midwifery.
KeywordsIndigenous women Maternal health Mexico Pregnancy Central America Prenatal care Chiapas Oaxaca Midwife Maternal morbidity Maternal mortality Midwifery training Education Pregnancy education Maya Mazatec Nahua Mexican Midwifery Association Traditional midwife Professional midwife
- Asociación Mexicana de Partería, or Mexican Midwifery Association (AMP). (2017). Asociación Mexicana de Partería. Retrieved March 15, 2017, from www.asociacionmexicanadeparteria.org.
- Grupo de Información en Reproducción Elegida (GIRE). (2015). Omisión e Indiferencia: Derechos reproductivos en Mexico. Retrieved February 10, 2017, from http://informe.gire.org.mx/.
- Instituto Nacional de Estadística y Geografía (INEGI). (2015). Encuesta Nacional de la Dinámica Demográfica, Boletín de Prensa Num 271/15, Retrieved, March 19, 2017, from http://www.inegi.org.mx/saladeprensa/boletines/2015/especiales/especiales2015_07_1.pdf.
- International Confederation of Midwives (ICM). (2008). Investing in midwives and others with midwifery skills to save the lives of mothers and newborns and improve their health. Retrieved February 10, 2017, from https://www.unfpa.org/sites/default/files/pub-pdf/midwives_eng.pdf.
- International Confederation of Midwives. (2014). Philosophy and model of midwifery care. Core document. Retrieved March 15, 2017, from http://www.internationalmidwives.org/assets/uploads/documents/CoreDocuments/CD2005_001%20V2014%20ENG%20Philosophy%20and%20model%20of%20midwifery%20care.pdf.
- Marcos, S. (2006). Taken from the lips: Gender and eros in Mesoamerican religions. Boston: Brill Press.Google Scholar
- Marcos, S. (2010). Indigenous spirituality, gender, and the politics of justice: Voices from the first summit of indigenous women of the Americas. In S. Marcos (Ed.), Women and indigenous religions (pp. 45–68). Santa Barbara, CA: Praeger.Google Scholar
- Mendez, C. (2017). Half of Mexicans are born by Cesarean. El Universal. Retrieved from http://www.eluniversal.com.mx/articulo/periodismo-de-datos/2017/01/22/nacen-por-cesarea-la-mitad-de-los-mexicanos.
- Observatorio de Mortalidad Materna en México. (2014). Indicadores de mortalidad materna. Retrieved March 28, 2017, from http://www.omm.org.mx/images/stories/Documentos%20grandes/INDICADORES_2014_Web.pdf.
- Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2016). Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews, 2016(4), CD004667.Google Scholar
- Secretaria de Salud, Gobierno de México. (1992). Manual de la partera tradicional. Mexico City: Secretaria de Salud.Google Scholar
- Secretaria de Salud, Gobierno del Estado de México. (2013). Programa de Acción Específico: Salud Materna y Perinatal, 2013–2018. Retrieved March 19, 2017, from http://cnegsr.salud.gob.mx/contenidos/descargas/SMP/SaludMaternayPerinatal_2013_2018.pdf.
- United Nations Fund for Population Assistance (UNFPA). (2014a) Setting standards for emergency obstetric care. Retrieved March 14, 2017, from http://www.unfpa.org/resources/setting-standards-emergency-obstetric-and-newborn-care.
- United Nations Fund for Population Assistance (UNFPA) (2014b) The state of the world’s midwifery: A universal pathway. A woman’s right to health. UNFPA. New York, NY. Retrieved September 1, 2016, from http://www.unfpa.org/publications.
- World Health Organization, Department of Reproductive Health and Research. (1999). Care in normal birth, a practical guide. Geneva: World Health Organization.Google Scholar