The Emerging Role of the Comadrona as a Broker Between Ancient Cultural Beliefs and Modern Biomedicalization to Improve Maternal Health Care in Guatemala
The Mayan highlands of Guatemala are home to the culturally esteemed comadronas, spiritually selected women that serve as ritual and obstetric providers for expectant mothers in these indigenous communities. Comadronas are highly respected traditional Mayan birth attendants that are generally untrained and usually illiterate. The role of the comadrona is changing from a cultural practitioner to a recognized healthcare provider within the formal healthcare system of Guatemala. With over 22 Mayan dialects and pronounced maternal mortality rates in indigenous communities, the direct accessibility and meaningful impact of the comadronas on indigenous women are key to optimizing their role as community healthcare providers which ensures the best possible outcomes for the mother and child. The Ministry of Health has determined that all healthcare facilities in Guatemala are equipped to handle only 20% of annual deliveries, thus relying heavily on comadronas to assist with home births and refer patients with life-threatening complications. Recognizing this dilemma, the government and nongovernmental organizations have developed training programs that teach clinical skills to complement cultural practice. These efforts are instrumental to shaping a future of reduced maternal mortality through strong, clinically and culturally competent comadronas.
KeywordsIndigenous women Maternal health Guatemala Pregnancy Central America Prenatal care Traditional birth attendant Midwife Maternal morbidity Maternal mortality Midwifery training Postpartum hemorrhage Pregnancy education Maya Comadrona Traditional midwife Prevention Stigmatization Spiritual belief Obstetric death Obstetrician
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