I’d like to talk about the how the cultural customs and practices affect the birthing process in Guatemala. Birth is a very transitional period in a family’s life and Guatemala has uniquely traditional characteristics surrounding the concept of birth.
Guatemala’s population is roughly divided with half being in rural areas and the other half in urban areas of the country. Guatemala is multiethnic which includes a large indigenous Maya population. These characteristics affect how a transition like bringing a new child into the world is done. When it comes to being in the delivery room, around 59% of births in Guatemala have traditional birth attendants or unskilled family members present (Walsh 2006). In rural regions, the statistic is higher. The traditional birth attendant, especially within the indigenous community, is commonly a comadrona. A comadrona is a wise, trustworthy community member who has the “calling” to participate in midwifery, and may or may not be educated. Comadronas are usually overlooked and undervalued as assets to birthing sessions by healthcare formals because they are often uneducated, indigenous, and female (Walsh 2006). The common attendance of a comadrona or midwife instead of a doctor may have to do with the increased accessibility and more affordable prices. An appointment with a midwife cost 10 Quetzales ($1.40), while an appointment with a doctor cost 50-100 Quetzales ($7-14) (Rae & Melimopoulos 2018). Indigenous females are twice as likely to die from childbirth or pregnancy than non-indigenous women, and indigenous infants are two-thirds more likely to pass away than non-indigenous babies (University of Toronto: Department of Family & Community Medicine 2017). Comadronas are essential to indigenous women in Guatemala as the indigenous population in Guatemala is regularly discriminated against and face disparities regarding access to healthcare.
Not everyone can be considered a comadrona. Three necessary themes the comadronas experience are the sacred calling, sacred knowledge, and the sacred ritual. The comadronas are usually called to become a midwife in a dream or vision coming from God or a saint explaining the reasoning for which it is “sacred” (Walsh 2006). Some comadronas are formally uneducated and claim to learn the midwifery position through foretelling dreams and visions. They receive knowledge from the visions that are believed to be communication from God (Walsh 2006). In preparing for the actual birth, extended periods of prayer and ritualistic candle and incense burning is done at the prospective mother’s home. The comadronas then utilize their knowledge from educational classes and/or sacred visions to help assist in the labor and birth. Birth is usually believed to be a spiritual event, not just a physical one (Walsh 2006).
Brigitte Jordan explains the authoritative knowledge complex in two very different birthing scenarios: a labor room and an airlines operation room. Both settings hold very different networks of authoritative knowledge and power. She uses both cases in order to gain a greater knowledge on how authoritative knowledge is working in these two settings. Jordan claims that some knowledge is devalued, but other knowledge is considered to be “official,” concrete, and accepted information which allows action to be conducted (Jordan 1992). In Guatemala, authoritative knowledge is dominantly expressed by the community-based caretaker, a comadrona. By knowledge-giving visions/dreams and possibly educational training, comadronas are the essential figure in a birthing space. They create a “sacred space” for the newborn to come into, while also performing assessments to the mother and unborn child (Rae & Melimpoulos 2018).
Brigitte Jordan’s piece was eye-opening and informational. The dynamic between the doctor and the birth giver in the labor room setting was dominant at best. The power structure in the labor room showed hierarchy with the doctor and then medical staff ultimately controlling the birthing process. The mother being essentially ‘butt out’ of making decisions in her own labor and allowed limited participation (Jordan 1992). The airline operations room displays an hierachal complex that is virtually non-existent. The authoritative knowledge aspect in a birth in Guatemala is unique from the two settings explained, where authoritative knowledge is accepted from the comadrona. Though, the comadrona’s knowledge is highly spiritual, intuitive with the mother’s feelings, and relies heavily on the grace of God for the birth to run smoothly.
Works Cited:
Jordan, Brigitte. “Technology and Social Interaction: Notes on the Achievement of Authoritative Knowledge in Complex Settings.” Institute for Research on Learning and Work Practice and Technology System Science Laboratory Xerox Palo Alto Research Center, Apr. 1992, drive.google.com/file/d/1FbFM9GAdVZ_AwFNteaNXNP1M0zBEk7Jm/view.
“Maternal, Newborn and Child Health (MNCH) in Guatemala: Transforming Indigenous Lives.” Department of Family & Community Medicine, 11 Oct. 2017, www.dfcm.utoronto.ca/event/maternal-newborn-and-child-health-mnch-guatemala-transforming-indigenous-lives.
Rae, Ali & Melimpoulos, Elizabeth. “Saving the Traditional Midwife in Guatemala.” Guatemala | Al Jazeera, Al Jazeera, 8 Oct. 2018, www.aljazeera.com/indepth/features/saving-traditional-midwife-guatemala-180921043201819.html.
Walsh, Linda V. “Beliefs and Rituals in Traditional Birth Attendant Practice in Guatemala.” Women’s UN Report Program & Network, Journal of Transcultural Nursing, Apr. 2006, www.wunrn.org/news/2006/07_03_06/070906_guatemala_beliefs.pdf.