Central American Midwives - A True Labour of Love

There is no doubt that midwives worldwide areDoña Alicia, compares the care the
very special people. They possess a unique abilitytraditional midwives give to the impersonal care of
to care for women and newborns and it takes athe local hospital; "The midwife offers love and
distinctive set of skills to qualify for the job. Moretrust and confidence and she doesn't do it
than 60% of the world's babies are helped intomechanically like the nurses and doctors.
the world with the hands of a midwife orHowever, I don't mean to offend these health
traditional birth attendant. In Central America,care workers, who do the best job they can. For
midwives are generally referred to as "traditionalexample, a woman goes to have her baby in a
midwives".hospital. In the room she will find a nurse, a
Central American traditional midwives are usuallyperson who cleans and another woman in the
well known and respected in their community.next bed to her. The doctor arrives and says
Many traditional midwives say they felt a calling to"let's see lady, open your legs", and the woman
be a midwife and learned their skills throughfeels ashamed. On the other hand if a midwife
apprenticeship and experience rather than formalattends this woman in the privacy of her own
training.home, the woman experiences trust."
But Central American midwives have a tougherDoña Alicia went on to say that she didn't
job on their hands than their counterparts inwant to offend the doctors because they do
wealthier countries. In countries such asoffer good care when they are needed. But that
Guatemala, Honduras, Costa Rica, Nicaragua and Elthey do not possess the kindness of a midwife,
Salvador midwives can often be found workingand often lack the patience the midwife has.
under appalling conditions, depending on howJosefa Mira, a midwife from El Salvador, explained
unstable their country's health system is, and thethat the midwives are constantly monitoring the
majority of these women do not get paid forprogress of the labour and when a complication
their hard work.presents itself they organize immediate transfer
PAHO (Pan American Health Organization)to a hospital. "And we don't only care for women
estimates that there are about 22,000 maternalof the community during pregnancy and birth",
deaths per year in Latin America and theshe said. "We also look after the general health of
Caribbean with an aggregate ratio of 190 deathswomen and their families, domestic violence and all
per 100,000 births. PAHO also estimates thatthe illnesses that are common in our communities."
under-reporting in many regions can be as high asHowever, lack of transport is a major problem in
70%.most areas and women in high-risk conditions
In Central America, traditional midwives attendoften cannot be moved to a hospital for medical
most of the deliveries where the maternalhelp due to this dilemma. The same problem
mortality is the highest due to poverty. Theexists if there are not enough basic medicines to
contribution of traditional midwives to the healthtreat disease in pregnancy.
of nations has been undervalued by governmentsThe Central American Midwives plea is to be
and insufficient resources have been allocated torecognized and accepted for the value of their
providing midwives with the equipment, trainingknowledge, to work as a team with health care
and medicines that they need to carry out theirservices, to be adequately trained and equipped,
job safely and effectively.and rightfully compensated. This issue needs to be
In April 2004, a group of midwives from theserecognised as an important, pressing matter.
five countries took a ground-breaking step byLet us help those who bear the hands that hold
coming together in Costa Rica to share theirour future generations. Let us help the Central
experiences as midwives in their respectiveAmerican Midwife Crisis.
countries. Their tales reflect their love andGuatemalan midwife María Cecilia says;
devotion to their work, and their ongoing"What I would like most for our country
commitment to the many women they haveGuatemala is health for everyone, that having a
helped through childbirth.baby would become safer, that we would have
They tell their stories of how unjust their healthsafe and healthy childbirth, and that society would
systems are and share harrowing accounts ofgive importance to mothers and the work of
health care systems which fail its people.mothers. When we are expecting our babies we
Central American Midwives, the charitableshould feel cared for and receive love. And the
organization that funded this assembly, producedother thing I wish for is that one day midwives
a DVD depicting these women's stories. In thewould really be part of the health care system
documentary, one of the Nicaraguan midwives,and have a salary that we can enjoy.