Healing Hands



Life and Death Mural in the town's center

The comadronas of ACAM are well connected.  They speak highly and frequently of health providers in the United Status who 1) help obtain funding through grants, 2) offer their own expertise during day or week-long medical volunteerships, 3) Donate medical supplies and clothing, and 4) often times when here, Provide trainings to the midwives.  Most of their volunteers come through acquaintances of Nikki May, a certified nurse midwife in Massachussets, to whom the midwives refer every day as though she were their holy savior.  Of course that's an exxageration, but...Perhaps she is.

The Mayans have had a long tradition of midwifery.  Some communities have the good fortune of passing on this tradition to the younger generations, who can replace them as they grow older.  The Mam area of Quetzaltenango is one such place.  The youngest midwife at ACAM is 15 years old.  The oldest 76.  And unlike the United Status where to be a midwife, the cost can be exhorbitant, here the education is free.  After a year of theory and a year of practicum, the midwives begin tending to birthing women.  They learn about complementary medicine, such as herbal teas first –recipes that have been passed down from their mothers and grandmothers.  Preservation of this craft is very important to them.  

Herbal Salves at ACAM

I am astounded by their practice since this is the first time I have seen natural birth take place in the way I was taught during Doula training.  Women walk around most times until they are 10cm dilated.  Birthing women eat whatever pleases them and drink teas during labor.  They are told sometimes to climb the steps in ACAM to help the labor process.  And through it all, they are courageous and strong.  Hospital San Juan de Dios, the public hospital in Xela, doesn´t charge for childbirth.  But many women in the Area Mam don't have the same trust in the hospital that they have in the comadronas in their community, where they are willing to pay Q400 (50USD).  Each midwife earns Q100 (13USD) each shift they work; and most work just one per week, totaling an income of 13USD per week.

My Portraits of the Midwives - I couldn't resist making them laugh

The midwives are warm, generous, welcoming, and wise.  They boast that I am a very agreeable American, willing to eat everything they offer me; unlike with other foreigners with whom they are nervous and worry over them because of their very high needs.  It's selfish, but it warms my heart to hear that I will be missed by them.  They say they have grown accustomed to me being here and will be sad to see me go.  There is no doubt that I will feel that sadness as well, since they have become my family.

Donas Santos Mendez, Cristina, Emelda, Azucena, Antonina (From left to right)

Dona Antonina´s Beginning

Antonina's own experience began when she was pregnant with her 3rd child who was in breech position.  The midwife performed manual external version of the baby -- a process by which a midwife turns a baby gently but firmly using her hands positioned on the mother's belly -- to correct the position.  (Technology and fear of being sued have convinced many American doctors that they are incapable of doing the same, so they usually defer to a cesarean in cases like this.)  The midwife then instructed Antonina to do the same on her own, if the baby was restless and stubborn enough to turn himself around again.  And so she did.  For her this was a very empowering moment in which she realized that she is capable of healing with her own hands.

She tended to her first patient in the home, when no comadronas could be found in the community.  With no formal training, her experience was limited to past invitations by neighbors to see the birth of a family member.  And yet SHE was now at the helm of the childbirth of a dear friend.  When her friend´s pains came stronger and more frequently, the husband asked, ¨Antonina, you will be the one to receive our baby.  Please help us.¨  Reluctant to do so at first, she directed family members to get a Schiller (razor), bedsheets, towels, and hot water.  And in an instant, she held a newborn she had helped birth, in her hands for the first time.  News spread in the community.  And as a consequence, the flow of requests have been consistent for nearly 30 years.  Antonina works 3 of the 7 shifts, and from what I see, is the midwife whom the patients most request.  And during her shifts, I have been lucky to play a big role in births.

Midwives : My Maya Mama Antonina, Cristina, Ofelia

 

Maria's Childbirth

Antonina and Ofelia were the receiving midwives on this day.  Antonina spent many hours by the mother-to-be´s side, coaching her through contractions, offering herbal tea to help reduce the pain, and recounting birth stories to the mother and family who all sat in the birthing room.  It was a time of celebrating life.  Despite the work she had done, it was me Antonina called for to tend to the mom as childbirth was impending.  And so she proceeded to take off her gown, gowned me, helped me with the ties, and reminded me of what I needed to do.  In Mam, she then stated to Ofelia also gowned, ¨Dana is going to be the one to receive the baby.¨ For a second time, I was graced with the generosity of Antonina to share the experience – to allow me to be the one to lay my hands on the baby in the moment when he breathes his first breath – and to welcome him into the World.  With more assurance than the first birth, I severed the connection between Mom and baby which no longer pulsed, wiped him clean, measured him, then dressed him for mom to embrace.  She tenderly touched him fascinated by his small nose, small ears, small mouth, small hands; as did her husband, who hovered closely above the two, inhaling every moment.  Her mother and grandmother also stood by her side, hand in hand with Maria, praying thanks in Mam – expressing gratitude for her strength through labor and hoping for her healing in the coming days and weeks.  To experience this ceremonious moment and long standing Mayan tradition among these women -- those who cared for her day to day, and those with healing hands, I was humbled.  And in realizing this, I nearly cried.

Each midwife here has their own story of how they came to be chosen, by God, to pursue this profession.  They all concur that it is a calling.  I guess I´m partly here to understand if it is mine.

The Lovely Affectionate, Dona Margarita