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Mayan Midwives and Western Medicine

By Barbara Rogoff

Doña Chona, at the presentation of our book in San Pedro, wearing traditional finery and her favorite Birkenstocks. Photo © Domingo Yojcom Chavajay 2011.
Doña Chona Pérez, who turns 87 this week, was born with a piece of the amniotic sac over her head like a veil, indicating a birth destiny of being a sacred midwife. This credential indicating divine selection to the profession has been recognized in the Mayan region for many years.

Traditional Mayan midwives continue skilled obstetric practices from more than five centuries ago, before the arrival of Europeans in Mayan lands. For example, they correct the position of the fetus through external version, a form of skilled massage. For many years, Western doctors disparaged this practice, but now they turn to traditional midwives to learn how to do it.

Divine selection of Mayan midwives is accompanied by spiritual instruction to learn both the obstetric and the spiritual practices for easing a new soul into this world. Ancestor midwives appear in dreams, urging the woman to accept her destiny, though she resists it because this work is ardous and she could be blamed for maternal or infant deaths.

In the dreams, the ancestor midwives tell the woman that she must accept her calling or she and her family will become ill. They assure her that they will be at her side, aiding her, and they teach her the obstetric and spiritual practices needed to protect the lives of mother and child.

With divine credentials, traditional Mayan midwives have long been trusted and respected by the people of San Pedro. They proudly point out that no one instructed them. In the words of another traditional midwife (iyoom):

I had to become ill, I stayed abed, my legs were trembling and even became paralyzed for a good while. This is a sign that truly one has been called by God to take up the work of iyoom. I never was a student; I have no academic preparation, there exists no man or woman who has trained me. In this I can see clearly that I carried this [calling] from my birth, from the time of the stars that saw me born.

Traditional midwives are now being supplanted by Western-trained midwives. San Pedro has changed from having no electricity or roads to having extensive contact with Western ways, including schooling, transportation, and media such as television and internet. I can call Chona on her cellphone to wish her a happy birthday, but she, like most women of her generation, does not read or write or speak the national language Spanish — she speaks a Mayan language, Tz’utujil.

Traditional midwives criticize Western-trained midwives, saying that they do not respect the old wisdom. In the words of a traditional midwife,

They don’t respect the old ways, the ancestors’ ways, such as the need to heat the umbilical stump (so that it dries and falls off)…. That is the old way…. Yes, it’s true, we are ancient like the rocks, ancient.

The ancient ways of the traditional midwives themselves change, however. Doña Chona has introduced some changes based on her experience; some changes are based on contact with Western medicine through nationally required licensure courses. For example, Doña Chona has changed the practice of scolding the mother in labor to push; she substituted a gentler approach, telling the mother to wait until the baby is ready and then encouraging her through the final stages of labor.

Making use of the wisdom of both Mayan and Western medicine is pressing because national and international organizations in Guatemala (and Mexico) have become interested in incorporating traditional midwives’ wisdom in Western medical institutions. In fact, a promising international midwife-training program is being developed in San Pedro, collaborating with Doña Chona and other traditional midwives.

It is a challenge to blend these two medical traditions due to the long history of rivalry. Spanish doctors in the “new world” initially had no interest in usurping the role of traditional midwives. But in the 1700s, the Western medical establishment became interested in obstetrics for economic reasons; Western doctors published scathing condemnations of traditional midwives’ practices.

However, cultural practices are dynamic. Both Western medical practices and practices of traditional Mayan midwives change with contact, new ideas, and the changing circumstances of new generations.

How to make changes the most beneficial to the health and wellbeing of mothers and babies? A key is the mutual respect that can come from seeing each system as having something to offer to effective childbirth practices.

Barbara Rogoff is a developmental psychologist at University of California, Santa Cruz. Her research focuses on how people learn by observing and pitching in to the activities of their communities, especially in Mexico and Guatemala. She is the author of Developing Destinies: A Mayan Midwife and Town. Her previous books include The Cultural Nature of Human Development and Learning Together: Children and Adults in a School Community. Author royalties from Developing Destinies are donated to the Learning Center and other projects in this Mayan town. See a six minute video with historical film clips and photos since 1941 and photos, interviews, and reviews for more information.

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