This post from the field comes from Lauren Abrams, a certified nurse and midwife who has worked with Saving Mothers since the very beginning. She just recently traveled to Guatemala and spent a week living with a Guatemalan comadrona to immerse herself more deeply in understanding the challenges and opportunities that exist in providing health care to local women. We hope you enjoy reading her story!
Last week I got to combine my two great passions, midwifery and international work, by participating in Saving Mothers’ Midwifery Immersion Project. I had traveled to Guatemala before with Saving Mothers to help provide safe birthing kits and formal training sessions to the comadronas in the Lago Atitlan area, but this time I was going to live with one of the comadronas herself, in the hope that participating in her daily life would provide opportunities for a true exchange of culture and information.
As it turned out, I got my wish, and then some!I was warmly welcomed into the home of Maria Elena Coche, the leader of the comadronas in San Juan La Laguna, who is not only a comadrona but a well-respected traditional healer. As a mother of four children and a healer whose services are much in demand, Elena is a very busy woman. I quickly learned that after her daily housework is done (which includes the making of what seems like hundreds of tortillas daily, many of which I happily consumed), she spends her evenings and nights responding to calls from community members in need of spiritual and physical healing.
On our first night we went to visit Josefa, a young mother of 2 children who was suffering from general body pain and stress. When we arrived, her 4-year-old daughter was asleep, and her 7-year-old son was watching her weave on her traditional loom, which was attached to the wall of the one room the family of 4 shared. Josefa gave Elena a bag of fragrant green herbs which I later learned were rue. Elena ground up the herbs with various solutions, lit candles and incense, and chanted quietly over the mixture for several minutes. She then gently rubbed it all over Josefa’s body, chanting over Josefa as well, and had Josefa drink the rest of the solution. We then spent a long time chatting with Josefa; she had had c-sections for each of her births and we talked for a long time about her labors and birth experiences. She served us coffee and some sweet bread, and we were on our way.
Over the week that I spent there, we spent many hours this way, visiting with and providing services for community members: men and women, pregnant and non-pregnant. Elena never turns down a request for help, and so we were often out till long after midnight, accompanied always by her faithful dog Peluchin. Over the week, we became something of a team, combining our resources to provide what felt to me like truly holistic care. Elena used traditional Mayan herbal remedies and massage to treat flank pain, vaginal infections, and anxiety; we worked together to assess pregnant bellies and provide prenatal care and referrals to more “modern” facilities when it was needed. One of the pregnant patients’ baby was breech at term; we used a combination of Mayan remedies, spiritual practices, American midwifery tricks and Chinese medicine to try to get the baby to turn. Elena also used the training she had received through the government hospital to counsel her patients about family planning methods and making birth plans, seamlessly integrating her traditional skills with modern medicine. The women were always welcoming and grateful, and we spent many hours after the treatments sipping coffee, playing with the kids, and telling birth stories.
One highlight of the week was the “capacitation”, which was a training for the San Juan comadronas held at Elena’s house. Experienced and new comadronas alike came and attended the training, in which we spoke about providing complete prenatal care and trained the comadronas in the use of a fetal heart Doppler, which was donated by NYC Midwives, the local chapter of the American College of Nurse-Midwives. At the end of the training each comadrona received a safe birthing kit with instructions; in order to help us improve the kits, we asked each comadrona to fill out a survey after using the kit. Upon returning the survey, they will receive another kit. The newer comadronas were particularly enthusiastic, and approached Elena at the end of the afternoon to ask that we return to provide monthly trainings.
Saying goodbye to Elena and her lovely family after the week was very sad, but I left looking forward to returning and continuing the work we have started in San Juan. We have identified a local clinic which will welcome visits from North American midwives providing prenatal and gyn care, and hope to integrate that care with the home care provided by the comadronas. We plan to continue formal trainings and distributing birth kits. And perhaps most importantly to me, we will continue to build a strong cross-cultural friendship between American midwives and Guatemalan comadronas, sharing knowledge, experience, tricks of the trade….and lots of tortillas!