“Morir En Camino”: Community Narratives about Childbirth Care in Rural Chiapas

Abstract

This anthropological study explores why more women in the rural Sierra Madre region of Chiapas, Mexico birth at home rather than at the hospital. Between January and May of 2014, the primary investigator conducted in-depth, semi-structured interviews with twenty-six interlocutors: six parteras (home birth attendants), nine pregnant women, four mothers, four healthcare providers, and three local government leaders. Participant observation occurred in the health clinic, participants' homes, and other spaces in a community with a population of 1,188 people. Drawing from narrative analysis, the findings suggest that women face structural obstacles to accessing high-quality childbirth care, which lead them to give birth at home instead of the hospital. These obstacles include financial barriers in obtaining facility-based care and poor quality of care, such as mistreatment in the facility. The study highlights the importance of centreing community narratives in healthcare programming in order to bridge the implementation gap between women in rural communities, healthcare workers, and policymakers.

Traditional partería providing women's health care in Latin America: A qualitative synthesis

“…Another article analyzed the historical context of parter í a tradicional (Quiroz, 2012). Nine articles explored parteras tradicionales status within specific regions and relationships with pregnant women, environments, populations, formal health care providers, and governmental entities (Amanuel et al., 2019; Anderson et al., 2004; Davis‐Floyd, 2001; El‐Kotni & Ramírez‐Pérez, 2017; Laureano‐Eugenio et al., 2016; Laza Vásquez & Ruiz De Cardenas, 2010; Low et al., 2006; Rangel Florez et al., 2017; Romero Zepeda, 2012). Seven articles explored the practice and roles of the parter í a tradicional in relation to sexual and reproductive health in individual regions (Calixto Gomes et al., 2018; Castañeda et al., 2003; Laia da Mata & Keiko Kakuda Shimo, 2018; Laza Vásquez et & Ruiz De Cardenas al., 2009; Pelcastre et al., 2005; Valdez‐Santiago et al., 2004; Villaseñor et al., 2014).…”

“…Government officials and health care professionals optimally encourage appreciation for both formal and traditional models. This requires mutual respect and understanding of the knowledge of parter í a tradicional alongside a desire to preserve beneficial traditional practices (Amanuel et al., 2019; Rangel Florez et al., 2017).…”

“…The 21st century witnessed the emergence of non‐tradicional parteras educated in academic institutions and calling themselves partera, partera profesional, partera titulada (midwife, professional midwife). Nurses also receive specialized training in midwifery to become enfermera partera, enfermera obstetriz, enfermera matrona, enfermera comadrona (midwife, nurse midwife) (Amanuel et al., 2019; Davis‐Floyd, 2001). A third category, partera urbana (urban midwife), refers to women practicing partería in urban settings with neither traditional heritage nor formal education.…”

Violencia y emergencia obstétrica desde la perspectiva de las parteras tradicionales en comunidades rurales

“…Por otro lado, se ha encontrado que en comunidades marginadas las mujeres prefieren dar a luz en su casa en lugar del hospital (Amanuel et al, 2019); un estudio realizado en comunidades indígenas de México reveló que de 62 mujeres entrevistadas, 33 dieron a luz en su casa sin asistencia calificada y 5 dieron a luz completamente solas en sus hogares, y en estos eventos 5 neonatos murieron durante el parto o el período perinatal (Gamlin y Holmes, 2018). Esta preferencia de algunas mujeres en zonas rurales o indígenas por parir en su casa, se puede atribuir a diversos factores, que podrían ser culturales, de accesibilidad a los servicios de salud, desconocimiento o a una resistencia a aceptar los servicios de salud institucional, debido a una experiencia de maltrato o violencia.…”

The Embodiment of Traditional Partería in the Colombian Pacific Region

“…The presence of Traditional Parteras is enduring. Traditional Parteras can be found in every corner of the globe, especially in those regions in which their role is fundamental for maintenance of the population's health, as is the case for Africa, Asia, and Latin America (Amanuel et al, 2019). Several ethnographic studies conducted in Latin America described the endurance of Traditional Parteras' practice despite ethnocide, and recognized the Traditional Partería as a repository of culture and collective identity (Ix-Chel Vázquez González et al, 2015).…”