Part four: Childbirth and Midwifery on a Guatemalan Finca

Cosminsky, Sheila

doi:10.1080/01459740.1977.9965825

Cited by 36 publications

(18 citation statements)

References 5 publications

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“…Classic studies conducted 30 years ago suggested midwives were spiritually called to their practice and thus likely to reject interventions [21][22][23] . However, only one midwife who participated in this study said she felt spiritually called to midwifery.…”

Section: Discussionmentioning

confidence: 99%

Mixed methods evaluation & teaching with Guatemalan traditional midwives’ regarding nursing interventions to manage postpartum hemorrhage

Garcia¹

2013

JNEP

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Purpose: The purpose of this pilot descriptive study was twofold: to explore Guatemalan traditional midwives' knowledge, attitudes and practices about nursing interventions to manage postpartum hemorrhage (PPH), and to evaluate the effect of a culturally sensitive teaching on traditional midwives' knowledge of nursing interventions to manage PPH. Methods:Thirteen midwives participated in a one-day teaching at a Refuge International Health Clinic in the remote town of Sarstun, Guatemala. The quasi experimental study used a one-group, pretest posttest design. Researchers relied on a PPH checklist from the American College of Nurse Midwives (ACNM) to evaluate knowledge of PPH interventions before and after the PPH teaching. One 45-minute focus group also was conducted among the midwives. The Long Table Approach was used to develop a matrix of common themes. Results:The culturally sensitive teaching improved traditional midwives' knowledge and skills about nursing interventions to manage PPH (pretest M=1.385/8, posttest M=4.846/8). In the focus group, midwives revealed several themes that contradicted the literature. Midwives repeatedly denied managing PPH despite a combined 197 years of midwifery experience. Midwives said they trusted local health care providers, and would transfer patients to hospitals in emergencies. Midwives asked for assistance in educating villagers about the importance of prenatal care and of seeking early labor support. Conclusions:Results of this pilot project suggest a culturally sensitive oral teaching in the primary language of participants improves traditional midwives' ability to manage PPH. Future training should follow a similar format to address the needs of illiterate participants in resource-poor settings, and should include the entire community, not just midwives.

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Section: Discussionmentioning

confidence: 99%

Mixed methods evaluation & teaching with Guatemalan traditional midwives’ regarding nursing interventions to manage postpartum hemorrhage

Garcia¹

2013

JNEP

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“…A recent study indicates that the majority of Guatemalan midwives (comadronas) have attended training (Goldman & Glei, 2003), during which they were encouraged to send all pregnant women to a government health facility for tetanus vaccination, prenatal examinations, and postpartum follow-up, and instructed to refer high-risk women and those with complications to a doctor or hospital (Cosminsky, 1977;Putney & Smith, 1989). Nevertheless, most midwives (even trained ones) did not refer their clients to a biomedical provider (e.g., the staff of a government health facility or a private doctor) on a regular basis, and most pregnant women did not see a biomedical provider during pregnancy (Goldman & Glei, 2003).…”

Section: Introductionmentioning

confidence: 99%

Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?

Glei

Goldman

Rodrı́guez

2003

Social Science & Medicine

145

104

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This study examines factors associated with the use of biomedical care during pregnancy in Guatemala, focusing on the extent to which complications in an ongoing or previous pregnancy affect a woman's decisions to seek care. The findings, based on multilevel models, suggest that obstetrical need, as well as demographic, social, and cultural factors, are important predictors of pregnancy care. In contrast, measures of availability and access to health services have modest effects. The results also suggest the importance of unobserved variables-such as quality of care-in explaining women's decisions about pregnancy care. These results imply that improving proximity to biomedical services is unlikely to have a dramatic impact on utilization in the absence of additional changes that improve the quality of care or reduce barriers to access. Moreover, current efforts aimed at incorporating midwives into the formal health-care system may need to extend their focus beyond the modification of midwife practices to consider the provision of culturally appropriate, high-quality services by traditional and biomedical providers alike. r

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“…Al mismo tiempo se da una "desocialización", es decir, una separación de los contextos sociales donde se insertan, con unas representaciones culturales, unas relaciones sociales y unos procesos sociopolíticos que rompen con la supuesta universalidad del ser humano en general, o de las mujeres en particular. Se dejan de lado también las emociones que acompañan y han sido estructuradas socialmente para vivir el epp, que sí han sido estudiadas en algunas etnografías como las de Michaelson (1988), Cominsky (1977) y Kitzinger (1962.…”

Section: El Modelo Biomédicounclassified