LEMON GROVE, California — In 2017, 83 out of 100,000 Colombian women passed away due to pregnancy complications. In fact, the number of maternal deaths in Colombia is rising for Indigenous and Afro-Caribbean women.
Low-income women who need prenatal care rely on Colombia’s public healthcare insurance to cover medical costs. However, state-issued insurance often takes a significant amount of time to approve pregnancy-related procedures. Apart from dealing with unreliable health insurance, pregnant women experience mediocre treatment from doctors who do not look out for their patient’s best interests.
Nevertheless, traditional midwives in Colombia visit Indigenous and Afro-Caribbean women in their communities to offer culturally appropriate prenatal care. Furthermore, they educate them on how to take care of themselves after labor and delivery and allow patients to take charge of their pregnancy care. In this manner, midwives assist in lowering maternal deaths in Colombia for minority women.
In rural communities, expecting women often rely on traditional midwives instead of western-trained doctors for prenatal services due to closer proximity and a greater sense of trust in local practitioners. Specifically for Afro-Caribbean communities, midwives represent a cultural tradition that needs to be protected.
Afro-Caribbean midwives, also known as parteras in Colombia, offer women services from the start of their pregnancy until after post-partum. The midwives allow patients to dictate how they want their labor to go and what individuals should witness the birth. During labor, parteras reassure women by declaring customary chants in their language, bringing in close family members and allowing women to give birth in their own homes. After birth, the midwives teach women how to take care of their bodies by maintaining clean and healthy routines.
However, when a partera detects a dangerous medical situation that can put a woman at risk, they send their patient to a local hospital to receive care from a doctor. Although traditional midwives prefer to handle pregnant women’s care on their own, they trust Western medical treatment to help keep their patients healthy.
Like their Afro-Caribbean counterparts, Indigenous midwives persevered for thousands of generations due to deeply instilled traditions and culturally sensitive prenatal care approaches. Steph Navjeet Smith from the Give Light Film told The Borgen Project in an interview, “The midwives take into consideration cultural as well as physical wellbeing of mother and child. This creates an understanding at a deeper, more personal level than the chasm that usually exists from the doctor to the ill patient.”
During prenatal appointments, midwives touch the woman’s stomach to determine how big the baby is. Midwives conduct the appointments in the same language that their patients speak and tailor certain prenatal care recommendations to their culture. Also, midwives advise their patients to exercise, eat in moderation, avoid lifting heavy objects and take showers in the mornings to avoid feeling cold. Next, midwives give expecting mothers certain medicinal plants, such as sangre de mono and alepo, to keep them healthy throughout pregnancy and ensure fast labor and delivery. Lastly, midwives support and take care of women during their postpartum period.
To combat the high maternal deaths in Colombia among Indigenous and Afro-Caribbeans, organizations such as The Association for United Midwives of the Pacific (ASOPARUPA) and Malteser International educate midwives on how to provide better and higher quality care to their patients in a culturally sensitive manner.
ASOPARUPA came into fruition in 1991 and strives to preserve the traditional knowledge of Afro-Caribbean midwives. First, ASOPARUPA attempts to lower maternal deaths in Colombia by refusing to work with patients who have never received a conventional doctor’s medical exam. Second, the association turns away any woman with a severe medical problem and urges them to see a medical professional. Then, the association partners with the Red Cross to provide several emergency care classes to the parteras. Lastly, the head of ASOPARUPA, Liceth Quinones, informs the other midwives about new information acquired from her time in nursing school and discussions with midwives in different countries.
Malteser International came to Colombia in 2014 and assists in improving the consequences of climate change, well-being and nutritional intake of vulnerable communities. More specifically, the agency focuses on helping the Indigenous Wayuu tribe. The agency teaches Indigenous midwives how to solve uncomplicated medical issues, watch out for high-risk pregnancies and transfer patients with severe medical problems to a licensed medical professional. Malteser International brings in medical professionals to teach the classes and takes the midwives into a clinic to practice what they learned. Lastly, the instructors attempt to teach the classes in a culturally appropriate manner that allows Indigenous midwives to acknowledge several modern practices.
Recognition of Traditional Midwives
In 2010, Colombia’s Senate accepted a new bill that allows midwifery to be seen as a legitimate career. If the bill becomes law, more midwives can work alongside conventional doctors and earn a greater income. On top of that, the elimination of the stigma surrounding midwifery can be achieved.
The National Council of Patrimony allowed Afro-Caribbean midwives to become a part of the Intangible Cultural Heritage list. With this recognition, the Government of Colombia acknowledges that traditional midwifery should be protected for years to come due to its important cultural value.
All in all, traditional midwifery assists in lowering maternal deaths in Colombia for Indigenous and Afro-Caribbean women. Unlike Western doctors, traditional midwives help women feel in control of their prenatal and postnatal care. With the help of ASOPARUPA and Malteser International, midwives became more knowledgeable in providing higher quality care to their patients. Since the Government of Colombia began to take midwifery more seriously, progress appears to be inevitable toward accepting traditional midwifery and reducing maternal mortality rates.
– Samantha Rodriguez-Silva