High maternal and infant mortality rates have plagued rural Chiapas for decades, often due to the lack of accessible hospitals and modern lifesaving skills amongst midwives when faced with complicated or high-risk births in rural settings.
Some prominent obstacles include a lack of young women with the desire to learn the tradition; difficulty in organizing and receiving benefits, recognition, or pay for their work; as well as the constant challenge of more modern birthing techniques. Another issue is institutions taking precedence over, as opposed to complementing, traditional midwifery.
A possible solution, however, is emerging in Mexico via both public and private institutions: lifesaving skills training for these midwives, with the potential to merge traditional labor and delivery methods with more modern medical practices. While a reduction in maternal and infant mortality rates has been reported in Chiapas in recent years, a new problem is arising: the oversaturation of hospitals, often with high rates of “normal” births, thus creating difficulties for doctors to attend to high-risk births. In order for this complementary solution to work, traditional midwives must continue to deliver babies, particularly normal births, and pass their integrated skill set to future generations of midwives — something that has proven to be far easier said than done.
In collaboration with Global Pediatric Alliance (GPA), I spent three days photographing the midwives who participate in their programs.
Welcome to Yajalón, Chiapas
I stayed in a small hotel located in the city center of Yajalón during my time photographing GPA’s work.
The next day, as we set out to meet the midwives of Petalsingo, I couldn’t help but notice these homes that seemed to defy structural norms. I was told that the rainy season (which had just ended) had flooded parts of Yajalón, taking with it masses of earth and causing heavy damage to the homes along the riverside.
Midwife of Petalsingo
This woman was one of the first traditional midwives that I met. She is from Petalsingo and participates in GPA’s midwifery workshops. In rural Mexico, traditional midwifery has been an integral part of childbirth, passed down from generation to generation. The midwives I photographed are part of the civil association Tzoblej Chihchil Nich Romero, which GPA helped to formally create in 2008 and, as GPA notes, “is self-governed by a board of indigenous midwives and is the first in the region to give community midwives a collective voice to increase their recognition within the health care system and gain better access to services for their clients.”
One of the youngest women in the group of midwives; she told me she mostly works as a curandera (traditional healer) in her community. While they are few and far between, younger women with the desire to learn the tradition often attend to women during their pregnancy, but rarely participate in the labor and delivery, therefore jeopardizing the practice’s longevity.
Midwife of Petalsingo
A traditional midwife in traditional dress; she seemed to speak little Spanish, so communication was difficult. But she did mention that she loves “los partos” (the births). According to Alejandra Alvarez, Program Director at GPA, the traditional midwives she works with attend an average of two to three births per month and around 30 annually.
Midwives leaving Petalsingo
The traditional midwives of Petalsingo leave the GPA meeting. In a recent interview with Alejandra Alvarez, she explained that “[traditional birth attendants/midwives] not only attend to the birth itself, but rather can be more accurately thought of as the woman’s gynecologist throughout her entire reproductive life.”
The following day we traveled to Tila, a neighboring community where GPA also runs their trainings. In the region where GPA works, women who choose to give birth with a traditional midwife are often checked at the local clinic when they go into labor, and then if the birth is deemed safe, they have the option of delivering with a traditional midwife, an option being chosen with less and less frequency.
Midwives in Tila
Upon arrival, I met these five traditional midwives. While only one of them spoke Spanish, they all held a fierce presence. The one (far right) who spoke Spanish reiterated the difficulties faced in traditional midwifery, the importance of it in her community, and the lack of young people with the desire to carry on the tradition.
Midwives in Tila, mother + daughter
This mother and daughter captured my lens; I couldn’t help but continue photographing them. They both participate in GPA’s workshops and the daughter (left) told me she was grateful for the organization’s presence.
These two traditional midwives watch the road after finishing their program evaluations. Since most of the women participants do not speak Spanish, volunteer university students helped with translating the women’s knowledge regarding birth-related themes presented in GPA’s workshops. Various local nonprofits are arming midwives with knowledge in lifesaving skills, as well as the understanding of ideal pregnancy and postpartum care.
Midwife in Tila
While this midwife did not speak much, she kept a sweet smile throughout the day. In communities where access to modern hospitals or birthing facilities is plagued with a variety of difficulties, traditional midwives become vital players in all aspects of pregnancy, labor, delivery, and postpartum care.
Midwife in Tila
Many of the midwives receive a small sum of 500 pesos (about $39USD) a month with the condition that they regularly participate in IMSS- (Instituto Mexicano del Seguro Social) run trainings; typically, this is their only income.
Midwives in Tila
These two traditional midwives pose for a photograph together, arm-in-arm. After finishing the project, I sent the photos to GPA’s office in Chiapas to give to each woman photographed.
Midwife in Tila
I found this photo particularly intense. While she never smiled for the camera, this midwife smiled off camera quite a bit. She is one of the midwives that public and private institutions offer midwifery skill-building workshops to in hopes of reducing high maternal and infant mortality rates in Chiapas.
Midwife and curandera in Tila
A midwife and curandera showed us one of her medicinal recipes used to cure respiratory aliments. In return for their services, many midwives and curanderas receive a chicken or other food product from community members, as tangible money is not in abundance in the region.
A healer, she was the last woman photographed in Tila. Most of the traditional midwives continue to be an integral part of their communities, whether it be in the context of birth, or as healers who are called upon when one falls ill. Their presence and skill set is still of great value in many health contexts within their respective communities.
Men helping each other
As I left the meeting with the midwives, I saw this sight: one elderly man helping another to his door. The phrase “A helping hand goes a long way” rang clear in my mind.
A reminder of where I was
On the way back to Yajalón, I saw this sign, a reminder of where I was. It reads: You are in Zapatisa Territory in rebellion; here the people order and the government obeys. “North Zone”. It is strictly prohibited to traffic arms or drugs, the illegal sale and consumption of intoxicating beverages [alcohol]. No to the destruction and sale of nature and the illegal sale of fine woods.
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Nikhol is a photographer based out of Oaxaca, Mexico, where she documents themes related to social justice and human rights. Combining her passion for visual storytelling with social justice, she has been documenting many aspects of life in Mexico since 2010, often in collaboration with grassroots nonprofits working in impoverished regions of the country.