Healthy Mothers, Healthy Babies
Indigenous women in Guatemala train to become midwives, bridging traditional and modern health care
Sofía Lorenzo, a 24-year-old Indigenous woman from the Western Highlands of Guatemala, smiled as she recounted the memory of her first time working as a midwife.
“9:05 in the morning on May 19th, 2019; you never forget the first baby you deliver,” said Sofía.
Sofía was inspired to become a midwife by her great-grandmother, who was a comadrona — part midwife, doctor, pharmacist, and all around community leader in Michicoy, the small village in the mountains where Sofía grew up. Comadronas provide traditional health care to women and children in Indigenous communities in Guatemala.
In the Western Highlands, financial, cultural, and geographical barriers often prevent pregnant women from giving birth in health care facilities. Many women are simply afraid due to negative experiences.
A lack of access to health care presents life or death consequences. In Guatemala, the average maternal mortality ratio is 105 deaths per 100,000 live births, the highest in Central America. For young Indigenous women, the risk of maternal mortality is 38 percent higher than average.
Since 2018, USAID has partnered with the Guatemalan Government and private educational institutions to create a professional midwifery program to recruit, educate, and create jobs for young Indigenous women, who can provide culturally sensitive health services in their communities.
To date, 150 young indigenous women have participated. As part of the program, Guatemala’s Ministry of Health guarantees the women a job as a midwife after they complete their education. This year, 33 midwives were hired, 16 of which graduated the program in February and 17 in July.
Women like Sofía, who speak the local language, understand cultural birth practices, and recognize modesty and gender concerns, can help improve trust in their communities and their access to health care.
Sofía is the first woman in her family to go to university — she graduated valedictorian from her program at Da Vinci University in Huehuetenango. She’s passionate about breaking cultural biases against women pursuing higher education.
“I have learned while studying that I have a responsibility to empower girls and women,” said Sofía.
As a midwife, Sofía is a bridge between modern and traditional practices, providing a cultural context to prenatal, delivery, and postnatal care. She will soon work alongside comadronas to provide health care for Indigenous women in their homes and augment the traditions and practices of Indigenous communities with modern medical practices.
More than 6 million people in Guatemala, about 35 percent of the country’s population, lack access to basic health and nutrition services. USAID programs improve human resources for health by supporting the training and development of health providers like Sofía, and strengthening the health system to ensure community needs and cultural traditions are respected.
USAID works with communities on health and nutrition issues, as well as the adoption of healthy behaviors such as breastfeeding, hand washing, nutrition, adequate birth spacing, gender-based violence prevention, safe sex, and responsible fatherhood.
USAID’s efforts to reduce preventable maternal and child deaths helps address the root causes of irregular migration from Central America to the United States. By improving access to health care and meaningful employment opportunities, USAID is helping families stay safe and healthy in their home countries.
Sofía is proud to be a midwife, continuing a tradition in her family. By combining modern medical practices with traditional practices, women will have access to dignified, safe, and quality healthcare.
One day, Sofía too will inspire the next generation of midwives.
“I hope to be a great midwife for rural communities,” Sofía said, “but also I hope to represent Mayan women, to prove that rural, Indigenous women can contribute to public health and save lives.”
About the Author
Benjamin Ilka is a storyteller and visual media specialist at USAID’s Mission in Guatemala.
