Reading in “Maternal & Child Health” regarding the balance of tradition and midwifery in Guatemala opened my eyes to the reality of giving birth in other nations outside of the United States. While most Americans seek modern technology before, during and after pregnancy and childbirth, this is not the case in many less developed and economically struggling nations. Notably, I was surprised to find that although approximately 71% of births in Guatemala are attended by midwives, a high percentage of these personnel do not meet WHO or UNICEF criteria for skilled birth attendants. When reading the statistic about having midwifes attend the majority of births, I was under the influence that because of this the nation’s infant and maternal mortality rates must be lower than in other nations without the help of birth attendants. However, as the chapter points out Guatemala is among the highest in maternal and infant mortality rates in the Western Hemisphere. The initiatives taken in the nation helped to train midwives in proper techniques, acknowledging signs of obstructed labor, and help to reduce these rates. One concept I found interesting was the need for support given to midwives, in return for the support they give to pregnant women and their families. For this reason the program Midwives for Midwives was developed, giving them an area for open and honest communication for the work they do and how it affects them. Looking more into this program, I found that between 2007 and 2010 a total of 450 midwives were trained in Guatemala. I find this statistic very hopeful for the future, and the possibility of sustaining the work and dedication numerous health officials have shown the region.
Source: http://www.midwivesformidwives.org/about-us
Hey, Hannah. I enjoyed reading your post, for I agree with some of your statements. As you mentioned, the Midwives for Midwives program successfully trained midwives as a way to combat the high maternal mortality rate in Guatemala. As illustrated in other studies, such as “Sing Safe Motherhood: A Story of the Women of Chiwamba, Malawi”, the training of trainers (TOT) approach to public health prevention yields successful results due to its sustainable nature. Thus, the Midwives for Midwives program lasted for nine years, a hopeful statistic indeed. However, the case study also mentions other obstacles associated with sustainable practices that illustrate that the Midwives for Midwives program “failed” in some capacities. For example, the Ixmucane Birth Center closed due to a lack of funding to sustain the efforts, which stemmed from the new global emphasis on training skilled birth attendants rather than midwives. Thus, I am not as “hopeful” from the conclusions of this case study. Instead, I focus on the necessity to incorporate sustainable practices with regard to funding rather than just on the training of the individuals.