Bienvenido al Mundo

In the mornings that I have spent in the workshop space at Luna Maya I have read on the white board the words "para cambiar como vivir, debemos cambiar como nacer" to change the way we live we must change the way we are born. These have been very poignant words as I have delved more deeply into the world of midwifery and birth here in San Cristobal. I have faced this issue by looking into the many facets of how we birth. One aspect is who we birth with. In the united states most women choose to give birth in a hospital environment, in case something goes wrong. The midwives here at Luna Maya and I have discussed this concept thoroughly. To choose a hospital just in case, is based on a general assumption that something will go wrong, that as women we do not have the capacity to birth. When we know, either consciously or not, that hospitals can offer c-sections and emergency care, it begins to chip away at our resolve to push our babies out into the world. The united states suffers from one of the highest rates of c-section in the western world. Those countries that have the lowest rate of c-section (nederlands and scandanavia) are those in which women are attended to primarily by midwives. So where does Mexico fit in this picture? Mexico suffers from the second highest rate of c-section world wide after Chile, between 40-70% depending on the hospital. To choose to give birth in a hospital is akin to signing a waiver allowing a physician to slice into your belly to bring your child into the world. Mexico, though, still relies on midwives in various rural and impoverished areas. This midwives are often refered to as "traditional" midwives who have received information passed down from elders in their communities. A prominent issue with traditional midwives is what i have deemed "el sindrome de estar en medio" or the sindrome of being in the middle. This is a complex of symptoms that I have seen played out all over mexico and developiong countries. To be put simply, when globalization or development influences a loss of traditional customs and knowledge in exchange for "newer and better" ideas often leaving entire populations in the middle. For example, urbanization: people give up their simple homes in rural areas to move to the city. They exchange good soil and access to water for a hovel in the city where water must be purchased in order to work for an industry and earn $$; another example is a woman that is brought up in a family that has left its traditional community in which she would have seen women birth babies and breasfeed, to be in a more modern community in which birth is not discussed. In the moment that she is faced with actual labor her level of fear is so great that she needs to be constantly coaxed back into her body, she has never seen a woman breastfeed and relies on a male doctor in a hospital who is not trained in lactation to attend her. To bring this discussion back to the tradtional midwives, many of them have been trained in western medical techniques such as the use of injections of Pitocin, a synthetic version of Oxytocin a hormone that is released during labor to promote contractions. It is now assumed that when a woman in labor goes to a traditional mayan midwife she will receive an injection, when an injection is not provided her skills are brought into question. With this reliance on modern medicines her knowledge of normal, unassisted birth declines. Not only is she left in the middle with a loss of her communities traditional knowlegde and a mis-managment/understanding of western medicine, but her patients are also left in this limbo, being hung between the worlds of tradition and medical science. Basically they are jodido, stuck in the middle with nothing!

This last thursday i was given the honor to be at my first birth here at Luna Maya. She was a fifteen year old mexican woman whose family had disowned her when she ran away from home to be with her boyfriend. They decided to get pregnant, coming to Luna Maya at the first signs of labor. Not only had she virtually had no prenatal care, she had no idea what to expect during birth. After three days of ¨practice contractions¨she returned to the clinic to truly birth. She was supported by a fabulous team of myself, cris the midwife, her spanish muslum assistant Sayida, and another apprentice jennifer. It took all four of us to support her through the birth, remind her to breath, and tell her that she could do it as she gazed out the window between contractions. The beauty of this birth was watching how a woman who has been given no training, and who has no understanding of birth or her body could actually bring her child into this world with the right support team. She labored for apporximately 12 hours and then pushed for one. She had no desire to connect with her baby, and didn´t talk to him after he was welcomed into the world by his midwifery team. It is beleived that a common cause of hemorrhage post birth is this lack of connection with one´s baby, a complication that occured and was easily handled in the clinic. Almost a week later the baby still doesn´t have a name, but is grow healthily here in San Cristobal. This young woman seemed to embody this sindrome de estar en medio, having been brought up in a community that has lost the ability to share the womanly arts of birthing and breastfeeding, having no experience or knowledge, leaving her dangling in the middle. Her birth was not that of an empowered woman wanting to take back birth, nor was it of an indigenous woman who was confident in her body´s abilities. All that said, it is still a miracle to watch a new life take its first breath...Bienvenido bebe!