1 / 16

Melissa Gadilla Dr. Claudia Valeggia Health and Societies April 27, 2011

Comparing Childbirth Practices in Santiago Atitlán, Guatemala Connections, Variations, and Conflicts in Traditional and Biomedical Obstetric Care . Melissa Gadilla Dr. Claudia Valeggia Health and Societies April 27, 2011. Two Birth Stories. Magdalena’s and Chonita’s birth experiences

perry
Download Presentation

Melissa Gadilla Dr. Claudia Valeggia Health and Societies April 27, 2011

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Comparing Childbirth Practices in Santiago Atitlán, GuatemalaConnections, Variations, and Conflicts in Traditional and Biomedical Obstetric Care Melissa Gadilla Dr. Claudia Valeggia Health and Societies April 27, 2011

  2. Two Birth Stories • Magdalena’s and Chonita’s birth experiences • Magdalena gives birth at home with Antonia, a 77 year-old traditional midwife (comadrona) • Chonita gives birth at the free birth clinic in the Centro de Salud with a physician and two auxiliary nurses • Narratives to represent present day obstetric practices in Santiago Atitlán

  3. Background: Santiago Atitlán • Located in the western highlands of Guatemala in the state of Sololá • Population: 44, 220 inhabitants • 98.18% Maya Tz’utujil 1.82% non-indigenous • Site of major state-sponsored violence during the country’s 36-year Civil War • Severely affected by Hurricane Stan in 2005 causing hundreds of deaths and homeless

  4. Social Context • Economy of agriculture, fishing, and tourism • More than half of all families in Atitlán earn less than $200 a month • The “Exclusion of the Maya” • Disparities that inflict Atitecos today contingent to their history and strong sense of cultural retention

  5. Maternal Mortality in Guatemala • Guatemala has the highest rate of maternal mortality (MM) in Central America and third highest in Latin America • ~ 290 deaths per 100,000 live births • 80% of childbearing women are attended by a traditional birth attendant • Department of Sololá has the 3rd highest MM rate in Guatemala • MM profile: “A woman of indigenous background, with little or no education, who intended to give birth at home with a comadrona.”

  6. Medical Pluralism in a Tz’utujil Culture • Coexistence of two medical systems: traditional medicine and a biomedicine

  7. Traditional Medicine • Historically, most widely-used system • Composed of traditional healers (curanderos) and traditional midwives (comadronas) • Hierarchy of resort today continues to be skewed towards traditional medicine • Group of ~28 comadronas • Informal women’s health system: assist women throughout all stages of pregnancy and treat issues related to gynecological care

  8. Profile of the comadrona • Unclassifiable and heterogeneous • Generally an older woman, often with minimal or no schooling, who lives in the community and is recognized for her experience caring for pregnant women” • Vary in process of selection, formation, and reproduction • No formal training

  9. Biomedical Community • Lack of strong centralized health care system model trickles down to smaller villages like Santiago • Biomedical community: • Centro de Salud with integrated birth clinic • Hospitalito Atitlán • Rxiin Tnamet • Prodesca • Private doctors • Not a consolidated community • United by the “Red de Salud”

  10. Research Questions What factors influence the childbirth practices of traditional midwives and physicians in present day Santiago Atitlán? • Connections: Where comadrona meets doctor • Variations: Where health models diverge • Conflict: Disagreement between caregivers

  11. Methods • Participant Observation • Midwifery training sessions • Traditional pre and postnatal care, labor and delivery • Volunteer at Centro de Partos (birth clinic) • Semi-structured and Structured Interviews • Comadronas and biomedical practitioners • Questionnaire • Apprenticeship • A student of midwives

  12. Topics Explored • Where obstetric knowledge comes from • Intents of collaboration: • Biomedically-directed midwifery trainings • Incorporating midwives into biomedical settings • Defining the “Birth Space” • Role of Caregiver

  13. Results • Empirical vs. non-empirical knowledge • Marking birth priorities • Why incorporating comadronas did not work • An intermediate “birth space” • Challenging a traditional model of birth

  14. Conclusion • Connections • Variations • Driving forces: a midwife’s experience and spiritual guidance and a physician’s biomedical background • Conflict • Midwives expect normal births, they do not treat pathologies

  15. Further Implications • Establishing effective partnership • Sustainability of public birth clinic • Intermediate space as “layover” location • Ability to choose care

  16. Thank you!

More Related