Born In Chiapas

Women in the highlands of Chiapas, Mexico often rely on traditional midwives when they give birth. They want to be cared for according to their indigenous customs, and they distrust government hospitals. Midwives in Chiapas are respected and loved for their skilled hands and wisdom, and for the affection and comfort they bring to women in labor. Yet, they have long felt marginalized in Mexico’s healthcare system. Recently, authorities have started to reach out to the midwives by registering them and by organizing sporadic training sessions. They hope that better cooperation between doctors and midwives could help lower the region’s alarming maternal mortality and stillbirth rates that are significantly higher than the national average.

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Traditional midwife María Lopez Gonzalez, otherwise known as “Doña Mari, massages the abdomen of her patient Rosita Gonzalez Lopez, 22. Doña Mari says she can adjust the fetus so that the head will be in the correct position for the birth. If she feels that something is wrong during the pregnancy she takes her patients to a nearby government health clinic because she does not want to be blamed for any accidents. Rosita has never been to a hospital in her life, and for this birth (her third child), she asked Doña Mari to be her midwife.
Born In Chiapas
A young girl watches while traditional midwife María López Gonzalez, otherwise known as “Doña Mari, massages the abdomen of the girl’s pregnant mother. Many traditional midwives learned their trade by watching their mothers give and receive treatment during pregnancies. Doña Mari says she can adjust the fetus so that the head will be in the correct position for the birth. If she feels that something is wrong during the pregnancy, she takes her patients to a nearby small government health clinic for assessment.
Born In Chiapas
Children play in the road in front of their house in a small community in the Highlands of Chiapas, Mexico. They are relatives of traditional midwife María López Gonzalez (not pictured), also known in her community as Doña Mari. López separated from her husband a few years ago and now makes a living by growing corn, raising chickens and sheep, and serving as a traditional midwife.
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Chickens gather near the kitchen of Maria Morales López’s house in an isolated community one hour from Oxchuc, Chiapas. Maria, 58, has been a midwife for 40 years and claims to have attended to nearly 1,000 births. She has never received any medical training but says she has never lost a patient. She has seen a number of miscarriages though. Whenever she gets worried, she personally takes her patient to the hospital for a check-up. In her opinion, her patients dislike hospitals, since they fear unnecessary operations or not being respected. Morales wishes that doctors and midwives could work together better.
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Family members convene for a meal, inside the home of traditional midwife Maria Morales, 58, while her patient, Juana Gomez rests in an adjacent dwelling before giving birth.
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Olga Lidia López (M) comforts Juana Gomez Santis (seated) minutes after she gave birth, while the young girl’s mother, Manuela Gomez Santis (L), cleans up the placenta, in the home of traditional midwife Maria Morales López, 58, who lives in an isolated community near Oxchuc, in Chiapas, Mexico. Morales has been a midwife for 40 years and claims to have attended nearly 1,000 births. Most indigenous women in the remote highlands of Chiapas still prefer to give birth at home with a midwife. Morales believes that patients don’t like going to the hospital since they fear unnecessary operations or not being respected. Morales wishes that doctors and midwives could work together better.
Born In Chiapas
Manuela Gomez Santis cradles her newborn grandchild inside a Temazcal bath, similar to a sweat lodge, in a small community near Oxchuc, Chiapas. It is common practice in this region for new mothers to cleanse with their newborn babies daily inside the bath for 10 days after giving birth. Less than an hour earlier, her daughter, Juana Gomez Santis (also inside), had given birth to the baby with the assistance of traditional midwife Maria Morales López.
Born In Chiapas
In the evening, Antonia López Santis gives birth inside her home with the assistance of traditional midwife Sebastiana Girón Pérez. Accompanied by her mother and her husband, López had waited all day inside a local health clinic to have her baby. They eventually became frustrated by the lack of progress and decided to return home to give birth.
The Midwives of Chiapas
After rushing into the kitchen with a newborn and the placenta, traditional midwife Sebastiana Girón Pérez prepares to clean the baby with lukewarm water.
Born In Chiapas
A nurse checks a baby with high fever in the public clinic in Tenejapa, Chiapas. The area was long known for its high maternal mortality rates but over the past decade health authorities, together with international NGO’s, have been able to reduce these rates. Since most health professionals do not speak the local indigenous dialects, communication can be a problem. If patients need emergency treatment, they must travel another two hours by road to reach San Cristobal. (Photo made on 23/10/14 – Tenejapa, Chiapas, Mexico)
Born In Chiapas
The body of a stillborn baby lies delicately wrapped up in a hospital emergency room, ready to be handed over to its family. Doctors and nurses in the hospital are frequently confronted with such cases and complain that most of these tragedies could be prevented if women would come to hospitals earlier, before they are in a grave state. Often however, women who live in remote areas are unable to reach a hospital in time due to limited resources, lack of emergency infrastructure or family pressures. Fear of discrimination by doctors also discourages women from seeking medical help.
Born In Chiapas
A candle burns in the early morning on a tiny gravesite in Romerillo, a celebrated cemetery in San Juan Chamula, Chiapas. Researchers estimate that for every 100,000 women who give birth in Chiapas, 55 or more die, a rate significantly higher than that in the rest of Mexico.
Born In Chiapas
Indigenous women listen to instructors during a training session for traditional midwives in San Cristobal de las Casas, Chiapas. The red liquid on the floor was left after doctors performed a skit to highlight different emergency situations during pregnancy and childbirth, in particular the dangers of hemorrhaging, which is a primary cause for maternal mortality worldwide. (Photo made on 10/09/14 – San Cristobal de las Casas, Chiapas, Mexico)
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Sergio Castro (L) makes a house call to a terminally ill resident in San Cristobal de Las Casas in Mexico’s Chiapas state. The patient and his family are among many who trust Castro (known as “Don Sergio”) more than they do public hospitals. Castro previously treated predominantly burn victims from rural Mayan communities, but his reputation followed him to the city where families seek him out to treat any type of wound, including bedsores and diabetes ulcers.
Born In Chiapas
Traditional midwives eagerly accept the personal phone numbers of medical doctors in the region during a state sponsored training session in San Cristobal de las Casas, Chiapas. They were urged to call these doctors should they have doubts about how to handle emergency situations. Healthcare authorities of the state put on sporadic sessions like this one in order to try and form a relationship with the traditional midwives, who still attend to most childbirths in the local communities. Over 300 midwives were transported from highland communities to attend the event.