True Labour of Love

Central American Midwives - A True Labour of Love
By Catherine Cunningham

There is no doubt that midwives worldwide are very special people. They possess a unique ability to care for women and newborns and it takes a distinctive set of skills to qualify for the job. More than 60% of the world’s babies are helped into the world with the hands of a midwife or traditional birth attendant. In Central America, midwives are generally referred to as “traditional midwives”.

Central American traditional midwives are usually well known and respected in their community. Many traditional midwives say they felt a calling to be a midwife and learned their skills through apprenticeship and experience rather than formal training.

But Central American midwives have a tougher job on their hands than their counterparts in wealthier countries. In countries such as Guatemala, Honduras, Costa Rica, Nicaragua and El Salvador midwives can often be found working under appalling conditions, depending on how unstable their country’s health system is, and the majority of these women do not get paid for their hard work.

PAHO (Pan American Health Organization) estimates that there are about 22,000 maternal deaths per year in Latin America and the Caribbean with an aggregate ratio of 190 deaths per 100,000 births. PAHO also estimates that under-reporting in many regions can be as high as 70%.

In Central America, traditional midwives attend most of the deliveries where the maternal mortality is the highest due to poverty. The contribution of traditional midwives to the health of nations has been undervalued by governments and insufficient resources have been allocated to providing midwives with the equipment, training and medicines that they need to carry out their job safely and effectively.