An undervalued task

By Aura Arango, Wendy Cifuentes and Claudia Méndez 

Midwives play a very important role in society, supporting woman in giving birth from the moment the mother realizes she is pregnant, during each stage of pregnancy, delivery, and nursing. Midwives have become important, as access to care rooted in cultural traditions has been shown to have positive effects on people’s health.

The paper Supporting birth: an under-valued task is a field investigation undertaken in the town of La Esperanza, Quetzaltenango by students studying a Master of Health Systems Management at Universidad Galileo. The focus of the paper is to outline the actions midwives take in emergencies, taking into perspective culture and the local context.

In Guatemala, midwives are vitally important, especially in remote areas that lack hospitals and health centers.

One of the objectives of this investigation was to gather and document the legal basis for their work as agents that promote safety in the Guatemalan health system and follow emergency procedures while helping mothers through delivery complications in a way that respects indigenous cultural traditions. All of this contributes to the strength of the town of La Esperanza.

The results of the study revealed that although midwives follow emergency protocols, they don’t follow any practical guide, which means they take on roles that lack any legal basis. This puts the safety of patients at risk. Having a guide based on the understanding of diverse cultures would help to prevent malpractice. This lack of written protocol can unleash an array of problems and is a continued risk to patients.

As these communities are closer to municipal centers, prenatal care consists solely of the ingestion of folic acid. Safe phytotherapy—the use of medicinal plants to strengthen the immune system—is often dismissed.

Actions, protocols, and constant evaluation are important because they are pro-life, pro-health, and also meet the objectives of the Ministry of Health.

The findings of this investigation show the importance of the creation, promotion, and evaluation of action-based protocols against emergencies in health centers. Even better, these should be formed systematically and synthetically, working with practical guides for all collaborators.

The government should support the academic spaces necessary for this work, such as university programs that educate and train midwives. In this way, action is taken to advance social and international responsibility towards health, human rights, and indigenous peoples.

Promoting public administration and management of midwives is a global health response. As presented by the World Health Organization (WHO), the United Nations Population Fund (UNFPA), and the International Confederation of Midwives (ICM), the world needs around 900,000 midwives to provide gestational and neonatal care.

The UNFPA indicates that the lack of midwives and slow progress to increase the number of midwives in the world has an enormous impact on families.

Aura Arango, Wendy Cifuentes, and Claudia Méndez are students in the Universidad Galileo’s Master in Health Systems Management, and authors of the research paper: Apoyo en el alumbramiento una tarea desvalorizada (Support in birth: an undervalued task).