Honouring traditional midwifery, valuing the knowledge: a Mexico conference: Diane Holzer, of the Midwives Alliance of North America, describes a meeting of traditional and professional midwives in Oaxaca, Mexico, September 2003.

• Auteur: Holzer, Diane

The theme of this joint conference co-organised by Midwifery Today and the Midwives Alliance of North America (MANA) Mexico was 'Honoring Traditional Midwifery'. It was a popular event with 250 participants, almost half of whom were traditional midwives. It was held in a church facility called 'Our Lady of the Poor People' which is located in Oaxaca, Mexico. Oaxaca is an enchanting city, nestled in the centre of a ring of sacred mountains. It holds ancient ruins that show where indigenous peoples have inhabited this land for centuries. The present population of the state of Oaxaca is 80% indigenous people with many different languages, customs and styles of dress. This rich culture combined with the rural nature of the area has enabled the traditional midwives and healers to remain central in the community.

There are thousands of traditional midwives living in this area. Many of those attending the conference were familiar faces who often come to meetings of MANA Mexico, and there were also a number of new participants who quickly became friends. There was representation from all over Mexico: as far North as Sonora, to Chiapas in the South. Along with Mexican midwives there were representatives from Denmark, Sweden, Spain, Switzerland, England, Puerto Rico, Guatemala, Jamaica, Brazil, Argentina, Costa Rica and about 30 or so from the USA. This provided for a rich cultural exchange as all of the sessions were translated.

Birth interventions

We heard updates on maternal health and midwifery from the countries in the Americas and learned that the Americas is home to the country with the highest Caesarean section (CS) rate in the world--Puerto Rico, with a rate of 46%. Brazil is well known for having a high CS rate, because many of the hospitals and clinics in the urban areas have rates of 95% or more. However, it seems that the reason that Brazil only has a 40% CS rate is because there are approximately 450,000 births a year, mostly in rural areas, that are attended by traditional midwives (this represents about 15% of all births in the country). As there are very few operative deliveries among these births, this balances out the high rates in the cities. Thus it appears that the traditional midwives' practice is the reason that Brazil does not have the highest rate in the world!

There is a national programme in Mexico, supported by television and radio, that urges men to not take their wives to the midwife but bring them instead to a clinic...