Comadrona

The Sacred Calling of the Comadronas:
A Tribute to Traditional Mayan Birth and
Postpartum Healing Practices, Rituals,
and Remedies
By: Essence Williams, RN, BSN, CBC, CCE, SNM
© 2015, Essence Williams
Overview of Midwifery Research and Passion
• Presentation focuses on:
• Information gathered from specific
interviews from traditional Mayan
Comadronas from the Mam Community in
Concepcion Chiquirichapa, Guatemala
• Ethnographic research on traditional
midwifery physiologic birth and postpartum
practices, rituals and cultural taboos
• Traditional Mayan herbal healing remedies
and holistic treatments
ACAM Birth
Center
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Asociation de Comadronas del
Area Mam
Study Abroad site specific
location in Concepcion
Chiquirichapa in western
highlands of Guatemala
Only medical facility owned and
operated by traditional midwives
who are decedents of the
ancient Mayans
Midwifery Board of Director
meetings held at the birth center
Midwives provide services
which include:
prenatal, birth and postpartum
care
Home visits in the community
Traditional healing remedies
and holistic herbal medicine
Who are the Comadronas?
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Midwives aka Comadronas or
parteras in Latin America
Women recognized by
community members as
trusted, wise, spiritual healers
Receive training by way of
observation or apprenticeship
Accepted the sacred calling of
midwifery
D/t lack of education, gender,
& ethnicity, they are commonly
devalued by formal health care
systems
Often the scapegoat for high
Maternal & Infant mortality
rates in the Guatemala
(Walsh, 2006)
Sacred Calling of the Comadronas
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Comadronas in Guatemala speak of being
called to the practice of midwifery
Receive the calling through communication
from God or a saint in dreams or visions
Dreams/vision indicate a sign from God
Believe that their calling is “sacred”
Comadronas believe in being born with the
“Don” or (God-given gift)
Mayan spiritual beliefs include a strong
integration of natural and the supernatural
world
The sacred calling often includes symbols and
objects linked to nature.
One comadrona described walking down a
path and finding a small stone with the shape
of a baby’s face. To her this meant she would
start the work of a midwife (Walsh, 2006)
Many comadronas often reject their calling at
first
If they reject the calling they usually get ill or
sick with unusual ailments that are unable to be
diagnosed by medical doctors (Walsh, 2006)
Once these women begin the work as a
comadrona, they regain their health
Meet the Comadronas at ACAM
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Azucena: midwife for over 35 yrs,
Attended 1st birth at 15
Vice President & Founder of ACAM
in 1999
Midwifery Board of Director member
Women’s rights public speaker & activist
Volunteer Firefighter
Mother of 3 daughters
Antonina: ACAM President,
President, Head midwife, visionary
midwife for 31 yrs
Founding Founder of ACAM
Mother of 7 children & 17
grandchildren
Imelda: Antonia's daughter, inspired
by Antonina to practice midwifery
Midwife, office secretary & teacher
Manages financial reports &
medical records
Responsible for blood tests,
teaching computer classes &
prenatal consults
Maria Azucena Fuentes Diaz, Midwife,
Herbal specialist
Maria Antonina
Sanchez Mendez,
Head Midwife
Imelda Lopez
Sanchez, Midwife,
Secretary
Meet the Comadronas at ACAM
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Ana Cristina
Villagers
Cifrentez, midwife
Santos Lopez
Romero, midwife
Ofelia
Augustina
Hernandez
Lopez,
midwife
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Cristina: midwife for 17 yrs
Was called to the midwifery
practice through dreams and
visions
Former ACAM vice president
Mother of 4 children & 7
grandchildren
Santos: midwife for 26 yrs
Midwifery Board of Directors
Member, artisan
Former Red cross member
Mother of 5 children & 6
grandchildren
Ofelia: midwife for 24 yrs
Member of ACAM for 12 yrs
Member of Maya Fraternity
Mam Association member
Mother of 4 children & 1
grandchild
Mayan Traditional Beliefs
and the Notion of Healing
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Mayan traditional healing is directly related
to their cultural belief systems
Mayans believe:
Universe divided into 3 main regions:
heaven, earth & underworld
Many Gods reside over all 3 regions
No clear separation b/t matter & spirit,
heaven & earth, & mind & body
Understood that individuals do not become
ill or receive cures in isolation
Responsibility of the entire family and whole
community to maintain health
Illnesses seen as a state of imbalance
Health is achieved by bringing a person
back to balance or homeostasis (balance
within, oneself, community, nature or
supernatural world)
2 classifications of illness:
1st class: caused by organic/physical
conditions (i.e. poor diet, contamination)
2nd class: caused by supernatural or spiritual
forces (i.e. concepts of “evil winds”,” evil eye,” & “fright.” (Proechel, 2005)
Mayan Concept of “Hot” & “Cold”
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Mayan concept of Hot vs. Cold directly
related to maintaining state of balance
& good health
Concepts do not only refer to the
temperature of something
Has more to do with:
Inherent qualities
The effect something has on the body
or its relationship to other things
All foods, herbs, & medicines are
classified as hot or cold
Conditions such as pregnancy, birth &
Postpartum (PP) are all considered
“hot” states
Traditional Mayans believe in order to
maintain good health, one must avoid
extreme temperatures, sudden change
in temp and the mixture of hot & cold
things (Proechel, 2005)
Mayan Pregnancy, Birth & Postpartum Taboos
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Cravings considered important: understood
that baby is asking for food
If a woman does not satisfy cravings during
pregnancy, baby may get sick
Considered taboo for pregnant women to walk
on a cold floor
During pregnancy, birth & PP women advised
to stay warm at all times
They should avoid cold foods & drinks and
cold temperatures
Avoid getting pregnant belly wet or cold
Believe that the baby can get cold so
comadronas have to keep them warm during
birth
Exposure to cold winds can cause illnesses, &
PP & breastfeeding problems
“The evil winds”: major cause of imbalance in the body
Belief refers to:
Physical winds (cold nights): can cause harm
Supernatural forces of the wind: bring evil
spirits, possess people or take away their
souls
Other supernatural forces of illness that are
taboo include: “Fright,” “Envy,” “Grief,” & “The Evil Eye,” (Proechel, 2005)
“The Evil Eye”
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Spanish: Mal de Ojo
Evil look, look of envy or hot
gaze
Mayan belief that if a
pregnant woman has a hot
gaze & looks at someone
else’s child with admiration they can cause illness to that
child (Proechel, 2005)
Necklace of Oxoh seeds
(Abrus Precatorius): plant that
resembles “eyes” cures evil eye in Mayan tradition
Mixture for the cure of the evil
eye includes:
Maria Luisa, Rue, orange leaf
mixed together in a tea
Oxoh seeds
Rue (Ruda)
Lemon Verbena
(Maria Luisa)
Orange Leaf (Hoja
de Naranje)
Susto
Pata de
Gallo
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Peppermint(Yer
ba Buena)
Marigolds
(Calendula)
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Fennel (Hinojo)
Geranium (Geranio
Santisimo)
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Susto in English means “fright” or “trauma”
Susto most common supernatural
illness
Can be caused by someone
experiencing trauma or seeing
something tragic (Proechel, 2005)
Mayan belief that pregnant women
need to be cautious to avoid Susto
Susto can cause illness to the unborn
child
Mayan Midwifery Cure for Susto
includes:
Yerba Buena (“Good Herb”), Marigolds, Geranio Santisimo, Fennel
& Pata de Gallo
Mix the herbs in 2-3 different glasses
Spit the herbal mixture on the mother
from head to toe
Then wrap the mother in blankets to
keep her calm
Alleviates fright or fear
Mayan Midwifery Prenatal
Rituals & Practices
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Prayers & ritual cleansings alleviate pain &
expel sickness from the body
Herbal remedies, teas, medicines are used
for ailments
Sobadas or Masajes aka Mayan abdominal
massages; promote comfort & healing
Abdominal massage repositions organs &
release tension in pelvic region
Masajes are the foundation of prenatal care
for Comadronas at ACAM birth center
Comadronas specially trained to do manual
external cephalic version for pregnant
women
Comdronas manually reposition the fetus as
they pray, chant and talk to the fetus in Mam
Ritual helps to rotate the baby from breech
or shoulder presentation to cephalic
presentation: Done b/t 29-36 wks
Then they wrap the mothers belly with a Faja
or abdominal cloth belt to prevent
malpresentation of the fetus
Mayan Birth Practices & Rituals
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Childbirth in Mayan culture is womencentered
Important to communicate with the
mother
Keep her comfortable & warm
Perform Masajes
Comadronas pray for mom & baby
during labor & after birth
Ritual cleansing (esp. washing vaginal
area & legs)
Mayan ritual to ensure that mom stays
clean
Give mother herbal teas to help her
stay calm & relaxed
Encourage & provide family support &
emotional support
Mayan belief that if the mom is really
sad during labor & birth with no
emotional support may lead to PPH
Postpartum Rituals
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Masajes are extremely important in PP
period
Help the uterus contract
Way for comadronas to make sure
uterus is firm & to assess bleeding
Comadronas give herbal teas to help
expel placenta and decrease bleeding
If woman has eclampsia PP,
comadronas place onion under her
nose to revive senses, promote
breathing & decrease convulsions
Informal APGAR score: check baby’s appearance, reflexes, RR & vitals
If baby has apnea or is not breathing
onion is placed under baby’s nose to increase O2.
ACAM Comadronas practice delayed
cord clapping, after cord stops
pulsating, its cut & tied off with a
cotton string
Weigh & measure baby
Promote skin-to-skin and ensure that
mom and baby stay warm
Postpartum Rituals & Practices
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Breastfeeding is the common
Comadronas encourage Breastfeeding, ensure
that baby has a good latch & is nursing well
Mom is given herbs to increase milk supply
8 day resting in period: mom & baby are
protected from visitors for a week
Promotes bonding, helps mom recoopretate
after birth
Mom is relieved of childcare & household
chores
Comadrona performs steam baths massages,
cares for baby & gives advice about PP
nutrition & activity
Prior to discharge from ACAM babies are
swaddled in traditional Guatemalan cloth to
keep warm
After a wk PP, Ritual celebration takes place in
the community honoring mom and baby’s new arrival
Ceremony held in gratitude of the “Heart of the
Sky” & ”Heart of the Mother Earth.” Baby remains connected with the cosmos: the
sun, fire, rain, water, air, clouds & the Earth.
Rebozos and Sabanas
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Rebozos: long piece of woven cloth or shawl (30 in
wide) Decorated w/ intricate colors and designs
Used for a variety of purposes:
Birth rope or sling: slung over a roof beam for the
mom to pull herself up on during contractions
Helps mom get into a good squatting position and
tilt her pelvis towards gravity; facilitates birth of her
baby (McGann, 2010)
Guatemalan women tie Rebozo around mom in PP
period to help get the placenta out
Mexican moms use it as an infant carrier
U.S. moms have adopted the rebozo during labor &
birth to help turn a baby from malpresentation to
occiput anterior position.
Used by slinging the rebozo underneath the
mother’s pelvis and lifting it up above her head and holding the rebozo in each hand then shaking it
back and forth.
Allows gravity to pull the fetus’ head out of the pelvis so that it may reposition itself.
Sabanas: longer piece of wool or woven cloth
similar to rebozo
Guatemalan moms use Sabanas as infant carriers
Slug over shoulder & tied, creating a pouch that the
infant may sit or lie down in.
Allows mom to carry baby close to her leaving her
hands free to do daily tasks & allows baby to
discreetly breastfeed on demand (McGann, 2010).
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Infamous Guatemalan Backstrap Loom Weavings
Backstrap loom includes 2 sticks with a backstrap attached to one side of it
One part is strapped around the back of the weaver
The other side is attached to a fix object such as a tree
Use flowers, fruits (berries) and dye from indigo for the vibrant colors of the
weavings
Guatemalans are known for weaving beautiful traditional ropas or clothes, blankets,
rebozos, sabanas, listons, bufandas or scarfs etc.
Mayan Fajas
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Wide-hand made abdominal binding
belt
Comadronas do a Faja wrap twice in
PP using a large traditional Mayan belt
Wrap Faja around the upper abdomen
over the umbilicus
Then they wrap a 2nd Faja around the
hips (lower pelvic region)
Hips are believed to be open after birth
Faja helps bring a woman’s hips back together
Faja wrap helps prevent PPH
Ties up the hip bones really tight to
prevent air from entering inside the
woman
Believed to keep the uterus from
falling down
Helps uterus close and contract
Worn for 2 wks except at night & in the
Temascal
Traditional Mayan Temascals
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Temascals: Traditional Mayan Sweat baths
similar to Native American sweat lodges
Mam: called Chuj
Important aspect of Comadrona’s midwifery
care
Used for bathing, curing illnesses, relief of
common discomforts of pregnancy & PP
recovery
Used to be made of adobe now made of
cement (5’ ft tall with a pointed roof)
Heated w/ an open fire built inside
Once smoke clears, only heat is given off &
temascal door can be closed
Large pot of water also heated inside with
traditional herbs for healing/calming including:
Eucalyptus, Salivia Santa (Verbenaceae) &
Matricaria Courrantiana (chamomile)
Comadrona goes in with mom during
pregnancy or PP
Moms are given full body masajes
with jabon negro
Comadronas also blow hot steam onto moms
vagina to help warm the uterus & baby
(Proechel, 2005).
Guatemalan
Temascal
Mexican
Temascal
Mayan Vaginal Steam Baths
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Traditional vaginal steam treatment
aka bajo
Performed in the temascal during PP
period
Comadrona opens woman’s vagina
Blows hot steam towards genital area
Herbal steam helps to warm the uterus
Used to nourish, heal, tone, cleanse
and bring oxygenated blood to vaginal
tissues
Good for perineal lacerations,
episiotomies & C-section wounds
(Proechel, 2005)
Helps improve blood flow and
circulation to vaginal tissues
Beneficial for PMS, cramps during
your period, blood clotting during
menstruation, endometriosis &
maintains healthy fertility (BartonSchuster, 2014)
JABON NEGRO
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Traditional Mayan black soap (size of a grapefruit)
Mayan Indigenous Comadronas & villagers make their own soap
Made out of Ashes, Lime & Lard in a 55 gallon drum, cooked over fire &
then rolled into a ball with lard as the base
Used for washing clothes, bathing, masajes, & healing in the temascal
Has heating qualities, antibacterial, strong smelling, very slippery
Aids in healing & cleansing a mom after birth in PP period (Proechel,
2005)
Interview with the
ACAM Comadrona Azucena
• Comadrona, Shaman
healer and Traditional
herbalist who
specializes in:
• Mayan Massages
• Traditional herbal
medicine & remedies
• Cures for the evil eye
and susto
Mayan Traditional Herbal
Remedies Used for Pregnancy
Salad burnet or
Pimpinela/
(Pimpinel)
• Pimpinela, Pericon, &
Chamomile: herbs to help
warm the uterus
• Helps uterus function
better & encourages a
smooth delivery
• Hierba Mora: High in iron Sweet Mace or
• Helps increase iron levels Pericon/ (Joq)
during pregnancy
• Good for diabetes & aids
in circulation (Proechel,
2005).
Chamomile or
Manzanilla/
(Mansaniy)
Nightshade or
Hierba Mora/
(Mo’ch)
Mayan Traditional Herbal
Remedies Used During Labor & Birth
Corn meal or
Harina de Maiz
Ginger or
Jengibre
Chili pepper or
Pimienta chapa
Anise seed or
Semillas de anise
Xpaq
• Atol de Suche: porridge
made of corn meal,
ginger, anise, xpaq &
pimienta chapa (type of
chili pepper)
• Herbal tea for women in
labor
• Helps warms the uterus &
the baby
• Gives extra strength for
the work of labor
Mayan Holistic Herbal Remedies Used in
Postpartum Period
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Altamisa: used to help
decrease PP infection
Cancerina: used to cleanse
the blood, antiseptic & diuretic
Milenrama: Used for PP
hemorrhage, helps purify the
blood, UTIs
Langa de Baca: used for
coagulation issues, helps with
blood clotting, good for nose
bleeds
Chosix: used as an herbal
slap treatment during
masajes in temascal
Comadrona uses herbal
bouquet to slap the moms
entire body, provides heat &
circulation to the skin
(Proechel, 2005)
Feverfew
(Altamisa)
Yarrow
(Milenrama)
Mexican
Heather
(Cancerina)
Chosix
Cow’s Tongue
(Langa de Baca)
Mayan Traditional Herbs Used For
Breastfeeding
Ixbuth
Holly Herb
(Verbena)
Fennel (Hinojo)
• Ixbuth: Increased milk
production
• Verbena: “Holly Herb” promotes lactation
• Used as an abortifacent
• Hinojo: Helps w/
mammary gland & milk
production
• Reduces intestinal gas in
mom & baby
• May also be used for
Susto
Mayan Traditional herbal Remedies Used
for Urinary Tract Infections
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Chichicaste: used for UTIs,
strengthen kidneys,
Reduce cramps, treats joint pain,
sprains, strains tendonitis, arthritis
& anemia
Diente de Leo’n: UTIs, decrease
inflammation, prevent infection,
helps treat diabetes, HTN, high
cholesterol, increases liver
function, fights cancer;
High in antioxidants, helps boost
immune system
Planta de Bolsa de Pastor
(Shepherds Purse): used for UTIs,
circulatory problems (Heart failure,
low b/p)
El Maiz de la Seda (Corn Silk):
used for UTIs, helps w/ bladder
function, prevents kidney stones
Nettles
(Chichicaste)
Shepherd's Purse
(Planta de Bolsa de
Pastor)
Dandelion
Leaves (Diente
de Leo’n)
Corn Silk (El Maiz
de la Seda)
Vision of the Future For Maternal-Child
Health care in Guatemala
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To help improve maternal and child health and reduce
the high infant mortality rate in Guatemala the following
interventions need to be implemented:
Promoting sexual health & childbirth education in health
centers, birth centers and local hospitals
More maternal-child health supporters advocating for
women’s rights in Guatemala
More government funding and expenditures geared
towards maternal child health
Additional midwifery training programs for midwives
available in the indigenous Mayan communities
Midwifery training workshops taught by health care staff
in their native languages (i.e. Kaqchikel or Mam)
Access to midwifery training written materials (program
pamphlets) available in both Spanish & indigenous
Mayan languages
Easy access to prenatal & pediatric care & women’s reproductive health services (contraception) in the rural
areas
More resources and supplies (medications, birth
supplies & equipment) available in the birth centers and
health centers in the rural community
Collaboration & networking amongst hospital healthcare
personal and traditional midwives
More women’s rights support groups promoting midwifery care & prenatal services & doing outreach in
the rural community
More midwifery schools & certification programs offered
for traditional midwives to earn advanced degrees that
are valued & recognized by the medical system
How my Study Abroad Experience
Has Impacted My Future Career in Midwifery
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My Study abroad experience in Guatemala has taught me about the importance of cultural
competency, cultural humility and cultural awareness. I fully recognize how imperative it is to
remain culturally sensitive, accepting, appreciative, nonjudgmental and to be open to learning
about another culture that may be different from my own. I have witnessed some of the inherent
struggles of racism, oppression and ethnic discrimination that women are facing in Latin America.
I have also learned how essential it is to stand up and advocate for women’s health & reproductive rights in Guatemala and across the globe.
I have gained an immense appreciation for indigenous Mayan traditional pregnancy, birth and
postpartum customs, rituals and beliefs. I have learned some incredible traditional Mayan
midwifery tricks of the trade, such as masajes, faja abdominal binding and vaginal steam baths
that I plan to educate my clients about and utilize in my current practice. I have also gained
extensive knowledge and understanding of the traditional herbal healing medicines and remedies
that can be used before, during & after pregnancy, for breastfeeding and for common ailments
such as colds, infections and inflammation. I plan to incorporate some of the traditional Mayan
herbal remedies by using them for treatment & prevention for clients in my future midwifery
practice. Witnessing the miracle of birth & helping bring new lives into the world with the Mayan
midwives and women at ACAM Birth Center has transformed my whole outlook on global
maternal-child health and it has further inspired me to fulfill my calling to become a midwife.
After gaining such unique intrapartum experiences in Guatemala, my goal Is to continue to
educate and provide good, quality, culturally competent services to women that focuses on a
holistic midwifery model of care. I plan to continue to network, collaborate, give respect & pay
tribute to midwives and birth workers cross-culturally. I hope to continue to empower women by
helping them gain enough confidence in themselves to know that they have the knowledge, the
right and the power to make decisions about their own bodies with relation to women’s health. I also hope to promote better maternal-child health outcomes by touching the lives of women,
children & families both domestically and internationally so that they may have more satisfying
birth experiences.
Maya Midwifery International ACAM Video
Scroll the the bottom of the slide and click play to view the video
References
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Alternative Archeology. (2015). Mayan Deities. Retrieved from
http://alternativearchaeology.jigsy.com/mayan-cosmology
Barton-Schuster, D. (2014). Natural Fertility Info. Traditional vaginal steam for
healthy fertility. Retrieved from http://natural-fertility-info.com/vaginasteam.html
Chary, A., Diaz, A. K., Henderson, B., Rohloff, P. (2012). The changing role
of indigenous lay midwives in Guatemala: New frameworks for
analysis. Midwifery, p. 1-7.
La Asociación de Comadronas del Área Mam. (2013). Retrieved from
http://acamxela.weebly.com/the-midwives.html
Hughes, R. (2015). Maya Midwifery International ACAM Video. Retrieved
from http://www.mayamidwifery.org/blog/
Mays, A. (2011). How to make an Inca blanket. Retrieved
fromhttp://www.slideshare.net/ayasha96/how-to-makeanincablanket-8077201
McGann, B. (2010). Maya childbirth traditions in a medical pluralist society:
An ethnomedical perspective. Medical Anthropology, p. 1-14.
References
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Proechel, S. (2005). Traditional healing and Midwifery of Maya. Voices of
Maya Midwives: Oral Histories of Practicing Traditional Midwives from the
Mam Region of Guatemala, Hillsdale: NY, Lulu Publishers. p. 50-62
Kunow, M. A. (2003). Evil eye. Maya medicine: Traditional healing in
Yucatan, New Mexico, University of New Mexico Press. p. 67-68.
Retrieved from
https://books.google.com.gt/books?id=5LQTYv8BU5oC&pg=PA67&lpg=P
A67&dq=nazar+evil+eye+in+maya+tradition&source=bl&ots=nmrLUj39lu
&sig=fiJLSuLpDGsKfvOTVDmTmvUDglw&hl=en&sa=X&ei=6AT9VNn_Kp
K1sQT1mYCQBg&redir_esc=y#v=onepage&q=nazar%20evil%20eye%20
in%20mayan%20tradition&f=false
Steel, H. (2013). Blog at WordPress. Endangered Mexican Rebozo.
Retrieved from https://rjohnhowe.wordpress.com/2013/11/19/hillary-steelon-the-endangered-mexican-rebozo/
Walsh, L. V. (2006). Beliefs and rituals in traditional birth attendant
practice in Guatemala. Journal of Transcultural Nursing,17(2), p. 148-154.