Far fewer women die from pregnancy and childbirth than they did just two decades ago. A report from the World Health Organization and the United Nations found that 287,000 maternal deaths occurred in 2010, half as many as in 1990. Yet for many women, childbirth is as dangerous as ever. Those who live in developing countries are more than 15 times more likely to die from complications.
I have been traveling the globe photographing birth and the culture of birth for six years. In January, I went to San Miguel de Allende, in the Mexican state of Guanajuato, to spend some time with midwifery students who are part of a government push to save the lives of moms and babies in rural areas. Mexico ranks 91st in the world in maternal mortality, with an estimated 85 deaths per 100,000 live births, according to UNICEF.
The CASA Professional Midwifery School teaches Western medicine while recognizing the cultural and medical significance of indigenous practices. Students come from all over Mexico and surrounding countries to participate.
After preparing public-health presentations to show rural mothers—hand-sewn model pelvises, breasts, and amniotic sacs—38 CASA students boarded a rundown bus and rode 32 hours from their school in San Miguel de Allende to the small Mayan town of Chunhuhub in the southern state of Quintana Roo. There, the students participated in an intercultural midwifery exchange. Traditional Mayan midwives demonstrated the use of herbal medicines, abdominal massage, and hammocks for birth. In return, the CASA students explained their approaches to neonatal resuscitation, postpartum hemorrhage, and prenatal care.
In my travels to the Dominican Republic, Nigeria, the Navajo Nation, and here in Mexico, I’ve seen how women can have meaningful experiences whether they give birth in operating rooms, hospital beds, or at home. When maternity care integrates midwifery and cultural traditions with doctor backup, women feel respected and heard while giving birth safely. CASA’s educational exchange is part of a recognition of midwifery’s potential to improve maternal health in Mexico.