BEFORE - The World Health Organization does not consider traditional birth attendants sufficiently skilled to manage normal deliveries and diagnose, manage, and refer obstetric complications. USAID is supporting midwife training in villages across Guatemala. In the above photo, women are learning about systems of the human body in their language, Quiché. Small children often attend training sessions with their mothers, who do not have childcare options.

AFTER - Graduates of the training program will become skilled health providers who can detect and refer complications, train and supervise traditional birth attendants, provide quality pre- and post-natal care, and attend births more effectively. After training, graduates will go back to their indigenous communities to work at health facilities or local organizations. The Ministry of Health is introducing the position of nurse-midwife into the public health system, which may lend graduates of this program even greater credibility in their communities and in the public health system.

Guatemala’s maternal mortality ratio of 153 per 100,000 live births is one of the highest in Latin America. Among rural Mayan women that ratio shoots up to 221 per 100,000. Mayans have endured a deeply rooted history of inequality, particularly women, who suffer from illiteracy, early marriage, frequent pregnancies, and limited pre- and post-natal care. In addition, most pregnant women have no access to skilled delivery attendants; 58.5 percent of all deliveries in Guatemala are attended by traditional birth attendants, family members, or no one. Adequate medical care could prevent over 75 percent of maternal deaths. USAID has developed an innovative program that combines Western medicine and Mayan culture — a scholarship training program for 120 Mayan Midwives. To qualify, applicants must be Maya, be proficient in the language spoken in communities she serves, and reside near communities with high maternal mortality. They must also commit to serving as midwives for two years after completing the training.