Midwife Teaching

Midwife Teaching in rural Guatemala

In rural Guatemala, most mothers give birth in huts, guided by lay midwives, without formal training. Instead, they are taught through generations of family members who are also midwives or comadronas. Because these midwives don’t have any advanced tools or instruments to help diagnose and treat life-threatening issues in women during labor and delivery, such as postpartum hemorrhage, Guatemala has one of the highest maternal mortality rates in Central and South America— 300 per 100,000 live births.

In 2018, Dr. Michael Sanchez, an anesthesiologist, and Dr. Michele Hakakha, an OBGYN, both attending physicians at Cedars-Sinai Medical Center, piloted a training program for midwives in the rural town of Tejutla, a 7-hour winding bus ride from Guatemala City. The two physicians worried that no one would show up the morning of the seminar. But 26 women did, and an amazing discussion ensued. Not wanting to be physicians from the US who showed up and “lectured” women about Western medicine, there was an extensive dialogue between the lay midwives with up to 5 decades of experience and two Western medically
trained doctors. Each side learned so much from the other.

This program has become an annual one that many OBGYNs on the Helps trip from Los Angeles to take part
in. Postpartum hemorrhage is reviewed, and demonstrations using red food coloring and water to help visually estimate postpartum bleeding are used. This helps visualize the difference in estimated blood loss volumes which can help determine when to seek outside help to save a mother’s life. Demonstrations on relieving shoulder dystocia and proper techniques for breech vaginal deliveries are aided by a pregnant model generously donated to our group. Blood pressure cuffs are given to each midwife, and training on taking blood pressure also occurs. We hope to leave a little more knowledge and supplies to help decrease maternal mortality in Guatemala.