Providing Dignified Care For Mothers In Rural Mexico

Yareth Macías, 30, is originally from Jaltenango, a rural city in the Sierra Madre region of Chiapas, Mexico, but has lived in Lima, Peru for the past year with her husband. In early 2021, she found out she was pregnant for the first time—a moment she and her husband had dreamed of for years.

The pregnancy went smoothly for the first seven months. Macías then returned to Jaltenango, because she wanted her daughter to be born with her family there. That’s when the challenges began.

One day, Macías felt her baby not moving as it normally did. Following the advice of her relatives, she drank orange juice, ate chocolate, and massaged her stomach to see if anything would stimulate her baby. But nothing worked. Four long hours passed, and she could no longer bear the worry.

She rushed to Casa Materna, the birthing center in Jaltenango supported by Compañeros En Salud, as Partners In Health is known in Mexico. Compañeros En Salud has worked in Mexico since 2011, providing medical care and social support to thousands of patients in the rural, mountainous, coffee-growing communities of the Sierra Madre region of Chiapas.

Since 2017, Casa Materna has provided dignified care to pregnant women, with the support of professional midwives and first-year clinicians hired and supported by Compañeros En Salud. The center, based at the community hospital in Jaltenango, has helped more than 1,000 women give birth, providing safe, respectful care for maternal health patients in a region where obstetric violence in hospitals is common.

Casa Materna

When Macías arrived, she was cared for by Estefania Monterrosas, a nurse who has worked with Compañeros En Salud since 2020. With patience and dedication, Monterrosas performed ultrasounds, checked the baby's heartbeat, and explained that there was nothing wrong with her: the baby was just sleeping.

As Macías spoke with the nurse, she began to feel more at ease. Monterrosas also told her about Casa Materna’s humanized birthing model where women can choose their birthing positions, listen to music during labor, and have a family member in the room. Macías decided she wanted to give birth there.

The delivery date was fast approaching. Macías’ husband, Fernando, was still in Peru. He did not want to miss such an important moment, so he made plans to travel to Mexico.

Then, contractions started—three weeks early.

On September 19, 2021, Macías began to have pain in her belly.

"I didn't know if it was the false contractions (Braxton Hicks) or if my baby was already going to be born," she says.

The contractions wouldn't go away. After three hours, her water broke. Her mother immediately took her to the Casa Materna.

"Many things were happening,” she recalls. “My husband was already in Tuxtla, three hours away from Jaltenango, but we didn't know if he would make it to see the birth of our daughter."

Dignified Care For Mothers, Newborns

As Macías was in labor, the obstetric nursing team at Casa Materna helped her do exercises with birthing balls and provided massages, aromatherapy, and a hot water bath with herbs to reduce the pain. Macías tried not to focus on the pain, as she was supported by her mother and a team of nurses.

She was dilating slowly. By 11 a.m., she was almost ready to give birth. Her husband arrived just in time, at 11:45. A half hour later, her daughter was born.

"I was impressed with the treatment at Casa Materna," says Macías. "Many times, you don't want to go to hospitals for fear of mistreatment. Obstetric violence is a reality that many women experience in Mexico, where they are scolded, mistreated, humiliated, and put through unauthorized procedures.”

That mistreatment includes health workers in Mexico's hospitals ignoring and dismissing the concerns of mothers, even as the women are in labor, leading to trauma and mistrust in the health system.

In Chiapas, women in labor have also been subjected to illegal, unauthorized procedures, including forced sterilization through tubal ligation or IUD. These procedures are carried out by doctors operating on the racist, classist belief that poor people shouldn't have too many children. These doctors are rarely ever prosecuted; the victims are almost always women living in poverty.

At Casa Materna, Compañeros En Salud seeks to upend these norms and provide humanized care at every step of the process, helping mothers give birth in the way most suited to their needs.

As she held her daughter for the first time, surrounded by her family and Compañeros En Salud staff, Macías expressed her gratitude.

"I didn't know how to thank them for what they had done for me,” she says.