The importance of midwives in the lives of women in San Juan La Laguna, Guatemala.

Abstract

In this thesis we first examine significant literature about pregnancy and birth from two perspectives of subfields within anthropology, namely feminist and medical anthropology. Subsequently, the concepts of gender, sexuality, motherhood, healthcare systems, the authority of knowledge and medicalization are discussed. We conducted our fieldwork research in the town of San Juan La Laguna in Guatemala. Based on the collected data we discuss how gender and sexuality are interrelated. Male sexuality is celebrated, whereas female sexuality is surrounded by silence resulting in it being a taboo. Consequently women have little knowledge about the workings of their bodies, which affects their reproductive health. Furthermore we will take a closer look at motherhood. Women are able to fulfill God s will by having children, which makes becoming a mother sacred and the societal norm. Although being a mother is a more valuable position than being childless, women's economic and social position within society does not grow exponentially when entering motherhood. During pregnancy these women are dependent on healthcare options available to them, which will also be discussed. In Guatemala a general distinction can be made between state-owned healthcare, private healthcare and healthcare provided by NGOs. These healthcare organisations do not always work together thus influencing the quality of healthcare on offer. Healthcare is not only offered by formal organisations. In fact, almost all of the women we talked to (also) used the services of a comadrona. Comadronas offer culturally appropriate care, which matches the needs of (pregnant) women in San Juan La Laguna and therefore is inclusive. We also examine the changing role of comadronas within society. We will illustrate that medicalization has resulted in the increase of knowledge among comadronas. Combined with consistently spreading a narrative which underlines their importance, this has led to the maintenance of their authority and legitimacy.