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Honorable Mention for the Association for Feminist Anthropology's Rosaldo Book Prize, 2021

Maternal health outcomes are a key focus of global health initiatives. In Delivering Health, author Lydia Z. Dixon uncovers the ways such outcomes have been shaped by broader historical, political, and social factors in Mexico, through the perspectives of those who are at the front lines fighting for change: midwives.

Midwives have long been marginalized in Mexico as remnants of the country's precolonial past, yet Dixon shows how they are now strategically positioning themselves as agents of modernity and development. Midwifery education programs have popped up across Mexico, each with their own critique of the health care system and vision for how midwifery can help. Delivering Health ethnographically examines three such schools with very different educational approaches and professional goals. From San Miguel de Allende to Oaxaca to Michoacán and points between, Dixon takes us into the classrooms, clinics, and conferences where questions of what it means to provide good reproductive health care are being taught, challenged, and implemented. Through interviews, observational data, and even student artwork, we are shown how underlying inequality manifests in poor care for many Mexican women. The midwives in this book argue that they can improve care while also addressing this inequality. Ultimately, Delivering Health asks us to consider the possibility that marginalized actors like midwives may hold the solution to widespread concerns in health.

The coming-of-age memoir of a homebirth midwife in the Southwest

Lori Wrankle was sixteen when she helped deliver her first baby. “I witnessed the entire universe unfold at my feet,” she writes in Desert Birthright. Later, working as a hospital doula, Wrankle observed firsthand the suffering inflicted upon birthing women by male-dominated Western childbirth practices, from casual racism to unnecessary and nonconsensual procedures, including the dreaded “husband stitch.” After a traumatic labor and delivery of her own, she decided to take back woman-centered childbirth and start a homebirth midwifery practice.
 
Desert Birthright traverses twenty-five years of midwifery, often in fundamentalist polygamist circles, weaving together birth stories with childhood memories as Wrankle grapples with her shifting Mormon faith. Her poetic voice shines—a placenta becomes the tree of life, the folds in a baby’s arm layers of sand in the desert. Desert Birthright is a deeply personal story of life, death, and modern womanhood in the rural Southwest, and of one midwife’s journey of faith, self-discovery, and liberation in the face of adversity.

Jesusita Aragon earned the title "la partera," or midwife, at the age of fourteen. Apprenticed to her grandmother, she learned the traditional Hispanic methods of assisting childbirth. She won the coveted title by performing her first delivery when an expectant mother went into labor in her grandmother's absence. In the years that followed, she was often the only source of medical care available in an isolated, mountainous area of New Mexico. Jesusita was so prized for her medical wisdom that she came to deliver more than 12,000 babies in the course of her career.This is Jesusita's story, told in her own words. She describes her early training as a midwife, her forced departure from home due to two unmarried pregnancies, and her solitary struggle to support her children. La Partera tells how she gradually emerged as a leader in her community, painstakingly building by hand a small maternity center for her patients while gaining the respect of the Anglo medical community.As Jesusita's story unfolds, so too does the story of the women of the region. Supplemental sections by the author illuminate Jesusita's culture and past, along with a historical account of the network of medical care provided by Hispanic and Anglo female healers. Illustrated with photographs of both people and places, La Partera reflects the culture of an era through the prism of Jesusita's hard and useful life.

Healing practices in Mesoamerica span a wide range, from traditional folk medicine with roots reaching back into the prehispanic era to westernized biomedicine. These sometimes cooperating, sometimes competing practices have attracted attention from researchers and the public alike, as interest in alternative medicine and holistic healing continues to grow.

Responding to this interest, the essays in this book offer a comprehensive, state-of-the-art survey of Mesoamerican healers and medical practices in Mexico and Guatemala. The first two essays describe the work of prehispanic and colonial healers and show how their roles changed over time. The remaining essays look at contemporary healers, including bonesetters, curers, midwives, nurses, physicians, social workers, and spiritualists. Using a variety of theoretical approaches, the authors examine such topics as the intersection of gender and curing, the recruitment of healers and their training, healers' compensation and workload, types of illnesses treated and recommended treatments, conceptual models used in diagnosis and treatment, and the relationships among healers and between indigenous healers and medical and political authorities.

The World Health Organization is currently promoting a policy of replacing traditional or lay midwives in countries around the world. As part of an effort to record the knowledge of local midwives before it is lost, Midwives and Mothers explores birth, illness, death, and survival on a Guatemalan sugar and coffee plantation, or finca, through the lives of two local midwives, Doña Maria and her daughter Doña Siriaca, and the women they have served over a forty-year period.

By comparing the practices and beliefs of the mother and daughter, Sheila Cosminsky shows the dynamics of the medicalization process and the contestation between the midwives and biomedical personnel, as the latter try to impose their system as the authoritative one. She discusses how the midwives syncretize, integrate, or reject elements from Mayan, Spanish, and biomedical systems. The midwives’ story becomes a lens for understanding the impact of medicalization on people’s lives and the ways in which women’s bodies have become contested terrain between traditional and contemporary medical practices. Cosminsky also makes recommendations for how ethno-obstetric and biomedical systems may be accommodated, articulated, or integrated. Finally, she places the changes in the birthing system in the larger context of changes in the plantation system, including the elimination of coffee growing, which has made women, traditionally the primary harvesters of coffee beans, more economically dependent on men.

During the twentieth century modern births in America came to involve mostly male physicians, hospitals, technological interventions, and quick, routine procedures. In a unique and detailed historical study, Nurse-Midwifery: The Birth of a New American Profession, Laura E. Ettinger fills a void with the first book-length documentation of the emergence of American nurse-midwifery. This occupation developed in the 1920s involving nurses who took advanced training in midwifery. In Nurse-Midwifery, Ettinger shows how nurse-midwives in New York City; eastern Kentucky; Santa Fe, New Mexico; and other places both rebelled against and served as agents of a nationwide professionalization of doctors and medicalization of childbirth. Nurse-Midwifery reveals the limitations that nurses, physicians, and nurse-midwives placed on the profession of nurse-midwifery from the outset because of the professional interests of nursing and medicine. The book argues that nurse-midwives challenged what scholars have called the “male medical model” of childbirth, but the cost of the compromises they made to survive was that nurse-midwifery did not become the kind of independent, autonomous profession it might have been.

Today, nurse-midwives have assumed a larger role in mainstream health care than before, yet they are still marginalized. As in the past, nurse-midwives’ futures will depend on continuing changes in American attitudes about childbirth, health care, and women professionals as well as on their own ability to adapt to the changes. The history of the profession suggests that nurse-midwives will continue to navigate in difficult waters in a middle space between the mainstream and the margins of medicine and between the nursing profession and midwifery traditions.

Recent anthropological scholarship on “new midwifery” centers on how professional midwives in various countries are helping women reconnect with “nature,” teaching them to trust in their bodies, respecting women’s “choices,” and fighting for women’s right to birth as naturally as possible. In No Alternative, Rosalynn A. Vega uses ethnographic accounts of natural birth practices in Mexico to complicate these narratives about new midwifery and illuminate larger questions of female empowerment, citizenship, and the commodification of indigenous culture, by showing how alternative birth actually reinscribes traditional racial and gender hierarchies.

Vega contrasts the vastly different birthing experiences of upper-class and indigenous Mexican women. Upper-class women often travel to birthing centers to be delivered by professional midwives whose methods are adopted from and represented as indigenous culture, while indigenous women from those same cultures are often forced by lack of resources to use government hospitals regardless of their preferred birthing method. Vega demonstrates that women’s empowerment, having a “choice,” is a privilege of those capable of paying for private medical services—albeit a dubious privilege, as it puts the burden of correctly producing future members of society on women’s shoulders. Vega’s research thus also reveals the limits of citizenship in a neoliberal world, as indigeneity becomes an object of consumption within a transnational racialized economy.

The extraordinary story of a seventeenth-century French midwife and her treatise on childbirth.
 
In 1671, Marie Baudoin (1625–1700), head midwife and governor of the Hôtel-Dieu of Clermont-Ferrand, sent a treatise on the art of childbirth to her powerful Parisian patron, Dr. Vallant. The story of how Baudoin’s knowledge and expertise as a midwife came to be expressed, recorded, and archived raises the question: Was Baudoin exceptional because she was herself extraordinary, or because her voice has reached us through Vallant’s careful archival practices? Either way, Baudoin’s treatise invites us to reconsider the limits of what we thought we knew midwives “could be and do” in seventeenth-century France. Grounding Marie Baudoin’s text in a microanalysis of her life, work, and the Jansenist network between Paris and Clermont-Ferrand, this book connects historiographies of midwifery, Jansenism, hospital administration, public health, knowledge and record-keeping, and women’s work, underscoring both Baudoin’s capabilities and the archival accidents and intentions behind the preservation of her treatise in a letter.