I love my Abuelita. That’s my pana full right there. She’s the sole reason I’d move to the Dominican Republic for a couple years just to be near her. Like most mothers and daughters, she has an interesting relationship with each of her five daughters, to say the least. I know the most about her relationship with my mother naturally, and it’s funny to me how the challenges they’ve had are the same my mother and I have had. I am constantly stunned by the matrilineal blood line and life, having often been brought to tears when I’ve attended a birth with the birthing woman’s grandmother and mother in the room. There are no words for the moment when three women become mother, grandmother and great grandmother.  It is a special moment regardless of the culture or language it occurs in, but there is something that moves me to the core when it comes to Latinas.

I remember when I told my Abuelita that I was studying to be a midwife. She barely batted an eye, which was a different reaction than others, who immediately launched into all the reasons why homebirth was archaic and dangerous. Instead, my Abuelita told me that I had an ancestor who was also a midwife. I told her about how much I loved my profession and she listened, while offering her sharp critique of modern childbirth options. It is refreshing to talk to her because it reminds me that not everyone has forgotten that birth did not always take place in hospitals.

One of my favorite conversations with her was about her own births. I was curious about how she gave birth to her 8 children. I realized quickly that she didn’t have the long detailed stories that I am often used to hearing nowadays. She was born and lived in el campo, where midwives were the one who primarily attended birth. Abuelita told me that she birthed just 3 in the hospital but the rest at home. Her recollection of the births were brief but it was the nonchalantness and practicality that she spoke with that resonated with me most. Birth seemed to be just as normal as any other life activity, which is precisely the point that I make constantly in my life. She told me that the placentas usually got buried by the midwives when I got back from a midwifery conference and realized I had never asked. I thought it was hilarious but awesome when she told me that she rode horses when she was pregnant and carried on with her work as usual, a far cry from the view in this country that pregnant women are fragile and shouldn’t do anything strenuous. While it is true that pregnant women should be careful with certain movements, my grandmother’s account makes sense and echoes other accounts of women still working on their farms while pregnant. It also reminds me that there are many people in this country that have to work until they go into labor; the treatment of care and fragility that some people receive is often dictated by class.

Abuelita doesn’t understand why so many women get Cesarean section. “Ahora fue que se encontraron que las mujeres no pueden parir,” she began as she spoke about the trend in childbirth she’s witnessing in the Dominican Republic. According to the World Health Organization, the Dominican Republic has the highest rate of Cesarean section in the world, citing medical liability and vanity as the reasons for the rate. “Dique las mujeres no pueden parir.” She was vehemently against it. “Eso no es normal. That is not normal.” To my grandmother, the desire to keep a vagina in “virginal” conditions is not a good reason to give birth via C-section. It is so refreshing to talk to her about this topic, as I am of the belief that Cesarean sections should only be done for medically indicated reasons. Having the lived experiences she’s had in birth makes her point of view deeply authentic; as someone who has not given birth yet but has witnessed many vaginal births, hearing an elder speak about it does something to me. It makes me conscious of the countless women before the medicalization of birth who gave birth at home with midwives and thought nothing of it. Certainly, there are instances that birthing in a hospital is necessary because the interventions are life-saving but even then, citing possible maternal and/or infant mortality as a reason for avoid home birth is misleading. Malnutrition and other structural inequities are more indicative of poor birth outcomes.

Midwives were attacked by some members of the clergy for a reason that makes my blood boil. There is a belief that stems from the story of Adam and Eve that women deserve to suffer. That the suffering of childbirth and menstruation are God’s punishment for the sin of Eve eating the apple.  The fact that midwives have the training to reduce suffering is seemingly unacceptable. I was reminded of this when my mother said casually “pagarle a mi madre (repay my mother)” when speaking about giving birth. Moreover, the Latino community was colonized primarily by Spain, which brought with it the Catholic faith. These undertones affect the ways women deal and view their reproductive health; the modesty imposed by patriarchal views ingrained in Catholicism can make women embarrassed to talk about their bodies, which results in silence and lack of comprehensive sexual knowledge.

There is a slow but steady trend occurring with immigrant women. They normally have slightly better outcomes than African American and Puerto Rican women in childbirth due to a concept known as communalism. According to a study entitled “Communalism predicts prenatal affect, stress, and physiology better than ethnicity and socioeconomic status,” spearheaded by Dr. Cleopatra Abdou, communalism is defined as feelings, beliefs and participation in interdependent relationships with family and friends. They found that higher levels of connection to community and family were “associated with lower levels of prenatal blood pressure and stress. Emotional health was better as well,” Abdou noted. I bring this up because there is a tendency to have tight-knit immigrant communities in New York City. This can mean that a pregnant woman will find themselves still being cared for by their mothers and other women in their communities, which can produce optimal birthing outcomes. As the family and community bonds weaken through 2nd and 3rd generations, the outcomes get worse. This is also true for women who are alone in this country and have linguistic and cultural barriers to adequate healthcare that is culturally sensitive.

There are so many elements to being Latina and birthing in this country that are counter-intuitive for me because I still have ties to my mother and grandmother. My favorite way to say birth in Spanish is alumbramiento, which literally means lighting. Similar to dar luz, the imagery of giving light to a new human being is so inspiring for me and makes birth sacred. I am thankful for my Abuelita and the women in my life who showed me first the power they so effortlessly summoned to birth all the children they did.


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