Healthy Mothers, Healthy Babies USAID, Bridging Traditional Midwifery Practices With Modern Practices Through Young Indigenous Women

“9:05 in the morning on May 19th, 2019; you never forget the first baby you deliver”, said Sofia Lorenzo as she smiled, recounting the moment. Sofia, who just completed her studies to be a midwife, is a 24 year old indigenous woman from Michicoy, a small village in the mountainous Western Highlands of Guatemala. Her great grandmother was a Comadrona — part midwife, part doctor, part pharmacist, and all community leader — and inspired her to become a midwife. Comadronas are an integral part of indigenous communities in Guatemala, providing traditional healthcare to women and their children.

“To be born in our region represents suffering for so many.” - Sofía Lorenzo

In Guatemala, where one in five girls have given birth by age 19 and the average maternal mortality ratio is 113 deaths per 100,000 live births, the highest in Central America, a lack of access to healthcare has life and death consequences, especially for young indigenous women, where the risk of maternal mortality is 38 percent higher than average.

USAID’s Health and Nutrition Project partnered with the Guatemalan Government and private educational institutions to create a professional midwifery program to recruit, educate, and mentor young indigenous women to provide health services in their communities. The program provides a comprehensive education for young women to learn the midwifery skills needed to serve and address healthcare challenges in their communities.

Young women, like Sophia, speak the local language, understand and incorporate cultural birth practices, and understand modesty and gender concerns, improving trust and access to care. Like Sophia, participants are from local communities and attend a nearby university, which strengthens the young women’s ties to the area. USAID partnered with the Ministry of Health, which guarantees an employment opportunity upon completion of the program. Sofia, who graduated Valedictorian from the program at Da Vinci University in Huehuetenango, is the first woman in her family to go to University, breaking long held biases against women getting an education.

“I have learned while studying that I have a responsibility to empower girls and women.” - Sofia Lorenzo

Financial, cultural, and geographical barriers often prevent pregnant women in the Western Highlands from delivering their babies in healthcare facilities. Many women are simply afraid due to negative experiences. Midwives are a bridge between modern and traditional practices providing a cultural context to antenatal, delivery, and postnatal care. Sofia will work alongside Comadronas to provide health care for Indigenous women in their homes and augment the traditions and practices of Indigenous communities with modern medical practices.

More than six million people In Guatemala, approximately 35 percent of the country’s population, lack access to basic health and nutrition services. USAID programs improve human resources for health by supporting the training and development of health providers, like Sofia, and strengthening the health system to ensure that community needs and cultural patterns are respected.

USAID works with communities on health and nutrition issues as well as the adoption of healthy behaviors such as breastfeeding, hand washing, nutrition, adequate birth spacing, gender-based violence (GBV) prevention, safe sexual practices, and responsible fatherhood. USAID’s efforts to reduce preventable maternal and child deaths while simultaneously providing meaningful employment opportunities contributes to the Root Causes Strategy of the United States government to address the drivers of irregular migration.

Sofia is proud to be a midwife, continuing a tradition in her family. By combining modern medical practices with traditional practices, women will have access to dignified, safe, and quality healthcare. One day she too will inspire the next generation of Midwives. “I hope to be a great midwife for rural communities, but also I hope to represent Mayan women, to prove that rural, indigenous women can contribute to public health and save lives”.

Created By
Benjamin Ilka


Benjamin Ilka, USAID