Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial
Plain English summary In many Indigenous communities, traditional midwives support mothers during pregnancy, childbirth, and some days afterwards. Research involving traditional midwives has focused on training them in Western techniques and redefining their role to support Western care. In Guerrero...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-021-04344-w |
| _version_ | 1798024959679791104 |
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| author | Iván Sarmiento Sergio Paredes-Solís Abraham de Jesús García Nadia Maciel Paulino Felipe René Serrano de los Santos José Legorreta-Soberanis Germán Zuluaga Anne Cockcroft Neil Andersson |
| author_facet | Iván Sarmiento Sergio Paredes-Solís Abraham de Jesús García Nadia Maciel Paulino Felipe René Serrano de los Santos José Legorreta-Soberanis Germán Zuluaga Anne Cockcroft Neil Andersson |
| author_sort | Iván Sarmiento |
| collection | DOAJ |
| description | Plain English summary In many Indigenous communities, traditional midwives support mothers during pregnancy, childbirth, and some days afterwards. Research involving traditional midwives has focused on training them in Western techniques and redefining their role to support Western care. In Guerrero state, Mexico, Indigenous mothers continue to trust traditional midwives. Almost half of these mothers still prefer traditional childbirths, at home, in the company of their families and following traditional practices. We worked with 30 traditional midwives to see if supporting their practice allowed traditional childbirth without worsening mothers’ health. Each traditional midwife received an inexpensive stipend, a scholarship for an apprentice and support from an intercultural broker. The official health personnel participated in a workshop to improve their attitudes towards traditional midwives. We compared 40 communities in two municipalities that received support for traditional midwifery with 40 communities in two municipalities that continued to receive usual services. We interviewed 872 women with childbirth between 2016 and 2017. Mothers in intervention communities suffered fewer complications during childbirth and had fewer complications or deaths of their babies. They had more traditional childbirths and fewer perineal tears or infections across home-based childbirths. Among those who went to Western care, mothers in intervention communities had more traditional management of the placenta but more non-traditional cold-water baths. Supporting traditional midwifery increased traditional childbirth without worsening health outcomes. The small size of participating populations limited our confidence about the size of this difference. Health authorities could promote better health outcomes if they worked with traditional midwives instead of replacing them. |
| first_indexed | 2024-04-11T18:11:06Z |
| format | Article |
| id | doaj.art-b2f7933a77e14abca8f9fa622935ea21 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-11T18:11:06Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-b2f7933a77e14abca8f9fa622935ea212022-12-22T04:10:07ZengBMCBMC Pregnancy and Childbirth1471-23932022-01-0122111510.1186/s12884-021-04344-wSafe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trialIván Sarmiento0Sergio Paredes-Solís1Abraham de Jesús García2Nadia Maciel Paulino3Felipe René Serrano de los Santos4José Legorreta-Soberanis5Germán Zuluaga6Anne Cockcroft7Neil Andersson8CIET-Participatory Research at McGill, Faculty of Medicine and Health Sciences, Department of Family Medicine, McGill UniversityCentro de Investigación de Enfermedades Tropicales, Universidad Autónoma de GuerreroCentro de Investigación de Enfermedades Tropicales, Universidad Autónoma de GuerreroCentro de Investigación de Enfermedades Tropicales, Universidad Autónoma de GuerreroCentro de Investigación de Enfermedades Tropicales, Universidad Autónoma de GuerreroCentro de Investigación de Enfermedades Tropicales, Universidad Autónoma de GuerreroGrupo de Estudios en Sistemas Tradicionales de Salud, Escuela de Medicina y Ciencias de la Salud, Universidad del RosarioCIET-Participatory Research at McGill, Faculty of Medicine and Health Sciences, Department of Family Medicine, McGill UniversityCIET-Participatory Research at McGill, Faculty of Medicine and Health Sciences, Department of Family Medicine, McGill UniversityPlain English summary In many Indigenous communities, traditional midwives support mothers during pregnancy, childbirth, and some days afterwards. Research involving traditional midwives has focused on training them in Western techniques and redefining their role to support Western care. In Guerrero state, Mexico, Indigenous mothers continue to trust traditional midwives. Almost half of these mothers still prefer traditional childbirths, at home, in the company of their families and following traditional practices. We worked with 30 traditional midwives to see if supporting their practice allowed traditional childbirth without worsening mothers’ health. Each traditional midwife received an inexpensive stipend, a scholarship for an apprentice and support from an intercultural broker. The official health personnel participated in a workshop to improve their attitudes towards traditional midwives. We compared 40 communities in two municipalities that received support for traditional midwifery with 40 communities in two municipalities that continued to receive usual services. We interviewed 872 women with childbirth between 2016 and 2017. Mothers in intervention communities suffered fewer complications during childbirth and had fewer complications or deaths of their babies. They had more traditional childbirths and fewer perineal tears or infections across home-based childbirths. Among those who went to Western care, mothers in intervention communities had more traditional management of the placenta but more non-traditional cold-water baths. Supporting traditional midwifery increased traditional childbirth without worsening health outcomes. The small size of participating populations limited our confidence about the size of this difference. Health authorities could promote better health outcomes if they worked with traditional midwives instead of replacing them.https://doi.org/10.1186/s12884-021-04344-wCommunity health workerTraditional birth attendantRandomised controlled trialEquity in accessAboriginal healthNahua |
| spellingShingle | Iván Sarmiento Sergio Paredes-Solís Abraham de Jesús García Nadia Maciel Paulino Felipe René Serrano de los Santos José Legorreta-Soberanis Germán Zuluaga Anne Cockcroft Neil Andersson Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial BMC Pregnancy and Childbirth Community health worker Traditional birth attendant Randomised controlled trial Equity in access Aboriginal health Nahua |
| title | Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial |
| title_full | Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial |
| title_fullStr | Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial |
| title_full_unstemmed | Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial |
| title_short | Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial |
| title_sort | safe birth in cultural safety in southern mexico a pragmatic non inferiority cluster randomised controlled trial |
| topic | Community health worker Traditional birth attendant Randomised controlled trial Equity in access Aboriginal health Nahua |
| url | https://doi.org/10.1186/s12884-021-04344-w |
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