Viva La Partera: Traditional Birth Attendants in Honduras

Viva La Partera is a project by Un Mundo that works to unify midwives and traditional birth attendants in rural Honduras to provide them with training and honor their decades of work serving the local communities, ultimately leading to improved maternal health in the area. A host site for the Midwife International 1-Year Midwife Immersion, this truly community-led initiative provides entry-level midwifery students with the opportunity to work alongside and learn from elder midwives while immersing in rigorous midwifery book study, and delving into community leadership theory and practice.

The Viva La Partera project, an initiative of Midwife International partner Un Mundo, works to develop a support network of midwives and traditional birth attendants (TBAs) in the Cangrejal Valley, in the Atlántida district of Honduras. The project was initiated in 2009, when a comprehensive health systems assessment conducted by Un Mundo revealed one common theme: the desire to integrate midwives into the health infrastructure.

The need for a network that unifies the rural midwives is clear, as nearly 50% of deliveries in Honduras, and over 70% of deliveries in rural areas, are attended by traditional birth attendants. Around 57% of all births in Honduras occur in rural areas, indicating heavy reliance on midwives to facilitate deliveries.Yet recent studies have indicated strained dynamics between TBAs and health clinics in rural areas. This has unfortunately caused midwives to use their own money to purchase essential materials that they are trained to use, such as gauze and cotton wools. One reason for the tension between TBAs and health clinics is the lack of formal recognition of midwives who have received midwifery training through a certificate.

Moreover, interviews conducted by Un Mundo with clinic workers, midwives, and villagers in the Cangrejal Valley have indicated a clear disparity in health services available to remote communities in the region and a resulting need to integrate existing midwives into the local health system to strengthen the capacity and utility of midwives who have yet to realize their full potential to serve their communities. Bolstering respect with an organized network of TBAs that are recognized for their training will help improve dynamics between the midwives, clinics, and the women they serve, ultimately leading to better birth outcomes and efficient use of resources.

Developing a support network does more than improve the relationship between health clinics and TBAs. It works to save lives by educating TBAs to deal with complications in pregnancy and birth. The World Health Organization (WHO) indicates that in 2005 both the maternal mortality ratio and the lifetime risk of maternal death in Honduras were more than double the averages for Latin America and the Caribbean. This WHO report also reveals that 21% of maternal deaths in Latin America are due to hemorrhage (uncontrolled bleeding) and that 21% of pregnant women are anemic at the time of birth, which increases their risk of hemorrhage.Moreover, a UNC School of Public Health study of TBAs in Honduras states that “hemorrhage and infection are the major treatable risks to maternal survival in the postpartum period.” The Viva La Partera network provides a conduit for training TBAs, improving their knowledge so that they can skillfully perform first aid techniques, treat hemorrhage and prevent anemia by promoting good nutrition in antenatal care. In turn, this has led to better outcomes in maternal healthcare.

In addition to providing training via the regional network of midwives, the Viva La Partera project celebrates the TBAs, their work, and their role in the community. In July of 2010, the organization hosted a celebration that recognized the invaluable work and service conducted by the midwives throughout the past 50+ years. They have also organized an educational workshop for interested youth on the practice and importance of midwifery among their communities, to increase respect, improve awareness, and pass the practice on to the next generation.

The Midwife International entry-level midwife immersion program in Honduras, which works directly with Viva La Partera, is intended for students who are interested in exploring the art of midwifery in the context of rural home birth. Students will participate in home birth rotations with traditional midwives who are part of the Viva La Partera Project, in addition to engaging with rigorous book study supervised by their preceptor. Portions of the clinical experience will take place in the hospital with supporting organization Dar a Luz Honduras. In this unique program, midwifery students will immerse in the study of community organizing and cultural heritage, while simultaneously focusing on the philosophy and fundamentals of the Midwives Model of Care and exploring best practices in midwifery skills. Participants will also investigate existing conditions of maternal and child health at the local, national and international level and begin to define their own personal philosophy of care.

Learn more about midwife training in Honduras with Midwife International.

Founded on the principles of promoting dignity, community and self-sufficiency, Un Mundo is a non-profit organization dedicated to facilitating access to education, health care and livable wages in the Cangrejal watershed region of Northern Honduras. Guiding our community-driven projects are the following values: involving the community as stakeholders, respect for the traditions and worldview of others, a faith in human potential and the solidarity of many, and the revolutionary belief that through the undeniable force of honest dialogue we can achieve the unity and critical consciousness necessary to effect authentic change.