ADAWA

COMADRONA COLLABORATIVE

 

What's a comadrona, and why do they need our help?

In rural Guatemala, comadronas (midwives) have been delivering prenatal care, labor support,

and post-natal follow-up to women for centuries. While many women now choose to receive care

in one of the nation’s free public hospitals, impoverished women living in rural areas continue to rely
​on the care, dedication, and experience of their local comadrona.

 

Comadronas wake at all hours of the night, travel 2 hours on foot in the dark, and attend births

alone without any supplies to protect themselves or their vulnerable patients from potentially life-

threatening infections- without any compensation whatsoever. These women selflessly provide

their services, according to one, “for love of the community… and the fact that someone has to do it.” 

 

27 of our 30 comedronas were mentored by those that preceded them, and have not had the opportunity to complete even basic medical training. Our comadronas cannot afford to purchase gloves or masks, let alone costly items like stethoscopes or blood pressure cuffs. Many are admittedly unsure of how to monitor for complications, let alone save a hemorrhaging mother or baby born in distress.

 

Comadronas also counsel expectant and nursing mothers in pre-natal nutrition, breastfeeding, and infant feeding. The information mothers receive varies greatly depending upon the experience and understanding of her local comedrona. One comadrona informed us that she was trained by her predecessor to tell women that the a pregnancy diet of water, bread, and soda was best to ensure that “the baby does not grow too big and put the mother's life at risk.” In a country where as many as 8 out of 10 children growing up in indigenous communities are chronically malnourished and many do not live to see age 5, this misinformation can carry grave consequences for the tiny, frail babies they deliver.

 

 

What is ADAWA doing to support local comedronas?

 

Education: ADAWA comedronas are eager to learn about prenatal nutrition, how to monitor for complications, and how to administer life-saving emergency care (infant CPR, etc). We are collaborating with health educators to deliver trainings in these areas, with our first, on Prenatal Nutrition, scheduled for early April.

 

Medical Supplies: Knowledge is power and our comedronas are hungry for it- but basic equipment like stethoscopes and blood pressure cuffs allow them to successfully implement their new skills in the community. We are seeking donations to cover the cost of a “starter kit” of basic necessities for each comedrona choosing to participate in our program.

 

Empowerment: Our comadronas understand that to rely on onging donations for supplies and salaries will simply shift their dependence from the government, which has all but abandoned them, to foreign donations, which are inconsistent and fluctuate according the economy and time of year. ADAWA is supporting the creation of the region’s first comadrona collaborative, where members have a forum to receive ongoing training, share their experiences and concerns on a regular basis, and work together to advocate for their profession and services throughout the region.

 

Comedronas will select leaders from within their own ranks to assume responsibility for various aspects of the collaborative, from organizing capacitacion days, maintaining records, and managing their resources. A cornerstone of this collaborative is the creation of a collective fund, similar to a health insurance plan, paid into by expectant families, that shifts the burden of purchasing costly medical supplies from the comedronas to the communities being served while remaining fully accessible to all who need their services. While “starter kits” of basic medical supplies will be provided to each comedrona, program participants understand that this donation is non-renewable and that the long-term success of the collaborative is dependent upon their commitment to working together, exploring, and implementing the best solutions for their community.