The following is the fourth article in the series Trachtmaokas, Parteras, and Midwives: 100 Years of Maternal Care in Chihuahua’s Mennonite Campos.
Today, after nearly a half-century of decline, midwifery is undergoing a resurgence not only in Mennonite communities in Chihuahua, but all across Mexico, particularly in rural areas and Indigenous communities. A MacArthur Foundation report on public health in Mexico found, “In recent years, more than thirty organizations—from small, indigenous led organizations, to government institutions and non-profit organizations—have worked together to bring back professional midwives with the hopes of improving access and quality of care for mothers and babies and respecting the reproductive rights of women. This movement wants midwives to be more respected and acknowledged and for them to be seen as a safe and reliable alternative, which according to many women is more comfortable and dignified than current hospital methods, especially in rural areas. After education and promotion, the number of training programs has grown to more than a dozen and the number of clinics that work with midwives has doubled. Hundreds of seminars, workshops and basic courses have become available to health authorities and practitioners throughout the country.”1
Casa Geburt Birthing Center and Midwifery School, located in Campo 6 ½ in the Manitoba Colony, approximately twenty kilometers north of Cuauhtémoc, is part of this movement to provide “partos humanizados” or “humanized births” that respect and empower women to be active agents in their reproductive choices and experiences. Founded in 2016 by Katia LeMone, a nurse, midwife, and public health practitioner with more than thirty years of experience, Casa Geburt is at the center of reproductive and maternal care in the Tres Culturas region of Chihuahua. Originally from New Mexico, Katia relocated to the Mennonite Campos in 2015 at the request of members from the Mennonite community to train doulas and midwives in the Tres Culturas Region.
In 2018, she shared how her decision to become a midwife and to train midwives had its origins in an encounter she had with an Indigenous Rarámuri woman in Chihuahua in the late 1970s with the Rebels, Exiles, and Bridge Builders Oral History Project (REBB)2:
In 1979, I was living in Parral and I met a Tarahumara [Rarámuri] woman on the street and she invited me to her house. We were talking and drinking tea and she asked me if I wanted to see her “instruments.” She showed them to me and said, “I’m a midwife. I help women give birth.” I was very interested and when I returned to the United States, I volunteered in El Paso with some friends of mine who were training to be midwives. At that time, I had a transformative experience during a difficult birth and I decided that I not only wanted to be a midwife, but I also wanted to train midwives. Women didn’t have and still don’t have access to the care that they need. I wanted to be an advocate for women and provide them with what they need. The important thing is women supporting women.
Katia had her first client from the Campos Menonitas in Chihuahua come to her midwifery practice in New Mexico in 2008, a Trajchtmoaka who was well known in the community, and by 2014, Katia had attended more than twenty births for Mennonite women from the Campos.
After a few years [of attending births], I was invited to come to the Campos Menonitas and teach some training classes in the community. The first time, I came for ten days to train doulas, but in December of 2015, I moved to the Campos to train midwives because there was a high demand for the course. My goal was to train women who could then later train others in Low-German. We have had two graduating classes from the midwife training course so far. The first class had fifteen participants and all of them were Mennonite, both liberal and conservative. There were students from such conservative communities that I was surprised that they wanted to come and train with us. In the second class we had 7 Mennonites, 2 women from the Rarámuri Pueblo and a Mestiza woman. In the second class I tried to integrate public health training in order to create relationships with churches and the community.
She continued, sharing about the challenges, successes and future goals for the work of Casa Geburt in the Campos Menonitas and the larger Tres Culturas Region.
We have really high maternal mortality rates and in this environment midwives and doulas have to be promotors of public health3. We have really big goals. I couldn’t have imagined what we have been able to accomplish. In 2016, we opened the Casa Geburt Birthing Center and Midwifery Training School. We have partnerships with La Asociación Mexicana de Partería (The Mexican Association of Midwifery) and some hospitals. We want for every woman to have quality care in her mother tongue. This is what I would love to see. There is always the goal of raising up more Mennonite women to be educators, midwives, childbirth educators, breastfeeding educators, doulas. To raise up those ranks so that we have a doula for every woman. A midwife that every woman can feel comfortable with. And then, the Tarahumara [Rarámuri] community, and working with them. Developing our program so more of our programs can be in Spanish and Tarahumara [Rarámuri]. More of them can be in Low-German. Those are the things that are all really important to us. The ultimate goal would be to have a functioning school with dormitories that’s associated with the Maternity Center Clinic where women in any of these communities could come in, and get care by women from their community.
Clara Enns, a seamstress and midwife from the Swift Current Colony in the Mennonite Campos in Chihuahua, Mexico, was one of the first graduates from Casa Geburt’s Midwifery Training Program in 2016. She spoke with REBB about the importance of Low-German speaking midwives and doulas as public health practitioners, educators and advocates in the Tres Culturas Region of Chihuahua4.
The return to midwifery is really modern in a lot of ways, but there also is a respect and a deep knowledge of the traditional, of what used to be. Deep down that makes sense to many of the traditional women. In our communities there’s a lack of information, a lack of education. Childbirth and women’s health in general, is not talked about. There’s very little knowledge. There’s a shame surrounding it. Women have lost the information they did have. Breastfeeding is completely a lost art for so many women here. The high rate of C-sections needs to change5. The World Health Organization guidelines are there and we need to change6. Mexico in general has a very, very high C-section rate, and is being pushed and incentivized to change that7. We Mennonites form a big part of that. The C-section rate in our communities is much, much higher than it is in general in Mexico in general8. A big part of it is language barrier. It may be the biggest one. We have a lot of traumatized women. We want to empower women in our community to take back what they need.
The fifth article in this series will feature first-hand accounts of present-day pregnancy, birth and post-partum care in Chihuahua’s Campos Menonitas, and will explore perspectives concerning midwifery within and outside the Campos, including the transcript from a segment that aired on the nationally syndicated news program El Milenio in early 2020 that featured Casa Geburt.
1. Sharon Bissell, “Strengthening Midwifery in Mexico.” MacArthur Foundation, January 17, 2019, https://www.macfound.org/press/perspectives/strengthening-midwifery-mexico/
2. Katia LeMone, interviewed by Abigail Carl-Klassen, Rebels, Exiles and Bridge Builders: Cross-Cultural Encounters in the Campos Menonitas of Chihuahua Oral History Project, Mennonite Heritage Archives, 2018.
3. World Health Organization Maternal Mortality Rate for Mexico, 38/100,000 (2015).
4. Clara Enns, interviewed by Abigail Carl-Klassen, Rebels, Exiles and Bridge Builders: Cross-Cultural Encounters in the Campos Menonitas of Chihuahua Oral History Project, Mennonite Heritage Archives, 2018.
5. World Health Organization Estimate for Medically Necessary C-section Rate, 10-15% (2017); World Health Organization C-section Rate for Mexico, 45.5% (2017).
6. World Health Organization Statement on C-Sections, “While many women in need of caesarean sections still do not have access to caesarean section particularly in low resource settings, many others undergo the procedure unnecessarily, for reasons which cannot be medically justified. Caesarean birth is associated with short- and long-term risks that can extend many years beyond the current delivery and affect the health of the woman, the child and future pregnancies. These risks are higher in women with limited access to comprehensive obstetric care.”
7. Word Health Organization C-section Rate for the state of Chihuahua (2017), 37.6% (public facilities) 60% (private facilities).
8. El Heraldo de Chihuahua, “Incrementan partos por cesárea hasta 90%” (“Caesarean Births Increase to Upwards of 90%), January 24, 2018 https://www.elheraldodechihuahua.com.mx/local/noroeste/incrementan-partos-por-cesarea-hasta-90-748516.html; Estimated C-Section Rate for Tres Culturas Region Based on Samples Collected by Health Care Providers, 80-95% (2018).