Professor of Anthropology and Gender Studies Sarah Williams discussed reproductive healthcare and midwifery on the Yucatán peninsula of Mexico in a Sept. 24 lecture titled “Always Already Vanishing: Midwifery, Indigeneity, and the Mexican State.” The presentation was the inaugural event of the anthropology department’s fall 2021 colloquium series, “Anthropologies of Hope, Transformation and Repair.”
The lecture examined the endangerment of midwifery as a medical and cultural practice in modern-day Mexico. A classification of midwifery as “an Indigenous cultural tradition,” coupled with the bureaucratic exclusion of individuals from indigeneity “irrespective of their own self-identification or connection to their communities,” in the Mexican state is driving the decline in midwifery, Williams told The Herald.
Williams argued that this process of excluding individuals from a classification of indigeneity “is actually quite dangerous for midwives … It seems like it’s protecting traditional midwifery, but what it actually does is narrow down the number of people who can be considered legally traditional Indigenous midwives.” This narrowing makes midwifery “almost impossible to practice and (to be) passed along to the next generation.”
In addition, Williams said that many reproductive practices in Mexico have become increasingly medicalized, reflected in the nation’s extremely high C-section rate. According to Williams, the nation sees high levels of “non-consensual (and) medically unnecessary surgical interventions,” especially in urban areas. The burden of these medical trends largely falls on indigenous women, influenced by gender dynamics and serving as a “manifestation of racism against indigenous people,” she said.
Williams, who arrived at the University July 1 as the Louise Lamphere visiting assistant professor of Anthropology and gender studies, said that she has always had a strong passion for examining female reproductive healthcare from an anthropological perspective. While receiving her PhD in medical anthropology from the University of Toronto, Williams wrote a dissertation titled “Re/producing Legitimacy: Midwifery and Indigeneity in the Yucatán Peninsula” based on “18 months of ethnographic fieldwork in Quintana Roo and Yucatán, Mexico,” according to the Pembroke Center for Teaching and Research on Women’s website.
Since then, Williams has also penned multiple peer-reviewed publications, covering topics including maternal mortality and reproductive justice.
“I’ve always been particularly fascinated by and interested in women’s health and reproductive health, and the work of midwives in general seeks to honor the rights of childbearing and birthing people in ways that institutional or hospital-based systems often are not able to,” Williams said. She is particularly interested in “working with midwives and hoping to advocate for them in making it possible to do the care work that they do for birthing people.”
Regarding the implications of this theme amid the COVID-19 pandemic, Williams added that, within the United States, midwifery could be a viable alternative to conventional, hospital-based birthing practices “because it is less medicalized.” Throughout the pandemic, “we’ve seen hospitals are not necessarily safe places to be because of COVID transmissions,” she said.
Williams further explained to The Herald that the United States “has one of the highest maternal mortality rates in the world.”
“Black women are 2.5 times more likely to die during childbirth than white women, and that is largely because of medical or obstetric racism, racist policies and structures in our world that make it much more difficult for (Black women) to emerge from childbirth healthy and with their babies healthy,” she said.
Adelaida Tamayo GS, who attended the lecture, noted that it was “the first colloquium (she has attended) in person” since the onset of the pandemic. As a PhD student in anthropology, Tamayo noted that she found the research especially engaging.
Jessaca Leinaweaver, professor of anthropology and chair of the anthropology department, added that Williams’s lecture “was a sensitive talk exploring how complex people’s identities are.”
Within the Mexican state, the government, many members of which are not Indigenous, determines which communities can and cannot practice midwifery. This approach leaves the decision of who “counts” to individuals outside of Indigenous communities, Leinaweaver said. Today, only Indigenous Mayans are allowed to be midwives, which omits a large portion of the nation’s Indigenous population, she added.
“Many of these midwives do have Maya ancestry, but they don’t consider themselves Indigenous, or they don’t seem Indigenous enough according to the state definitions,” Leinaweaver said. “They are Maya people with Maya heritage, but they don’t necessarily dress in Indigenous clothes. They dress in urban clothes, and then they show up and try to do their work. And then, they get told that they’re not practicing traditional midwifery,” reflecting “challenges of the politics around Indigenous identity” and its relationship to traditional Indigenous medicine.
“Midwives can be chosen by their community. There are also different educational routes to become a midwife,” Williams noted during the lecture. She emphasized the pre-existing qualifications for midwifery that exist within Indigenous communities and outside of federal bureaucracy.
Midwives, Williams said, “should be able to self-regulate and to develop their own certification and licensing protocols that are not based on the state’s classification of who is Indigenous or not, but rather based on their own standards.”
Correction: A previous version misspelled Professor of Anthropology and Gender Studies Sarah Williams' name. The Herald regrets the error.