Working the contractions: The birth model of BCs in Mexico

The model of care in the visited BCs was what is internationally known as the “midwifery model of care” (Alonso et al. 2015; Davis-Floyd 2018b)—an approach in which pregnancy and birth are understood as women’s normal life processes.

Midwife Gabriela: One of the things we work on with women during their pregnancies is that they manage to change the negative image of birth ... That when they enter labor [trabajo de parto], they know the process, know their bodies, have patience with their bodies ... [and] know that everything that happens during the labor is normal, is something good and healthy; that they learn how to support their bodies.

The model of care is thus rooted in respect and support for the woman to facilitate her conscious process of assuming her power to birth with freedom. The mother may also, if she wishes, bring the father to take part in the birth as a means of initiating his fatherhood. Before the birth, the midwife and expectant mother make a birth plan that outlines the principal wishes of the woman during labor, such as who will accompany her.

Midwife Gabriela: One of the most important things is that someone can be with them [birthing women], a partner, and many times that is the only thing that a woman needs for her body to work well, so that her process runs smoothly. To be accompanied is very important.

Part of the midwifery model of care is to promote the free movement of birthing mothers and enable them to eat, shower and move during the labor. In addition, the model favors breastfeeding and early contact with the newborn.

Midwife Gabriela: Here the women are free to choose the position they prefer during the labor; the one that [they think helps their progress] ... During the labor and birth we adapt to the way in which she wants to do it: wherever she feels the most confident, there we go. Sometimes we have been working in the bathroom, in the bed, beside the bed, the obstetric chair we have, whatever works, different positions.

In striking contrast to the hospitalized birth’s use of analgesia or full anesthesia, the visited BCs attempt to shift the perception of pain through various other techniques: massage, aromatherapy, water births, changing positions, listening to music and occasionally alternative therapies such as homeopathy and the traditional use of herbs:

Midwife Cintya: [We maintain the bath water at] the temperature of the mother’s body, which is a remedy, one more resource that provides help ... It decreases the intensity of pain, so that it will not be sooo intense.

Another midwife mentioned that women of reproductive age need to know more about the benefits of these spaces (as opposed to what happens in most Mexican hospitals), and of birthing at home with midwives:

Midwife Betzi: They birth in the hospitals but it is not the same as giving birth in a BC. In the hospital, there will be 99% women who labored and have a scar, have a episiotomy; another one has a C-section, yet another has the arm full of pricks in the veins, and the other one has a punch in the back, and another one couldn’t breastfeed, and so ... They were all abused, and their birth experience does not have the same reward.

The midwives in BCs avoid episiotomies and the abuse of technology (ultrasounds or electronic monitoring) as well as the unnecessary use of synthetic oxytocin or intravenous fluids.

Midwife Gabriela: In one of the classes that we give here, [we] talk about the unnecessary interventions during birth, [mothers] learn to recognize that... What kind of medical interventions exist during birth, which ones are justified and which are not, like the one of shaving the pubic hair, use of intravenous solutions, episiotomy, the fact of lying in the bed without changing position, the continuous fetal monitoring, all these things ... And here we try to do what is physiologically possible, whatever is possible to support the birthing body and to intervene as little as possible in the births.

Thus, the midwife-interlocutors emphasize that, in the BCs, the woman is the main protagonist of the process, and the midwife is only a companion and guide.

Midwife Gisela: We make a team with the woman who is ready to find her power and to prove that her baby has the capacity to be born. And with the man who trusts in his companion and is ready to support her in the process of feminine assurance of being able to do this, and thus giving him as well a gift of being close to the miracle of life.

To sum up, the BCs in Mexico emerge and are maintained in a context where standard birth care is marked by human rights violations. The increase of obstetric violence in the country; the abusive use of unnecessary practices like C-sections in low-risk labors; and the high maternal mortality in the country’s poorest regions make it necessary to find new paradigms for transiting pregnancy and giving birth more respectfully and consciously.

However, as previously noted, unlike BCs in many other countries, Mexico’s cannot be announced as such. They basically operate in secrecy, and given that they are private initiatives, access to their sphere of services is expensive—affordable mainly by middle- and upper-middle-class women.

However, the histories of women who have given birth in the BCs in Mexico offer evidence as to why these spaces represent an option very different from medicalized birth, as well as an option for reducing obstetric violence. The key is that the midwifery model makes the women the protagonists and owners of

From infantilization to body-territoriality 119 their maternity, thereby increasing the women’s self-esteem (as we shall see in the following section).