Med Anthropol. 2001 ; 20(4): 345-78.

Midwifery across the generations: a modernizing midwife in Guatemala.

Cosminksy S.

Rutgers University in Camden, New Jersey, USA.

This article examines change and continuity in midwifery knowledge and practice by comparing a mother and daughter, both of whom are local midwives, or comadronas, on a Guatemalan plantation. The daughter apprenticed with the mother, who died in 1997. Like her mother, she received a government midwifery license after attending an official training course. I discuss the applicability of the concept of "postmodern midwifery" as I trace how both mother and daughter adapted to the pressures of medicalization and modernization. The daughter negotiates with biomedical personnel and copes with increasing government regulations, and she tends to accept biomedical authority more readily than did her mother. Unlike her mother, she sometimes uses this authority to enhance her own status. Nevertheless, her acceptance of the biomedical model is not complete, for she recognizes the practical constraints of poverty, under which both she and her clients live, and she also insists upon the superiority of such practices as massage. Furthermore, biomedicalization is countered by a process of sacralization, which, I suggest, enables midwives both to contest biomedical authority and to deliver meaningful care.