 So, I have the great pleasure of now introducing our next speaker, Sarah Smith, and her presentation looking at the sacred Maya midwifery practices in support of the midwife project in Guatemala. Sarah is a private practicing midwife from Australia. She has spent many years traveling the world and learning about birth and postpartum practices across cultures and is particularly interested in traditional midwifery. Her travels took her to Guatemala where she spent some time living in a rural village. During her time, she connected with the midwife project, an association dedicated to supporting the Mayan midwives through their history collection and integration of modern and traditional practices. The project aims to support intergenerational knowledge exchange between the elders and younger generations to keep the Maya midwifery culture alive. She is passionate about supporting the midwives by sharing their stories and mission on international platforms to gain support for the project's successful continuation. So, I will give you control and sit off to the sides at Ofigo, Sarah. Thank you so much, Liz. It's such an honour to be able to present on this platform and at this conference again, particularly with the theme that art and science of midwifery. It's something I resonate with a lot personally, but to be sharing what I'm sharing today, there couldn't be a true representation in the world than this project and the midwives and how they work. So, I'm really excited to share with you today. So, here we go. So, I'm Sarah. I'm a private practicing midwife in Australia and I've always had a fascination with travelling and learning about other cultures, particularly surrounding birth and midwifery. I've been to Cambodia, India and Guatemala and learnt certain practices there, but in 2022, I was living in a rural village around the sacred Lake Attic land in Guatemala and formed a connection with the Midwife Project. So, today, though, I'm acting as a messenger for the project and the traditional Mayan midwives that it supports. So, I'm not speaking for the midwives. A lot of what I'm saying today is their words and how they wish to be presented on our global community scale. So, it's giving them the opportunity to generate the support that they need to continue their important work. So, the Midwife Project, it's a Guatemalan-based association and it was created to empower local Mayan midwives living around Guatemala, but it's based at Lake Attic land. So, they're working to integrate modern and traditional midwifery practices and exchange intergenerational knowledge between the elders and the younger generation of midwives. So, to support them to improve infant maternal health care and to reclaim their ancestral roles as leaders in their community. The core and heart of the Midwife Project is a group of 22 dedicated, strong and committed Mayan midwives from four different Mayan ethnic groups. So, the need for a council of elders became apparent to the project and has been created. So, the council consists of grandmother midwives who have served their communities for over 30 years. The project also has a board of advisors and this is made up of professional midwives, nurses and an anthropologist with over 40 years of extensive expertise in rural development in Guatemala. So, the project's core team consists of Mario Gabbato. So, Mario is a Guatemalan-independent midwife and she's held this sacred vision for 10 years before the project came to life about 18 months ago. And, Lika Moraes. So, she's a doula, a birth worker, a medical anthropologist and sociologist. But importantly though, everyone who is involved with the project has the needs of the Mayan midwives at the forefront and the midwives have an opportunity to express what it is that they want and need from the project whenever they meet. So, the project has three main objectives. The first being, oral history collection. So, this helps the project learn how to best support the midwives and to identify their needs and it offers a record to be kept of the valuable ancestral wisdom, stories and the practices of the Mayan midwives. And, we're aiming to create a short documentary. So, they've done this through interviewing and recording the midwives' stories and they're creating mementos for the midwives to keep as a thank you for their life's work. The second objective is an empowerment through education program. So, this is a six month training program which was developed to support the local midwives with basic midwifery skills whilst reviving ancestral wisdom that are inherent to their roots. The first round successfully from August 2022 until February 2023 with the plan being the next round to start in September this year. So, the project gathered weekly for six months with about 22 midwives and they range from 12 to 75 years old. So, it created a bridge between modern and traditional midwifery practices ensuring important intergenerational knowledge exchange and cultural preservation. So, the empowerment through education program, it provided the midwives with clinical knowledge, skills and basic midwifery kits. So, it was initially designed and funded for only eight midwives but were travelled and some of the weekly sessions had over 20 women attending. The program provides a space of connection and guidance for the women and girls who have received a calling to become a midwife. So, this year the project's looking at opening up the teachings to international midwives and birth workers although we're still in need of securing a space to be able to hold this. So, this year they aim to provide 15 more midwives with basic midwifery kits which are at a cost of $800 each. So, this year though as well we're looking to have more online sessions with international teachers and workshops and collaborations with other organisations such as Safe Birth Guatemala and Breach Without Borders. So, the final objective is a community birthing centre and holistic Maya Medicine Clinic. So, it's going to be focused on reproductive health and holistic support for women and the families in their community and it's going to offer a safe space for the midwives to practise from. It's going to be run by the Indigenous midwives and also it's going to provide a space for midwives, daughters and birth workers from around the world to come and learn from as well as security and a space for us to continue to run the Empowerment Through Education program. So, for six months prior to the start of the Empowerment Through Education program the midwives gathered every 20 days on the day of Kuwok. So, the day of Kuwok is the day of the midwife in the Mayan culture, in the Mayan calendar. So, during these gatherings the women formed a council and set priorities and goals to how to move forward with the project based on the needs of the midwives. So, all of this was held around the sacred fire. It was under the guidance of the midwives themselves and they helped interpret messages from their ancestors through the sacred fire and give guidance for the project to be in harmony with their ancestral traditions. So, during these gatherings they expressed a feeling of family amongst each other. So, for the midwives, for many of them this was the first time in their lives that they participated in a Mayan fire ceremony. So, still a lot of judgement surrounding ancestral traditions even amongst the Mayan people themselves and this is due to the ongoing effects of colonisation and the introduction of a foreign religion. So, they expressed how special it is to see the midwives reconnect with their roots under guidance of the firekeepers and the Mayan spiritual guides. So, this is Nanna Rosalia, Nanna Nikte and Nanna Ishkek. So, they are family of Mayan midwives and spiritual guides and they form part of the elder council. So, they've supported the project from the beginning and they're the ones who facilitate the Mayan fire ceremonies. So, a little bit about the area that the Mayan midwives live in. So, Lake Attic Land, it's a rural area in the Guatemalan highlands of the Sierra Madre mountain range. It's around three hours from the iconic city of Antigua. So, it's the deepest lake in Central America and it's surrounded by small villages and three volcanoes. So, it's known and very much feels like the womb of the earth, the energy there is really palpable. The area though is not easy to travel around. So, the small villages are connected by steeple, winding roads, dirt roads or via boat travel. So, the closest hospital is about an hour away, although access greatly depends on the time of the day, the weather and someone's financial means. So, the area unfortunately though has been severely affected by earthquakes and landslides. Poverty has high rates of chronic malnutrition and a civil war which lasted three decades and only ended in the late 1990s. So, that war was intended to wipe out the Mayan people and their traditional practices. So, tens of thousands of people were killed and the event is considered a Mayan genocide. So, during this time it wasn't safe to openly practice Mayan practices. So, much of that knowledge went underground or was lost. There are a number of Maya subgroups who live around the lake and the Maya culture is very prevalent in the area compared to other areas in Guatemala, especially with the women who wear traditional clothing. So, this is Nana Nicte. She's a traditional midwife and spiritual guide from a lineage of Maya kitsch wisdom keepers. So, she forms part of the advisory council and is the daughter of Nana Rosalia. The midwives in the Mayan culture are considered healers. They're around 17 different Mayan medicine practitioners from death shamans, healers who work with a sacred fire and tobacco, bone healers, spiritual guides who have a strong connection to the spirit realm. And among them all, midwifery is still practiced today and has withstood that Mayan genocide. So, for the Mayan midwives, midwifery is a calling. It's a path that's actually determined for them. So, in the Mayan worldview, you don't become a midwife, you were born as a midwife, which I'm sure many midwives can resonate with. Some of us don't really know consciously what drew us to this path. But for the Mayan midwives, illness and misfortune can come to them if they don't follow the path of midwifery. So, when a female baby is born on the Mayan cosmology day of Kuwak or N. Cole, it is thought that she is destined for the path of midwifery. So, if one is born as a midwife, it's important that the family supports the path of the child. So, a fire ceremony is held by a Mayan spiritual guide that helps to open the path of the child and help them access their sacred calling and their gift. So, some come from a lineage of healers and midwives, and their knowledge is passed onto them through their family, although the Mayan midwives have an extraordinary way of learning and actually occurs while they sleep. So, they gain knowledge through their dreams, and that's often starting from when they're around seven years old. They have a really deep connection to the spirit realm and the dream dimension, and they receive very specific and detailed instructions on what to do and how to do it. So, they dream with their elders to show them things like how to do a vaginal exam. They teach them how to do the massage with the women. They teach them what plants to use for what ailments. They even dream with babies. So, each dream holds profound symbolism and wisdom. Sometimes they see the future in their dreams. So, when a woman comes to a midwife, the midwife is already waiting for her. So, when there will be a complication in a birth as well, the midwife would have already dreamt about it. So, for my midwives, dreams are a powerful communication portal to the divine and to their ancestors. It's fascinating that actually many of the stories that they share are the same across the Maya region, and interestingly as well, this is also what I was hearing from the indigenous traditional midwives during my time in Cambodia. So, Nana Rosalia shares with us, our ancestors knew what they were doing and why they were doing the things they did. For us in the Kitch culture, the midwife is a fundamental part, because it is she who determines the explication of the existence of the baby and what this baby brings with it. When the baby is born, she will tell it what its work that it came here to do is. But now, this is getting lost. For example, when a baby is born with the veil, which is an coal, many don't know its significance anymore. Same with the belly button, same with the ambilical cord in the placenta. They don't know what it means anymore. Traditionally, births have always been at home. The midwives would perform important rituals and ceremonies to ensure the health and wellbeing of the woman and the baby from preconception all the way through to postpartum. So, however though, this is quickly changing. The Western narrative of the doctor knows best is fast encroaching. The government over the last 60 years, but particularly over the last decade, have attempted to systemise the indigenous midwives. As is the case in other countries around the world, the government has attempted to put restrictions on who the midwives can attend during birth and how they can practise. So, the midwives are required to attend a monthly government training to maintain their ability to practise as a midwife by law. These trainings they are required to follow are of low quality and the midwives have expressed that they do not feel supported in their work and are not given the basic necessities to practise as a midwife. The midwives express that this approach and treatment by the government disrespects their spiritual and cultural knowing. So, some of the elder midwives actually have been protesting this as they've been practising without this requirement for most of their lives. Luckily for the midwives and the women they attend, laws aren't heavily enforced in the country, particularly in the rural areas. So, the number of women birthing at home, it is reducing, but the midwives still have an important role and will often work alongside the nurse or doctor at the health post. They're not allowed in hospitals and at the moment are usually mistreated by medical professionals. They're ridiculed and shamed for speaking their Maya language and for their witchy practises, which contributes to the culturally unsafe treatment of the Mayan women in the hospital system. So, Donis Sebastiana, she's one of the elder midwives and she's from a village called Santiago around Lake Atitlán. And she says, the womb is like a flower, delicate and beautiful, so we have to take care of her. In the Maya Kachikal Kots-ish is the word used for both uterus and flower. The midwives often dream of flowers as part of their sacred calling and here, Nana Sebastiana is preparing flowers for the sacred fire ceremony to ask for guidance for the project. This is Marie, the project leader. She's receiving an abdominal massage to help position her baby Lucio in the right position. So, each midwife has her specialty. Some work more with curing babies and children who receive very special care, especially newborns who are vulnerable and need their energy protected. So, some midwives attend more births and others do more postpartum care. So, for the Mayan midwives though, birth is kept sacred. They see plants as sacred, working with many different healing plants that vary depending on the region and commonly work with sacred tobacco. They also use elements for healing such as charcoal, incense, candles, plants and certain stones. The very few are still connected with the Maya Cosmo vision, have a deep connection to the Nual energies and communicate with them through the sacred fire ceremonies. So, this connection to divine guidance is essential to preventing illness, maldevelopment of the baby and maintaining optimal health during pregnancy and postpartum. So, before the midwife enters the birth space, her most important tool that she connects to the divine great spirit or God and through these specific prayers and rituals, it helps her to receive strong guidance on how to support that woman during that birth. So, some carry the gift of communicating with babies and actually have the ability to turn rich babies. So, some midwives can read the Blasenter or work with the Mayan calendar to be able to provide the parents guidance for the path of the baby. They will know if a baby is destined to be a midwife and they actually have a responsibility to guide that baby. So, some work more with Mind Abdominal Massage, which supports overall physical, spiritual and emotional health. And specifically after birth, that helps to avoid infection by ensuring there's nothing left in the uterus. It helps to reposition the uterus after the pregnancy and avoid prolapse. The midwives have in-depth knowledge on how to support women during postpartum healing through massage, temer skulls, which is like a traditional sauna, vaginal steaming, herbal plant baths and bellybinding with a phaha. Sadly though, many of the midwives end up living in extreme poverty because it's culturally expected for them to provide the services that they do or for free or on a donation basis. So, the Western influence of a monetary society has actually caused a loss of value of the midwives in these communities. And yeah, they don't see the value in the work of the midwife anymore. So, the midwives tell me of how the families actually no longer provide what's needed for them to perform the ceremonies and this important like spiritual support for the pregnancy and birth. Some express they aren't even offered a glass of water by the birthing family. So, the path of a midwife in these communities is not an easy one. If they are paid, it would only be around five US dollars, sometimes at best up to 60. And for context, a meal in one of the local villages is around eight US dollars. And this is what they get paid for all of the prenatal care for attending the birth, for cleaning up and all of the extensive postpartum cares that they provide to the woman and the baby plus all of the other roles that we fulfill as midwives. So, psychologists and couples, counselor and therapist, friend, confidant, grandmother, healer, pediatrician, they do it all. So, some of the midwives have been practicing longer than I've been alive and they report having never had a woman die during birth. They are expressing though that birth is becoming more challenging and we had an opportunity to talk this out at one of the project meetings. So, they want to improve their knowledge to be able to better support their communities so they can understand medical terminology and practices and so they can gain more respectful collaboration with medically trained healthcare providers. So, an important aim for the project is the revival and revaluing an active practice of my ancestral Maya medicine which is a fast dying healing art way of life and part of Maya spirituality. So, those who have been practicing have been persecuted and it's cost the lives of many. The project is honored to be able to create a web of support for each of the Maya midwives practicing her ancestral medicine so they know that they're not alone. So, for many of the midwives, the project has offered the first ever opportunity for them to come together in ceremony and as women walk in the same path. They're coming together as equals and sharing wisdom rather than keeping their secrets and working individually. They have been provided a safe space to share stories, connect and deepen their wisdom, to feel supported and learn from each other. Providing the opportunity for the midwives to exchange knowledge on different practices has been a really valued achievement for the project and the midwives expressed that gathering together has been a very healing and transformative experience for them. So, why the Midwife Project is important for the community. Maternal mortality in Guatemala as reported in 2017 was 90 per 10,000 birthing women. However, in Guatemala, that is quite a socio-cultural divide. So, like in many countries, this puts marginalized and indigenous women at high risk of poor outcomes and despite outcomes improving overall for the country, some accounts report maternal mortality for the Mayan women are actually among the worst in the world. And these are the population of women that the Mayan midwives are caring for. So, usually the young single women, women affected by poverty and chronic malnutrition. So, the government facilities and rural areas lack the staff and resources necessary to offer dignified, respectful, or safe health care for the Mayan women, as is sadly the case as well around the world for minority and indigenous women. They don't receive the same standard of care and even experience abuse in hospital settings. So, for many women, care from the Mayan midwives is the most physically and culturally safe option. So, in the medicalized birth world, I feel we're experiencing the tipping point where birth interventions no longer reduce maternal and neonatal morbidity and mortality and are actually starting to contribute to poor physical and emotional outcomes. So, I feel we've gone so far in this direction that we're losing our ability to support physiological birth and all of the crucial health benefits that it ensures. So, this is something I very passionately shared with the midwives during one of the meetings to express why I acknowledge what they're doing as so important and why I feel so passionate about sharing the message of the project. So, preserving traditional knowledge and weaving it with safe clinical care has the ability to preserve midwifery as a respected practice and benefit the health of the community at large, especially in low resource settings, which don't have easy access to medical intervention even when it is truly needed, preserving the knowledge and skills to support safe physiological birth in these communities and our own will save lives ultimately. And at its core, the project aims to support the midwives in regaining their role as important guiding pillars in their community. Remembering and valuing the ancestral wisdom they carry and through this, supporting other women to also overcome their state of oppression that they live in. So, the project believes that by creating a strong positive change in the lives of the midwives, that this will ripple out into the lives of the women they intimately support in the community and their villages as a whole. So, here are some of the midwives who completed the six month empowerment through education program and they received basic midwifery kits thanks to our donors. So, this is Marlenny. She traveled each week four hours back and forth to attend the classes of the six month in education program. So, here she is receiving her midwifery kit on her final day and she recently attended her first birth in her community. Marlenny's only 20 years old. She's a traditional midwife and she's on the council representing the younger generation. So, the youngest midwife to attend the empowerment through education program was only 12 years old. This is Amry and she was born as a midwife and she says, it has been my dream to be a midwife. My grandmother was a midwife, but she died. I've never got to learn from her. So, I'm very grateful for this opportunity. I'm already having the dreams of a midwife and I look forward to start serving my community. And this is Ruth and she's 28. She was also born as a midwife. She says, since I was invited to join the empowerment through education program, my life changed. I had the calling and dreams of becoming a midwife but I didn't know how to start. During the program, I attended the first births in my community. I'm forever grateful. So, here's the midwives practice seeing some suturing skills and this is Dr. Amy. So, she's a very experienced chiropractor from America and she shares with the project chiropractic techniques for pregnancy and birth and how to turn rich babies. The project came together with some midwives from Santa Lucio in Abbott land to exchange knowledge on herbal medicine making. And this was during one of the empowerment through education program sessions where they were making herbal balms. And this was from a clinical postpartum hemorrhage workshop that was facilitated by the organization Helping Mothers Survive and the group of midwives that attended the workshop. And here I shared a holistic workshop on preventing and treating postpartum hemorrhage outside of the hospital system or health clinic setting. So, this was just to offer a perspective of teaching that was more in line with how a lot of them are midwives practice. And these are some of the midwives who attended. So, here Mariu is interviewing elder midwife Huana as part of the first objective, which is the oral history collection. Donna Huana is one of the five elder midwives and she's from San Marcos, Lake Attic land. This is Maleni listening to baby Lucio's heart rate. And this is Nana Rainer. She's doing a traditional egg clearing for baby Lucio. So, it's helping to release the meldiorho and that is any negative energies that are absorbed by the baby. So, meldiorho can cause sleep disturbances, restlessness, excessive crying and colic for the baby because babies are so sensitive they easily absorb energies from their environment. Here she's rubbing the egg over his body. So, the negative energies will then be absorbed by the egg and then the midwife breaks the egg into a glass and reads the egg yolk. So, that's gonna tell her which energies the baby had been affected by and whether they've now been released. The egg is then released at the roots of a tree and the negative energies returned back to the earth. So, here Nana Rainer is clearing baby Lucio with medicinal plants. So, Ru is what she's using and it's a plant commonly used amongst the midwives as a healing ally to cure meldiorho. It's also very supportive of women's health. So, she just rubs the plant over his body. Nana Rainer here is demonstrating how to remove the ingrown black hairs from Lucio's back. So, this is a practice that she learned directly from her mother, Nana Rosalia. So, first she chews on pure dried tobacco leaves and then rubs it on his back which makes all the hairs come out. And this was during the module on ancestral cures for babies as part of the six month training program. This is traditional midwife from San Marcos, Donya Domingan, she was born as a midwife. She started receiving messages in her dream as a child on how to massage women and how to attend births. But she was discouraged to follow her path of midwifery by her family who saw how challenging this life could be. So, she attended her first birth as a young teen without her family knowing and she was chronically ill until she had her path as a midwife opened. So, here she's praying and connecting with her spirit guides before she performs an abdominal massage. Here she's rolling up the phaha which she'll apply and it's applied after abdominal massage during pregnancy and during postpartum. So, this is the Temescar which is the traditional sauna and it's used for cleaning and cleansing energies and is also to support women during their postpartum healing. So, this is Alda, Nana Angelita and she shares, the uterus is the core of the woman. All of her emotions go there. If the uterus is sick, the woman is out of balance. It's very important to clear the uterus of old memories with plants for example. And every one of us carries seeds of knowledge. We need to get together and make ourselves stronger as midwives. All I want is to share the little that I know with the younger ones that are coming after us. So, these words are from Nana Rosalia. She's 75 year old Maya Kitch traditional midwife and spiritual guide. So, if you're interested in supporting us at the moment, Mario and Leica are doing the work of about five people alongside their own work supporting birthing women and they're not being paid for this work. So, we're really in need of support and connections with similar organizations that can offer us some guidance and support. We need support with our social media and our website so we're able to get the word out on a global scale but really we need finances. So, if the project's gonna achieve its goal we especially need help with grant writing which is a deficit that we have at the moment and connecting with people who have the means to be able to support us financially. But everyone can contribute through our GoFundMe page or running a fundraiser event or sharing about the project. So, we also welcome donations of midwifery materials for the midwives like good quality scissors and gloves and Dopplers. But if you'd like to find out more please get in contact with us through www.themidwifeproject.net or me directly at downtobirthmidwifery.com. Look, I'm just blown away to the traditions that they're able to still do but at the cost that to be able to do them traditionally but also they're thinking about the other and as you mentioned the other indigenous cultures around and what they've had to fight to keep the traditional cultures around. And I was just looking at some of the photos of the and thinking back to the Australian indigenous cultures and the smoking ceremonies of the newborn and there's a lot of similarities and yet kind of idiosyncrasies of each kind of culture which I think is just beautiful. Yeah, and that's absolutely been my experience as well like learning stories of traditional midwives across the world. They all have very similar stories with the same intentions really. So yeah, I don't find that by chance, that's for sure. I think that's kind of, I remember sitting in the Native American Museum in America and listening to some of their traditional stories and thinking how similar they were to the indigenous dream time stories. And there's a lot of... Yeah, I had the same experience in Cambridge as well. I saw lots of people blown that we can kind of bring in. And it's just, has anyone got any questions that would like to ask or they would like to kind of like write in? It is sad that it has gone from a respected profession that was supported in a barter type of situation to something that women are struggling to be able to support themselves for. Yeah, it was definitely one of the things that pulled on my heartstrings the most when I was listening to the midwives share their stories, especially like the work that they do is just so beautiful and so nourishing and to be held like in postpartum with the traditional practices that they do that really contribute to the women's long-term health and wellbeing and the babies to be not valued in that. Like I am heartbroken for these women. They work so hard, plus they work very hard in the home, just physically their lives are a lot more challenging than ours, but they're just so strong, very powerful, like very amazing women and just honestly it was an honor to be in their presence. So if I can support them in a way that brings value back to them and their work and they were so humble with like the conversations we had, I don't think they recognize the value of the work that they're doing. So I definitely like to share that with them. And so they've got people there can actually go into the midwife project and down to berthbedwifery.com. So Jen has written here, were there any other traditional practices that potentially harmful? With the things that I was shared, which was limited for the time that I was there, I wasn't there during the education program. I hope to be tuning in with that for some time like in the next coming program, but no, I didn't feel was the case at all. It was coming back to supporting physiology, but they really made a point of like the important part of their practice is supporting that energetic side of birth, which like they said, it reduced malformations in the baby, it reduced complications in the pregnancy and in the birth. So there was no practices that I came across that I felt there's definitely ones that are different to how we practice in the Western world, that's for sure, different concepts and philosophies, but nothing that was particularly harmful. You'd expect that also with dangers in resources and differences in resources and geography and things as well. So excellent.