An American Midwife in Mexico
an essay by Stacey Curnow
My husband and I knew we wanted to be parents, but we were in no hurry. Nine years ago I was 31 and only four years into my career as a nurse-midwife. I was working full time at the MAHEC Women’s Health Center in Asheville, and I loved my job. But what I enjoyed most was interacting with the few Latina women who came to a public health clinic I staffed one morning a week. I dreamed of being fluent in Spanish to better communicate with these women. What’s more, I realized that I had time for one great adventure before I welcomed my own baby into the world.
I considered a few possibilities. Previously that year, I had run the Boston Marathon and figured I needed a bigger challenge. I had devoured Into Thin Air, Jon Krakauer’s account of his trip to the top of Mount Everest, and for a while, I was rather taken with the idea of climbing Everest myself, though I didn’t own a pair of crampons. Then I started reading The Scottish Himalayan Expedition by the mountaineer W.H. Murray and was struck by something he wrote: "The moment one definitely commits oneself, then providence moves, too." I realized then that I could do anything I set my mind to, and it was not climbing Everest—the thought of falling into an icy crevasse scared me too much. But the dream of living and working in a Spanish-speaking country suddenly seemed attainable.
And sure enough, as I took my first step, providence moved. I applied to Doctors Without Borders and within a month was offered an interview in their New York office. They had no positions for midwives in Latin America, but I wasn’t interested in any other placement. The director kept my application, but she didn’t think there would ever be a desirable position for me. Within two months, the phone rang. It was Doctors Without Borders telling me they were starting a new maternal health project in Mexico. They wanted me to join the medical team.
People thought I was crazy to leave my life in Asheville for a volunteer position in a remote Mexican village. I would be living in a region of Mexico where there was no electricity, no running water and few people to call for help. Doctors Without Borders chose this region because the Mexican government was allegedly persecuting indigenous people there. (This threat of danger was a particular concern for my parents.) I was leaving the known and comfortable for a place unknown and filled with risks. But I knew, like the Scottish mountaineer Murray, that I had created this opportunity by committing to my dream and I was not going to be dissuaded.
So I went. In June of 2002 I quit my job to work for six months in southwest Mexico with an all-Mexican medical team, setting up clinics in rural areas of a region known as La Montaña, or The Mountain. We always gave preference to women and children, but we saw everyone who needed attention and were available for emergencies 24 hours. We saw a continuous string of women, who often brought in five or six children at once. As expected, we saw a lot of respiratory and intestinal infections but also skin problems, mostly scabies and infected bug bites.
My most memorable patient was Celia. When I met Celia, she was lying in bed and didn’t feel well. I learned she had given birth eight days earlier. It was Celia’s second pregnancy, and her first birth had been unproblematic. This time, however, she started labor in the evening with stronger contractions all night but with no evident labor progress. In the morning, her family and partero (a male midwife) realized something was wrong and decided to seek help in the closest town. This meant a seven- to eight-hour walk, plus a four- to five-hour drive to a regional hospital. But after almost an hour of walking, they realized the road was impassable. Discouraged and in great pain, Celia turned back and went home.
The partero again tried to facilitate the baby’s birth. When that did not work and the contractions diminished, he gave two injections. He was not on hand when I saw Celia (he was in the countryside tending to his animals), but I suspect he gave Pitocin, a synthetic form of the hormone oxytocin, which causes uterine contractions. (Anyone can buy the medicine without prescription in Mexico, and it can have serious side effects.) About ten minutes after the injections, the baby’s head emerged, but the rest of the body was stuck. The partero tried what he could, but the baby died.
When I examined Celia, she seemed to have a uterine infection, and I gave her an antibiotic. I visited her for a week, and every day we talked about her loss and grief. Fortunately, her two-year-old daughter was the source of much joy for both of us. By the time I left, Celia’s vital signs were normal and she said she felt much better.
I remember other things about my time in Mexico, like the evenings my Mexican colleagues and I would walk 20 minutes to a natural spring. It was always a treat to walk through the cornfields ringed by mountains just as the air cooled after the sun set. We always arrived hot and dirty and left clean and refreshed. Every morning just before sunrise was a wonderful time to be outside. I saw things I didn’t notice during my busy days: mostly the ebb and flow of country life, baby pigs the size of kittens and baby goats the size of small terriers with their dried umbilical cords still attached, all tottering after their mothers.
Back in the States, I started reconnecting and looking for work. After a short search, I found the dream job I had been seeking when I started my journey, a position in a public health practice serving Latina women. Today, my patients remind me of the women I served in Mexico, and I’m grateful my language skills and cultural knowledge help me to care for them as they navigate a foreign country.
I’m also finding that my time in Mexico changed my life in other, more profound ways. Mexicans value family and community above all else, and I have come to adopt those same values. And yet, if I had never taken that first step—if I had never committed to my dreams of adventure and travel—I might never have appreciated the way I do now the gifts my family and community have to offer.
For more about Stacey Curnow’s midwifery and life coaching practice, go to midwifeforyourlife.com.
Verve-acious
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