News from the Edge

The Story of a Birth in a Temascal

A home in a Pokomchi village (not actual home from the story)

Giving birth in a rural indigenous community in Guatemala can be an unimaginably difficult experience. The following story is of three Pokomchi women, a pregnant woman, a traditional midwife, and a nurse who were brought together through a very challenging situation. These women showed amazing strength and fought for a positive outcome, as you will see.

A young pregnant woman, nurse Alicia, and a traditional midwife (pregnant woman and midwife pictured not actual women from the story)

A 26-year-old single mother of one, became pregnant with another child. She thought this time would be different, but the birth father again refused to take any responsibility for her and the new child that was on the way. She was living with her parents, but they weren’t happy that she was pregnant again from the same man who refused to be responsible for her and the children that he fathered. The assistance she was receiving from them was minimal.

When her labor started she had to leave the house as her parents didn’t permit her to give birth inside. Most Pokomchi families have a traditional bathing area outside the home called a temascal. This handmade structure is made from the surrounding earth and wood. Temascals are often small with a narrow entrance, and low roof. You can imagine it looking like a small cave. One must crawl into it. A fire is made inside and water for bathing is heated. It is often used to promote healing when one is sick through the use of herbs and the effect of the smoke. In this case, giving birth in a temascal was anything but a therapeutic experience.

Sample image of a temascal

It had been raining heavily around that time and the ground was wet and muddy. It was very cold. The laboring mother crawled in the mud, into the tiny space. There was no fire lit. She didn’t have the supplies to start a fire, neither the ability to do so in the midst of laboring. The family did not help her, but knew that she would need help, so they went to get the midwife. The family refused to let their daughter in the home to continue giving birth, despite the midwife’s attempts to change their minds.

Midwives and the families they positively affect through their excellent care

The midwife assisted the patient in giving birth in the temascal. Her physical health was frail and the birthing location only made things worse. She fainted immediately after giving birth and was starting to get hypothermic. The newborn baby girl was crying hysterically from the cold and she was in danger of developing hypothermia as well. The patient only had the clothes she was wearing and the newborn baby had nothing. There were only a few small, old rags which were used to try and cover the baby. The midwife knew she needed help and contacted Nurse Alicia.

Upon arrival, Alicia assessed the unconscious patient. Her vital signs were not within normal range and she was deteriorating. Alicia tried to insert an IV to give fluids and revive her, but the space was just too small and she couldn’t. Alicia and the midwife tried to start a fire to warm her and the newborn. The wet, muddy, and cold condition of the temascal were not conducive to a fire. They had managed to revive her, but it didn’t last long. By this time, she had fainted three times. This wasn’t an adequate place to care for her and the newborn. They weren’t going to regain health in these conditions. They needed to get them out of there and into the house.

In the midst of caring for the mother and baby, Alicia was also pleading with the family to let them into the house so that she could properly care for them. Alicia explained the great danger that they were both in. Alicia made sure that they knew that their daughter had fainted three times, was hypothermic, and that the baby would be hypothermic soon too. She explained that if anything happened to them, they would be responsible as their daughter was living with them. For a long time, they were firm in their decision to not let them inside the house.

a Pokomchi parent

Finally, after 3 hours, the parents decided to allow their daughter, the newborn, Alicia, and the midwife into the house. The patient was unconscious at this point, but Alicia was able to insert an IV inside the house. She set up the IV to run as fast as possible to rehydrate the patient quickly. A fire was made close to the patient and newborn and they both regained some body heat. They were on their way to recovery. Alicia did not want their condition to worsen, but she had other patients to see and couldn’t stay with them all day, neither could the midwife. The community leaders came and were made fully aware of the situation. Alicia made sure they would call her if their condition changed negatively. They stayed with them until it was positive that they were both in stable health.

An example of Nurse Alicia at work: Providing competent care that keeps families healthy and whole

The next day, Alicia visited them at home to check on them. The baby was stable. The mother was very anemic though. Alicia gave her the treatment that was needed so that she would recover. At the end of all of this, the parents were grateful to Alicia for saving their daughter and granddaughter’s lives. Even though they are not in agreement with their daughter’s life decisions, she is still their daughter and they wouldn’t have wanted her or the baby to die. It was a situation in which both of them could have easily died. Through Alicia and the midwife’s skills and care that fought for their lives, they survived and have the chance to continue to fight to thrive in life.

A happy Pokomchi family that has the opportunity to blossom: With quality medical care, this can be a reality