TIMES ARE CHANGING: THE ROLE OF BIOMEDICINE AND CHILDBIRTH PRACTICES IN RURAL OAXACA _______________ A Thesis Presented to the Faculty of San Diego State University _______________ In Partial Fulfillment of the Requirements for the Degree Master of Arts in Anthropology _______________ by Nadia Merino-Chavez Summer 2012 iii Copyright © 2012 by Nadia Merino-Chavez All Rights Reserved iv DEDICATION This Master’s thesis is dedicated to my parents, Pedro Merino and Patricia Chávez, who have dedicated their lives so that my sisters and I can have a life filled with opportunities and live in a world where we can accomplish our dreams. In particular, I want to dedicate this thesis to my husband, Ramon Hernández, who has encouraged me through every step of this journey and continues to be my source of strength. In addition, I want to dedicate this thesis to my loved ones, my sisters Nayeli and Nidia Merino, and my grandmother, Austreberta Dirzo. Thank you for all of your continued guidance and support. Without your help, patience, and endless encouragement, I would have not been able to embark on this academic journey of higher learning as a first-generation graduate student. Most of all, I would like to dedicate this thesis to all the Mixtec women who participated in the study and my mother-in-law who were invaluable to the completion of this thesis. I want to thank them for allowing me to be a part of their world and learn about their knowledge of life and birth. This project was conducted in hopes that the wisdom imparted from these Mixtec women regarding childbirth and maternal care inspires younger generation to preserve traditional forms of knowledge and care. v ABSTRACT OF THE THESIS Times are Changing: The Role of Biomedicine and Childbirth Practices in Rural Oaxaca by Nadia Merino-Chavez Master of Arts in Anthropology San Diego State University, 2012 With the introduction of biomedical models in rural Mexican communities over the past years, traditional child birthing practices are slowly being abandoned and the use of traditional midwives is declining. This study explores the management of childbirth practices in the rural Mixtec community of Santiago Juxtlahuaca, Oaxaca, México. This project seeks to examine the implications caused by the reorganization of obstetric care and the changing birthing practices among Mixtec women. The project also assesses the ways in which the introduction of biomedical care is transforming the birthing practices of the indigenous women in rural Oaxaca. vi TABLE OF CONTENTS PAGE ABSTRACT ...............................................................................................................................v LIST OF TABLES ................................................................................................................. viii LIST OF FIGURES ................................................................................................................. ix ACKNOWLEDGEMENTS .......................................................................................................x CHAPTER 1 INTRODUCTION .........................................................................................................1 2 RESEARCH SETTING .................................................................................................7 3 THE ÑUU SAVI PEOPLE ...........................................................................................16 History....................................................................................................................16 Demographics ........................................................................................................18 Indigenous People of Oaxaca...........................................................................19 Language ..........................................................................................................20 Subsistence .......................................................................................................23 Infant Mortality and Maternal Mortality..........................................................25 Social Inequality and Health ............................................................................25 Sociocultural Context.............................................................................................26 4 RESEARCH METHODS ............................................................................................33 Research Questions ................................................................................................36 Profile of Mixtec Women in the Study ..................................................................37 Distribution by Age..........................................................................................37 Language ..........................................................................................................37 Marriage and First Pregnancies .......................................................................40 Place of Birth ...................................................................................................42 Protection of Informants ........................................................................................43 5 AUTHORITATIVE KNOWLEDGE AND BIOMEDICINE .....................................45 6 MIXTEC HEALING: HEALTH BELIEFS AND TRADITIONAL CARE ...............52 Nature and Environment ........................................................................................54 vii Hot and Cold Equilibrium ......................................................................................56 Illness .....................................................................................................................59 Medicinal Plants and Food.....................................................................................61 La Partera (The Midwife) .....................................................................................66 Management of Birth .............................................................................................70 Baños de Vapor— Steam Baths .............................................................................76 Maternal and Infant Care .......................................................................................80 7 “ANTES NO HABIA MEDICOS”: CHANGING BIRTHING PRACTICES .............83 8 TRANSNATIONAL MIGRATION AND CHANGING HEALTH BELIEFS ..........94 REFERENCES ......................................................................................................................103 APPENDIX LIST OF MEDICINAL PLANTS .............................................................................112 viii LIST OF TABLES PAGE Table 1. Profile of the 25 Mixtec Women in Study .................................................................38 Table 2. Distribution of the Languages Spoken by the Mixtec Women ..................................40 Table 3. Distribution of Age at First Pregnancy for the Mixtec Women in the Study ............41 Table 4. Type of Birth Assistance Sought by the Women in the Study ..................................42 Table 5. Distribution of Number of Children for the Women in the Study .............................42 Table 6. Distribution of Birth Place .........................................................................................43 ix LIST OF FIGURES PAGE Figure 1. Map of Oaxaca, México and the district of Juxtlahuaca, which contains 7 Municipios (municipalities). ..........................................................................................8 Figure 2. Santiago Juxtlahuaca, Oaxaca. .................................................................................10 Figure 3. Mixtec traditional dances of the Chilolos, Diablos, and Chareos. ...........................11 Figure 4. Distribution of women by age. .................................................................................40 Figure 5. This rebozo is used during delivery..........................................................................73 Figure 6. A structure of an old Baño de Vapor made out of stone rocks. ................................77 Figure 7. A model of the structure representing a baño de torito or temezcal. .......................77 Figure 8. Jarrilla de Rio is a flower used to perform steam baths. ........................................114 Figure 9. Ilite is a plant utilized by Mixtec women to perform steam baths after childbirth. ...................................................................................................................115 Figure 10. Salva Real is another plant used for curative purposes.. ......................................116 Figure 11. Pirrul, this plant is used for several medicinal purposes and also used for steam baths. ..............................................................................................................117 Figure 12. The plant known to Mixtecs as Hierba de Burro and found in San Martin Durazno is used by Mixtec women for steam baths. .................................................118 Figure 13. Borrega is another plant utilized to perform steam baths by Mixtec women. .......................................................................................................................119 Figure 14. Flor blanca is a another plant used to perform steam baths in combination with other plants. ........................................................................................................120 Figure 15. Ocotoe is used to ease