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UC Irvine UC Irvine Electronic Theses and Dissertations UC Irvine UC Irvine Electronic Theses and Dissertations Title Delivering Health: In Search of an Appropriate Model for Institutionalized Midwifery in Mexico Permalink https://escholarship.org/uc/item/25d9f2p7 Author Dixon, Lydia Zacher Publication Date 2015 Peer reviewed|Thesis/dissertation eScholarship.org Powered by the California Digital Library University of California UNIVERSITY OF CALIFORNIA, IRVINE Delivering Health: In Search of an Appropriate Model for Institutionalized Midwifery in Mexico DISSERTATION submitted in partial satisfaction of the requirements for the degree of DOCTOR OF PHILOSOPHY in Anthropology by Lydia Zacher Dixon Dissertation Committee: Associate Professor Michael Montoya, Chair Professor Leo Chavez Associate Professor Kris Peterson 2015 Chapter 4 © 2015 John Wiley and Sons Inc. All other materials © 2015 Lydia Zacher Dixon DEDICATION To My daughter, Juno Catarina Azuz Zacher who was there from the beginning and whose life is entangled in this dissertation as much as my own ii TABLE OF CONTENTS Page LIST OF FIGURES iv ACKNOWLEDGMENTS v CURRICULUM VITAE vi ABSTRACT OF THE THESIS x INTRODUCTION 1 CHAPTER 1: Midwives, Maternal Mortality, and Healthcare in Mexico Today 29 CHAPTER 2: Posing the Problem, Setting the Standards 63 CHAPTER 3: Becoming Mexico’s Modern Midwife 91 CHAPTER 4: Obstetrics in a Time of Violence 124 CHAPTER 5: Rethinking Traditional Midwifery 151 CONCLUSION 181 REFERENCES 191 iii LIST OF FIGURES Page Figure 1 La Razón: Woman birthing outside 1 Figure 2 Mexican Healthcare System Overview 43 Figure 3 Traditional Mayan midwife demonstrating uterine massage 170 iv ACKNOWLEDGMENTS This dissertation has been many years in the making. My relationship with Mexican midwifery began when I was awarded a Human Rights Internship grant as an undergraduate at the University of Chicago in 2002. I travelled to San Miguel de Allende, Mexico, to volunteer with midwives at the CASA midwifery school and clinic, planning to stay for only a few months. The midwives I met there inspired me to instead spend four years traveling across Mexico, working with women’s health organizations and learning about the issues facing midwifery today. The relationships I made during that time have grown throughout my doctoral research, and I hope that the issues and analyses I present here can bring attention to the ongoing struggles faced by those strong women. This dissertation was completed with the generous support of many different funding agencies, including the following fellowships and awards: the Fletcher Jones Foundation Fellowship, the UC Irvine Associate Dean’s Fellowship, the Dr. Dard Magnus Rossell Memorial Award, the UC Irvine Graduate Dean’s Dissertation Fellowship, the Inter-American Foundation Fellowship, the UC Irvine Center for Organizational Research Fellowship, the UC Irvine Global Health Framework Fellowship, and the UC Mexus Research Grant. Funding for preliminary research was also given by the UC Irvine School of Social Sciences and Department of Anthropology. I would like to express my deepest appreciation to my committee chair, Michael Montoya, who never stopped pushing me to ask hard questions and go deeper with my analysis. His approach to research and teaching have shaped the way that I think about my work and its applications. Professors Leo Chavez, Kris Peterson and Mei Zhan also provided valuable guidance along the way, reading many drafts and offering advice both practical and theoretical. Professor Tom Boellstorff was particularly influential in helping me clarify my arguments in Chapter Four for publication as an article. The academics in my family – Chris Zacher, Jessica Pandya, and Mihir Pandya – guided me through many difficult steps in the researching and writing of this dissertation. I would like to thank my classmates at UC Irvine for their academic and social support throughout this process: Caitlin Fouratt, Taylor Nelms, Stephen Rea, Ather Zia, Sana Zaidi, Lee Ngo, Michael Hurley, Mark Durocher, Janny Li, Natali Valdez, Cheryl Deutsch, Connie McGuire, and Eudelio Martinez. My husband Peter Dixon made it possible for me to complete the dissertation while living an at times very complicated – but very fun - life far from campus. Finally, I would like to thank all of the midwives and midwifery supporters in Mexico who inspired and shaped this dissertation. Chapter Four of this dissertation, with some modifications for article formatting, is currently in press with Medical Anthropology Quarterly as an article titled “Obstetrics in a Time of Violence: Mexican Midwives Critique Routine Hospital Practices,” and is printed here with the permission of the publisher, John Wiley and Sons Inc. v CURRICULUM VITAE Lydia Zacher Dixon EDUCATION Ph.D. in Anthropology – The University of California, Irvine – June 2015 Specialization: Anthropologies of Medicine, Science, and Technology Dissertation Title: Delivering Health: In Search of an Appropriate Model for Institutionalized Midwifery in Mexico Committee: Michael Montoya (chair), Leo Chavez, Kris Peterson M.A. in Anthropology – The University of California, Irvine – 2013 A.B. in Gender Studies - The University of Chicago – 2002 Minors: Latin American Studies and Pre-Medical Sciences Senior Thesis Title: Autonomy Denied: Mexican-American Women, Sexual Decision- Making and Contraceptive Choice (with honors) Advisor: Saskia Sassen RESEARCH AND TEACHING INTERESTS Knowledge production; online communities; Medical anthropology; gender; Latin America; science and technology; development; education FELLOWSHIPS, GRANTS AND AWARDS 2015 Fletcher Jones Foundation Fellowship for dissertation completion (awarded yearly to one student at each University of California Campus) 2014 Council on the Anthropology of Reproduction Graduate Student Paper Award honorable mention for “ Obstetrics in a Time of Violence: Mexican Midwives Critique Routine Hospital Practices” 2014 UC Irvine Associate Dean’s Fellowship 2014 Dr. Dard Magnus Rossell Memorial Award for Merit for Graduate Research 2013 UC Irvine Graduate Dean's Dissertation Fellowship 2013 UC San Diego Center for U.S.-Mexican Studies Visiting Scholar Position *declined due to concurrent position* 2013 UC Irvine Associate Dean's Fellowship 2012 Dr. Dard Magnus Rossell Memorial Award for Merit for Graduate Research 2011 Mellon Foundation and Institute for International Education Graduate Fellowship for International Study *declined due to concurrent funding* 2011 Inter-American Foundation Dissertation Research Fellowship 2011 UC Irvine Center for Organizational Research Graduate Student Fellowship 2010 UC Irvine Center for Organizational Research Graduate Student Fellowship vi 2010 UC Irvine Global Health Framework Research and Travel Fellowship 2010 Dr. Dard Magnus Rossell Memorial Award for Merit for Graduate Research 2010 UC Mexus Research Grant 2010 UC Irvine Department of Anthropology Summer Research Funding 2009 UC Irvine Center for Organizational Research Graduate Student Fellowship 2009 Dr. Dard Magnus Rossell Memorial Award for Merit for Graduate Research 2009 UC Irvine Department of Anthropology Summer Research Funding 2002 University of Chicago Human Rights Internship Grant PUBLICATIONS In Press Obstetrics in a Time of Violence: Mexican Midwives Critique Hospital Birth Practices. Medical Anthropology Quarterly 2015 Midwifery and the Millennium Development Goals in Mexico. Society for Medical Anthropology Section for Anthropology News, invited column http://www.anthropology-news.org/index.php/2015/01/13/midwifery-and-the- millennium-development-goals-in-mexico/ Accessed January 20, 2015 CONFERENCE AND PRESENTATIONS 2014 “Midwives and Maternal Mortality in Mexico,” Invited Guest Lecture, California State University, Long Beach, CA. October 2014 “Delivering Health,” Department of Anthropological and Geographical Sciences Colloquia Series Invited Speaker, Pierce College, CA. October 2014 “Delivering Health: In Search of an Appropriate Model for Institutionalized Midwifery in Mexico,” California Science and Technology Studies Retreat, Marin, CA. June 2014 “What the Midwife Saw: Mexican Midwifery Students Critique Obstetric Violence,” Society for Applied Anthropology Annual Meeting, Albuquerque. March 2013 “Finding Violence in Obstetrics: Mexican Midwives Critique Mainstream Medical Practices,” American Anthropological Association Annual Meeting, Chicago. November 2013 “Hot Vaginas and Homeopathy: Mexican Midwifery Students Navigate New Models of Expert Knowledge,” Society for the Social Studies of Science (4S) Annual Meeting, San Diego. October 2013 “Science from the Margins: Institutionalizing Midwifery Knowledge in Mexico,” California Science and Technology Studies Retreat, Marin, CA. June 2013 “Learning to Care: Ways of Knowing and Things to Know in Mexican Maternal Health Models,” Southern California Winter Science and Technology Studies Retreat, Borrego Springs, CA. February vii 2012 “Doctors as Devils, Midwives as Mothers: Mexican Midwifery Students Draw Birth Two Ways,” American Anthropological Association Annual Meeting, San Francisco. November 2012 “Midwifery Reborn: Crafting a New Model for Women’s Health,” Inter- American Foundation Mid-Year Conference, Panama City, Panama. March 2011 “Delivering the Future: The Role of Midwifery in Mexico’s Changing Reproductive Health Care System,” Reinventing the Future, Medical Anthropology Conference, University of California, Berkeley. May 2010 “Divisions of Labor: Obstacles and Authority in Mexico’s Institutionalized Midwifery Agenda,” American Anthropological
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