Magali Fabila on Luna Maya and Midwifery in Mexico
From Isabel Pintor
In this interview, Magali Fabila, Clinical Director and Midwife at Luna Maya’s birthing center in San Cristobal de las Casas, Chiapas, Mexico, discusses the crucial role of midwives in providing essential obstetric and gynecologic services.
Fabila is a feminist who gave birth at home and she is the mother of a 5-year-old girl. Her great-grandmother was a Zapotec curandera, so she grew up listening to stories and recipes of the natural medicine that her grandmother used. Fabila studied natural medicine in a self-taught manner, and she studied for a few years at the UNAM Faculty of Medicine. She learned midwifery practice with a traditional midwife and has obtained obstetric acupuncture certification, orgasmic birth certification, and graduated from the Midwifery training program at Luna Maya. She works every day for justice and the rights to safe sexual and reproductive health care.
English translation provided by Alina Prusko, MSN-Entry Candidate, GANM Content Editor and Isabel Pintor, MSN-Entry Candidate, GANM Content Editor
I am Magali Fabila, and I am an autonomous midwife and Clinical Director at Luna Maya’s birth center. I self-identify as an autonomous midwife that combines midwifery that is traditional and professional where we work in a way that is holistic and integral. Autonomous midwives work with herbs, homeopathy, acupuncture, massages, and therapies like hypnobirthing or ovarian respiration. We also do lab work, order necessary medicine, and we work in a holistic manner because we also look at the emotional wellbeing and nutrition of every person who visits us and receives our services.
I work in the Luna Maya birthing center that is in San Cristobal de las Casas, Chiapas. This birthing center was founded 16 years ago by an autonomous midwife so that all women who need our services can receive them in a manner that is dignified, respectful, safe, and with the most up-to-date evidence-based information. Our principal focus is to bring the necessary information to all our clients so that they can make informed decisions that are not based on fear and so they can be protagonists of their own health and have bodily autonomy. This way they can decide what treatment they want to receive and what is happening in their bodies.
The way in which we work is minimally invasive to bring a balance to the body. We work with the most important pillars: nutrition, lifestyle, physical health, and emotional wellbeing. Our work has an enormous impact on the society, especially in areas with a lot of poverty and areas that have vulnerable populations, especially woman who are more vulnerable and susceptible to violence. For this reason, our work has a profound impact especially in sexual and reproductive health which is an area that women experience a lot of violence here in Mexico and many other parts of the world. Therefore, we work to assure that woman can receive access to this human right of healthcare, especially sexual and reproductive health services.
We do this work with our own resources therefore often it is difficult to maintain. At Luna Maya, the services we provide are high quality, respectful, nonjudgmental, and nonviolent. We average about 6 patient consults a day, though sometimes more or less. We also provide sexual reproductive health services from the time that women begin menstruation until it ends. We provide services in fertility, support for elected abortions, labor and birth companions, pap smears, non-hormonal IUD placements, and gynecologic check-ups. Our consultations last between an hour and an hour and a half because we focus on all the pillars mentioned earlier. These consultations are personal; therefore, we maintain communication with our clients, answer any questions they might have, and stay in contact during their prenatal process. For this reason, our services are very personal and based on establishing trust between our midwives and our clients.
Something I would like for everyone to take away from our work is that midwives are a pillar of sexual and reproductive health services in our communities. We are frontline workers, and we are experts in the physiology of pregnancy, labor, and gynecologic services. The work of midwives is also important because it prevents maternal and neonatal deaths. These are safe services; more studies show that the midwifery model of care is safe, free of violence, and prevents unnecessary interventions in hospitals or clinics.
One of my biggest takeaways as I continue to develop my midwifery practice is that there is a dire need for more midwives in the world and more visibility of the midwifery model of care and of the work of midwives. There needs to be an increase in support of midwives and funding for birthing centers so that we may continue to exist. I have also learned the importance of midwifery and obstetric nurse networking since we are pillars of health services in our communities. Lastly, I have learned that violence against midwifery and birthing centers is enormous and requires outside community and international support. This support would bring awareness to the midwifery model of care as being indispensable and safe in low-resourced communities with high maternal and neonatal death rate. Thanks to midwives in these communities, hospitals can focus on pathologic cases requiring interventions while midwives can service low-risk pregnancies, safely and respectfully.