CARUARU, BRAZIL – Maria Fernanda da Silva, 39, is a traditional midwife from Caruaru, a city in the interior of Brazil’s Northeast region. She has been working as a midwife since she was 12. She started helping her mother, who is also a midwife, at age 9.
“My mom called me her ‘little assistant,’” da Silva says.
She says she became more than an assistant at age 12 when a woman in her community needed help and her mother was out of town.
“There was a woman in our community who would always give birth assisted by my mom,” she says. “One day, she started delivering, and my mom was out of town. She did not want any other doctor to assist her delivery, so she begged [me] to do it for her.”
She says she resisted at first because she did not feel confident to deliver a baby before reaching her teenage years. Although she had watched her mother do it several times, it would be the first time she’d be doing it by herself.
Since then, every once in a while, a neighbor asks her for help or a friend’s friend calls her to schedule a delivery.
Da Silva’s mother, Josefa Carvalho, known here as Zefinha, has been a midwife for 44 years. She explains that when she started in 1967, there was not a single health clinic in her city. One time, she assisted a friend who was in labor because there was no one else around to help. From then on, she became the community’s midwife.
“Some people thought we knew everything!” Carvalho says, giggling. “I gained experience in assisting deliveries at the same pace I gained respect from our community.”
Da Silva says that in the beginning, she did not want to follow into her mother’s profession.
“It is not even considered a profession,” she says. “The activity is actually very discriminated against. Most of the work we do in our community is unpaid.”
Da Silva says that sometimes, depending on how well-off families are, they provide financial compensation. But, as traditional midwives are more common in rural areas or indigenous communities where most residents can’t afford to pay midwives, midwives do not earn enough to make a living. Consequently, most midwives carry a double burden: They are midwives – usually for free – and something else – to earn money.
Da Silva says this originally deterred her from following in her mother’s footsteps.
“I wanted to have a ‘real’ job,” da Silva says. “I did not want to go through the sacrifices my mother did.”
But then she says she saw how important midwives were in her community.
“But then when you see someone who needs you asking for help, it is impossible to refuse,” she says. “And then I realized that being a midwife made me happy. Bringing someone to life is such a beautiful experience.”
Midwives say that they respect the mothers and babies they assist more than doctors do because of the personalized care they can give outside of hospitals. But they say they receive little respect in return from doctors and the government for the many communities they serve. Doctors say midwives lack the proper training to deliver babies. Meanwhile, various nongovernmental organizations, NGOs, are working to elevate the status of midwives and foster greater collaboration between them and public health officials.
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