In its early history, Mexico was occupied by a large number of indigenous civilizations such as the Mayans and Aztecs. In the 16th century, Spain colonized New Spain and took over the land from the indigenous peoples. Though it is now an independent nation, Mexico retains much of the cultural influence of Spain, including its official religion of Catholicism, the Spanish language, and the importance of machismo - the belief that men are superior to women. Mexico also retains much of the traditional beliefs of the indigenous peoples who first occupied the country. Besides Spanish, there are over one hundred different languages spoken in the country today. As a result, the current medical system involves a mix of traditional and Western medicinal techniques.
Traditional beliefs such as Susto, also known as fear of illness, is thought to occur when the soul leaves the body and wanders. It is believed that women experience this more often than men. Empacho, or the dislocation of body functions is often associated with morning sickness in pregnancy because it is believed that the baby is bringing increased energy to the digestive process. Mal de Ojo is another important perceived cause of illness which relates to birth. It is believed that if someone is looked upon with admiration or jealousy that they will become ill themselves.
In Mexico, approximately 46.2% are below the poverty line, the average life expectancy is 76.7 years, 73.9 years in males, and 79.6 years in females. 95.8% of the population is literate. In the country, the Infant mortality rate is low, compared to other countries, Mexico is 127 with 10.7 deaths to 1,000 births, the maternal mortality rate is also low, occupying number 108 compared to other countries with a ratio of 33 deaths to 100,000 live births. The contraceptive use rate in the country is about 66.9% a little high compared to other countries.
Pregnancy Mexico contains a variety of indigenous groups, cultural influences, and socioeconomic situations which all affect health outcomes. However, amongst all groups, pregnancy is welcome. The majority of the unintended pregnancies end up in an abortion. Furthermore, there is little information on the sex education received by women from different socioeconomic classes and geographic regions, which may influence pregnancy behaviors and beliefs. Traditional culture believes that pregnancy is a sacred event. This belief carries over into the post-Colombian Catholic culture that is very prevalent in Mexico today. The traditional birth culture is shaped by the beliefs of a hot-cold balance within the body. This balance must be maintained throughout the pregnancy and delivery process. To ensure the balance, women will avoid "hot" foods during their pregnancy as the gestation is considered a "hot" event. Furthermore, women attempting to become pregnant are advised to avoid cold surfaces, like medical examination tables, as they are thought to promote sterility or infertility.
The main differentiator of pregnancy behaviors is socioeconomic status. This will influence a woman's outlook on pregnancy, her level of care received during pregnancy and the lifestyle changes that she makes during this time. Women are encouraged to avoid strenuous work during pregnancy, and some are encouraged to leave work altogether in order to ensure a healthy pregnancy and birth. During pregnancy a majority of women will receive some form of prenatal care. The World Bank Data's most recent statistic for the Mexican prenatal care stated that 98.5% of women were seeking some prenatal care, while 94.3% of the women receiving prenatal care had at least four visits to the doctor's office (2020). While a vast majority of women are receiving care, this is often not consistent and varies across socioeconomic class. Women of a higher socioeconomic class are more likely to seek care from a GP than their counterparts. Historically, women have been more likely to seek prenatal care later in their pregnancy, with many women not obtaining such care until the second trimester. Data that breaks down incidence of modern prenatal care needs to be collected.
Besides maintaining the hot-cold balance and avoiding work, there are other lifestyle changes that a woman may take on during her pregnancy. Women are encouraged to walk frequently throughout their pregnancies and often talk to their mothers or grandmothers for comfort or advice. Strong familial support is tied to improved pregnancy outcomes as the family is traditionally very supportive of the pregnant woman.
Labor Recently, the president of Mexico, Andrés Manuel López Obrador (AMLO), removed the use of the Seguro Popular (Popular Insurance). The health insurance was provided to all the Mexican citizens but was commonly used by low income citizens; Now the president provided the citizens with the use of the Institute of Health for Welfare (Spanish: Instituto de Salud para el Bienestar, INSABI). Access to care is restricted in many ways, and to such an extent that certain members of the population have access to forms of care and choices that others do not. Citizens that live in small towns or rural areas are least likely to receive proper health care because there are not a lot of hospitals available in the areas or they are not properly equipped. There are private healthcare institutions available for those who can afford them, and large public health institutions which can provide care without costs to those eligible to be enrolled in their programs. Maternal hospitals, public and private, are generally available in large cities, while general hospitals are also available in rural areas. Typically, the number of days that women stay at the hospital after giving birth varies in every case. In 1987 more than 80% of births in Mexico took place under the care of traditional midwives and empirical midwives.
There are two fundamental concepts in the traditional medicine practiced in Mexico; hot-cold duality and naturaleza (inherent nature): Hot-cold duality— all illnesses, physical conditions, drinks, foods are either hot or cold. Pregnancy is considered a hot condition, where upon birth women lose heat and are at risk of becoming dangerously cold. Naturaleza— encompasses all the characteristics and qualities that physically and spiritually comprise an individual. One can have a strong or weak nature, this is determined by the phases of the mother, and the nature of the parents. This nature can in turn, influence sexuality, family size, and a person's physical spiritual and temperamental characteristics. By extension, these things can affect one's pregnancy and birthing process (onset and length)
Traditional midwives sometimes use hydrotherapy, there are two basic types described in the literature:
Temazcal (sweat bath)— used prenatally, postpartum, and sometimes during the intrapartum period. The bath uses herbs that have bacteriostatic, anti inflammatory and other therapeutic qualities Vapor (steam bath)— also uses herbal infusions with the addition of essential oils. Laboring woman will sit on a chair that is on top of a larger streaming container.
Traditionalist midwives may sometimes also incorporate some of the following to help ease the process of labor:
Medicinal plants and animal substances, not just orally, but through external application like massage and poultices, as well as douching. Sobada (therapeutic touch/massage); can be done prenatally to change position of fetus (can prevent problems with abnormal presentation), aid prolonged labor, and difficulty delivering placenta. May invoke protector spirits (Virgin Mary or saints). They pray and call to these spirits to find reassurance and deal with the uncertainties surrounding pregnancy, birth, and puerperium (6-week period after childbirth where reproductive organs return to their original nonpregnant condition). Use of oxytocic injections and administration of intravenous fluids to speed labor has become more widespread, even with traditional midwives. It is believed that things like brujeria, mal aire, and susto can affect birth outcomes and the labor process. Sometimes red ribbon and clothes can be worn or used to prevent el mal de ojo.
Policies surrounding labor vary from location and type of facility, so labor processes can vary amongst women geographically and by socioeconomic status. In large public hospitals women who birth there tend to have some sort of Psychoprophylaxis class (Lamaze technique) before going into labor. The Lamaze classes help women to prepare them for labor, they are taught techniques in preparation for childbearing without the use of anesthesia. Techniques include education, psychological and physical conditioning, and breathing exercises. These classes are not necessarily hospital affiliated (i.e. they are taught outside of the hospital and obstetricians do not directly refer women to them, so there is not a wide attendance). Women often laboring in these hospitals will have epidurals or other forms of analgesia, if deemed necessary. Family members are not allowed in labor unless the family member has also taken Psychoprophylaxis courses.
In privately ran hospitals, women will often get discharged 24hrs after vaginal delivery and 48hrs following a Cesarean. Standard practice is that all laboring women have intravenous lines, pubic hair is not routinely shaved, and all primiparas are given episiotomies. In these hospitals the father or other family members are required to be present during labor and birth (even for Cesareans), although only one member is allowed to be present because of space. Presence of support system (family members or father) is also encouraged at prenatal visits. During labor women are allowed to walk, drink juice (among other liquids). Babies must remain with their mother's postpartum because the only nursery available is meant for babies with low apgar scores and/or low temperatures, and even these babies are only kept under observation at the nursery for 3–4 hours. Sick babies, who have a birth condition, got sick at birth, or those who might need serious medical treatment are transferred to a children's hospital to receive better treatment. Most, if not all, neonates are breastfed.
In local midwife practice, the homes the midwife would attend would often have no telephones, electricity, nor running water. She (the midwife) will bring an oxygen tank, Doppler unit, Pitocin and methergine in case of hemorrhage, herbal tinctures, suture material, bulb syringe among other things. She might also bring a car in case emergency transportation is necessary. During labor the midwife will massage the laboring person with oils and use hot compresses, and encourage walking and position changes to facilitate labor. Delivery will often happen in a semi sitting or squatting position. After the baby is born the midwife will stay with the mother and baby from 2 – 4 hrs. She might use aceite de palo (plant oil extract) for the cord stump, which is to be applied with every diaper change to help disinfect and dry the cord rapidly.
Birth Birth attendants can include a variety of providers, including general physicians (GP), obstetric nurses (ON), professional midwives (PM) and traditional birth attendants (TBA). ONs and PMs are not widely used in the hospital setting and physicians account for 87% of obstetric care in Mexico. The education and outcomes for each profession are outlined here. The WHO-supported competencies for skilled birth attendants are met 43% by GP education, 54% by ON education, and 89% by PM education. The ON is educated at the University level while the PM must have completed secondary education and then a 3-year midwifery education program. A 2011 study found that PMs often have improved outcomes compared to GPs and ONs, possibly due to their apprentice-like education. GPs and ONs are associated with higher use of episiotomy and oxytocin.