Pregnancy is Not a Sickness: Maternal Health Knowledge, Well-Being, and Decision-Making Among the Q’eqchi’ Maya

Abstract

For many communities, Indigenous knowledge plays a key role in maintaining health and well-being during pregnancy, labour and delivery, and postpartum. However, this knowledge is often placed at risk as a result of public health interventions and the medicalization and institutionalization of pregnancy and childbirth around the globe. Ethnographic research was conducted with four iloneleb’ from the Maya Healers’ Association of Belize and 36 Q’eqchi’ mothers in the Toledo district of Southern Belize, as a way to gain understanding of the knowledge and experiences of providing and receiving maternal care. This thesis addresses the knowledge held by both iloneleb’ and Q’eqchi’ mothers as they navigate the changes that have occurred in the region as a result of medicalization. In-depth semi-structured interviews and participant observation were undertaken to gain a deeper understanding of the ways in which this knowledge and experiences of care, both Q’eqchi’ and biomedical, contribute to women’s health and well-being during pregnancy, labour and delivery, and postpartum in the past and present. Over the past 20 to 30 years, mothers have gone from relying on iloneleb’ for prenatal care and delivering at home with the assistance of their mothers, mothers-in-law and their husbands, to attending routine prenatal clinics and delivering at the local hospital in the nearby town of Punta Gorda. While pregnant women and mothers of today continue to rely on the iloneleb’ as a way to maintain well-being, they also feel they are legally required to access biomedical care during pregnancy and for birth. This recent medicalization and increased access to biomedical care has influenced where, when, and how they seek care, particularly during pregnancy and for labour and delivery. Despite these considerable changes in the region, this thesis demonstrates the continued importance Q’eqchi’ knowledge and iloneleb’ in facilitating well-being during pregnancy, which in turn impacts well-being during labour and deliver and postpartum.