Emergent Change in a Mexican Midwifery Center Organization Amidst the Covid-19 Crisis

Luna Maya is a Mexican NGO that operates two full-scope midwifery centers in Mexico City and Chiapas, Mexico, providing woman-centered, culturally appropriate midwifery model maternity care on a sliding cost scale. The COVID-19 health crisis has made it necessary for Luna Maya to quickly incorporate safety protocols for out-of-hospital maternity care. Yet many of the emerging guidelines on maternity care have focused on high-income and hospital settings; there are no specific guidelines for such care in out-of-hospital settings in low- and middle-income countries. Thus we have had to create our own, based on best available and emerging evidence. In this article, we describe the guidelines and protocols we have created in response to COVID-19, the international evidence and recommendations on which we base them, and precisely how we carry them out in practice. We also present and analyze the results of qualitative interviews we conducted for this article with eight of our midwives and eight of our midwifery clients. These interviews reveal the tremendous stresses both midwives and pregnant and birthing women are experiencing as a result of the pandemic, their creative adaptations, and the structural flaws, deficiencies, and inequities of the Mexican healthcare system. The article also addresses Luna Maya's ongoing challenges in continuing to provide care completely outside of governmental support and in difficult economic times, and demonstrates the extreme need for improvements in the Mexican system of maternity care and for full integration of community-based midwives and out-of-hospital birth

Coronavirus disease 2019 (COVID-19 · Geography · Health care · Maternity care · Maya · Pandemic · Political science · Qualitative research · Scale (ratio · Scope (computer science · Sociology · COVID-19 Impact on Reproduction · Global Maternal and Child Health · Maternal and Perinatal Health Interventions · Medicine · Nursing

• Exploring networks of care in implementing midwife-led birthing centres in low- and middle-income countries

  Open Access•Sabera Turkmani, Andrea Nove et al.•PLOS Global Public Health•2023

  Incluir item

• Prioritizing women's choices, consent, and bodily autonomy

  Open Access•C O''Brien, Morgan Newport•Social Science & Medicine•2023

  Incluir item

• An evidence review of face masks against Covid-19

  Open Access•Jeremy Howard, Austin Huang et al.•Proceedings of the National…•2021

  Incluir item

• Face masks for the public during the covid-19 crisis

  Open Access•Trisha Greenhalgh, Manuel B Schmid et al.•BMJ•2020

  Incluir item

• Physical distancing, face masks, and eye protection to prevent person-to-person transmission of Sars-CoV-2 and Covid-19

  Open Access•Derek K Chu, Elie A Akl et al.•The Lancet•2020

  Incluir item

• Stability of Sars-CoV-2 in different environmental conditions

  Open Access•Alex W H Chin, Julie T S Chu et al.•The Lancet Microbe•2020

  Incluir item

• Midwifery and quality care

  Open Access•Mary J Renfrew, Alysha Mcfadden et al.•The Lancet•2014

  Incluir item

• Health inequity in workers of Latin America and the Caribbean

  Open Access•Michael Silva-Peñaherrera, María López-Ruiz et al.•International Journal for Equity…•2020

  Incluir item

• Obstetric Violence in Mexico

  Open Access•Raúl Castro Pérez, Sonia M Fria et al.•Violence Against Women•2019

  Incluir item

• The Covid-19 pandemic and health inequalities

  Open Access•Clare Bambra, Ryan Riordan et al.•Journal of Epidemiology and…•2020

  Incluir item

• Home-birth emergencies in the US and Mexico

  Open Access•R Davis-Floyd•Social Science & Medicine•2003

  Incluir item

• Pregnancy, Birth and the Covid-19 Pandemic in the United States

  R Davis-Floyd, Kim Gutschow et al.•Medical Anthropology•2020

  Incluir item