'Porque tienen mucho derecho': Parteras, biomedical training and the vernacularization of human rights in Chiapas

This doctoral research stems from thirteen months of ethnographic fieldwork in the Mexican State of Chiapas. Chiapas is one of the regions with the highest maternal mortality rates in the country. To comply with international development goals to lower maternal mortality rates, indigenous midwives are trained in detecting risk factors in pregnancy and birth, while women are encouraged to give birth in hospitals. This dissertation sheds light on the impact of such policies on poor women's access to reproductive health care and Mayan midwives' practices. Over the course of my research, I utilized the methodology of participant-observation and conducted in-depth interviews with traditional Mayan midwives and professional midwives within and outside the public health system, mothers living in urban and rural areas, workers from the public health sector, and Non Governmental Organizations activists working in the field of reproductive health. In particular, this dissertation stems from my collaboration with the Organization of Indigenous Doctors of Chiapas (OMIECH), in San Cristobal de las Casas.;At the intersection of medical anthropology, institutional anthropology and the anthropology of human rights, this dissertation makes three major contributions. First, it documents the consequences of socioeconomic stratification, structural racism, and the marginalization of traditional medical knowledge on indigenous women's reproductive health. This triple oppression marks women in their bodies, as illustrated through cases of obstetric violence endemic in the country. Second, these social forces, combined with government trainings, lead to a displacement of traditional midwives towards the margins of the health sector and of the Mexican society. Their marginalization is reinforced by the push for professionalization, positioning Mayan midwives without any formal education at the very bottom of the medical hierarchy. Finally, this dissertation offers a nuanced understanding of human rights, as understood and brought forward by women, midwives and activists in their critique of public health policies. For OMIECH activists, indigenous rights provide a powerful framework to push their political agenda forward. For indigenous women, their local interpretations of human rights, coined vernacularization (Levitt and Merry 2009), allow them to call out the obstetric and structural violence these policies reproduce.