The Invisible Labors and Erased History of Puerto Rican Midwives

By Emaline Reyes

Abstract: In this brief excerpt from my paper, “This Woman’s Work: The Labors of Women and Laboring Women in Puerto Rico,” I discuss the history of midwifery, healing, and herbalism in Puerto Rico. I interviewed Puerto Rican birth workers and herbalists in order to uncover the erased history of midwifery and medicine on the island. Traditional medical systems and birth work have gone ignored and unrecorded globally, including in Puerto Rico. When the island was colonized, shamans and herbal medicines were slowly displaced. The medicalization of Puerto Rico that occurred during the late 20th century served to further displace traditional birth workers and healers and their legacies.

Prior to its medicalization, Puerto Rico had a long history of folk medicine and midwifery. Healing was in the hands of primarily-female practitioners and childbirth was controlled by the birthing woman herself. However, there is sparse information concerning the practices of traditional healers and midwives. This is a direct result of colonization and the erasure of the histories of Black and Indigenous communities (as many healers had Indigenous and/or slave ancestry). As a Black doula, Paloma Hernandez feels passionately about spreading awareness and creating visibility for birth workers of color and their histories. Here she tells a story about a traditional midwife-attended birth:

“They (the traditional healers) started doing a message to accommodate the baby and started pushing the baby from the front. They told me that the technique they used is a technique that is common in the African practice (in colonization and the slave time)…I alway have this birth story in my mind when I have to talk about the history and the whiteness that is in this work (birth work today)…in our stories they (African midwives) are our ancestors and their stories are our stories…Before professionalization of midwifery in Puerto Rico we had Black women doing birth work. In our history when the Africans and the slaves came to Puerto Rico we had people doing birth work with women. Before that the Tainos had the shaman who had the power and the responsibility to help the woman, but the Tainos usually gave birth alone. This kind of tradition of support is African.” [1]

In detailing the history of midwifery in Puerto Rico, Paloma highlights how it has been white-washed over time. This white-washing has contributed to the loss of information of traditional birth work.

To further my knowledge of the history of Puerto Rican midwifery, I consulted Rita Aparicio, who is considered to be one of the most experienced birth workers, and one of the last “mother midwives,” on the island. Below Rita describes the known practices of the traditional midwives:

“We know they (the midwives) used to put ash on the chord and such but have no information about the prenatal or postpartum practices or the death rituals…We know they used a lot of herbs and rituals and we have this flower (it goes by many names) and every midwife would carry it to the birth and hold it and pray. It looks like it’s dead but you put it in the water and it comes back (to life) and opens up. It’s like a symbol. We know they would burn everything they used after the birth. They were getting rid of contamination. We know they burned the chord (preventing mortality and morbidity).” [2]

The practices that Rita describes were both symbolic and functional, demonstrating the practicality and importance of traditional methods. Rita also referred me to another expert of the history of medicine in Puerto Rico, Maria Benedetti. Maria is an author and herbalist who has written extensively about the traditional healers of Puerto Rico, recording their oral histories, practices, and remedies. I asked her what ancient midwifery was like on the island and she explained the following:

“So many trees and palms were used for contraception…contraceptives were used by and under the control of women themselves up until the 1930’s and 40’s. They didn’t come into being in the 50’s and 60’s like everyone thinks. The pill wasn’t the first form of contraceptives. We got many methods from the Mayans… Abdominal massages were used to move babies at all times even during delivery. There was a great wealth of botanicals used during, before, and after delivery as well. Some of these practices include vaginal steam and treating the placenta. Was it (the placenta) eaten at one time in Puerto Rico? No one living knows… And no one would admit it… Is it an Mayan or Arawak practice? Investigating these issues will take you to the Mayans anyway.” [3]

What I found most striking about Maria’s explanation is that Puerto Rico had a history of contraception long before the island was used as a laboratory to test “the pill.” Often we become so focused on this event, however, herbs do and have played such an important role. I asked Tamara Trinidad about herbalism in midwifery in Puerto Rico, as she is both a certified birth worker and a trained herbalist. When I asked her if she could tell me more about the herbalism on the island she responded:

“Herbal medicine is just a part of the midwifery traditions in parts of the world and in Puerto Rico. It’s one of the midwife cultures that hasn’t gone away completely. It was lost in the west, but Indigenous communities still have it. We do because we still have our Indigenous and African roots. The Taino women would use herbs in daily living. Midwives from all places (Spain and Africa) would combine knowledge and pass it on from generation to generation.” [4]

This origin story of midwifery, provided by Tamara, is reminiscent of the origin story of Puerto Rican heritage and culture– it is a combination of the colonizers (Spainiard), Indigenous (Taino), and slaves (African). There can be no “one true history” of Puerto Rican midwifery when it is a composite of such vastly different traditions. It is intricate and diverse, like the people of Puerto Rico themselves.

Endnotes:

[1] This first quote comes from a conversation that I had with Paloma Hernandez, a doula and one of the few Black birth workers in Puerto Rico.

[2] This is from a conversation with Rita Aparicio, one of the oldest and most experienced midwives in Puerto Rico, considered to be one of the last “mother midwives.”

[3] This is from a conversation with Maria Benedetti, a Puerto Rican herbalist and journalist who is the author of such influential texts as “Earth and Spirit: Medicinal Plants and Healing Lore in Puerto Rico” (from which the above image was taken).

[4] This is from a conversation with Tamara Trinidad, a Puerto Rican midwife who has been trained in herbalism and helped to prescribe medicinal remedies during the 2020 earthquakes on the island.

Image: María Benedetti (1989) Earth and Spirit: Medicinal Plants and Healing Lore from Puerto Rico, pg. 22

Emaline Reyes is a Medical Anthropology PhD student at Temple University (after receiving her BA in Anthropology and Medical Humanities from the University of Delaware in 2018). She is a childbirth researcher, and trained childbirth doula, who previously studied maternal motives behind elective cesarean sections, and the psychosocial contexts in which surgical deliveries are performed. Emaline has presented this research at national conferences and her work has been published in the American Journal of Human Biology and the Journal of Mother Studies. Her current research focus is on how disasters impact childbirth experiences, and as such, how social movements such as environmental justice and reproductive justice intersect, especially for BIPOC. For her dissertation, Emaline hopes to study how hurricane Maria impacted pregnancy and childbirth experiences in Puerto Rico.

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