Passport alert affects ‘parteras'

Midwives struggle against new fears and horror stories among patients
August 23, 2008 - 8:43PM
By Kevin Sieff, The Brownsville Herald
In downtown Brownsville, the homes and storefronts in which local midwives once practiced have been bulldozed or remodeled. Few signs advertising parteras, as midwives are known in Spanish, remain.

The practice of midwifery - once a cultural institution along the border - has all but disappeared from the Rio Grande Valley, and a new State Department policy threatens to deliver a final, knockout punch.

The new policy assumes that midwives provided 15,000 South Texans with fraudulent birth certificates between 1960 and the early 1990s. As a result, the State Department is now denying the passport applications of many Valley-born men and women.

After hearing of the policy, a number of local residents are now unsure if they want to take a chance by having their children with a midwife.

"People now think that if they go to a midwife their child won't be able to get a passport," said Mary Saldaña, a practicing midwife in Brownsville for 39 years.

Saldaña once delivered several babies per week. Now, she said, she delivers several per month.

"We keep telling people that they can still get their passports," she said. "We do everything right. We keep all of our records."

But with the government's new passport policy still unclear - and with applicants' horror stories that abound in the Valley - midwives are struggling to reassure potential clients.

When the Western Hemisphere Travel Initiative is implemented in June 2009, individuals without U.S. Passports will be unable to cross the border into Mexico.

The passport concerns pose the latest chapter in the saga of a profession that once blossomed throughout South Texas.

In 1977, there were more than 30 midwives in Brownsville. Then came changes in the government's Medicaid program, which began covering the deliveries of indigent and undocumented mothers. Then came more stringent government oversight of Texas midwives, including a lengthy list of prerequisites.

Now, there are three midwives in the city.


The Texas Midwifery Board reports that in 1925 more than 50 percent of babies born in Texas were delivered by midwives. By 2004, the number had dropped to 6.6 percent.

According to local medical administrators and anthropologists, midwives continued to practice in the Rio Grande Valley even after they disappeared from other Texas cities.

"People who are recent arrivals from Mexico and other (places in) Central America are mostly here in an undocumented status, and they are fearful of the system," said Tony Zavaleta, an anthropologist and vice president for External Affairs at the University of Texas at Brownsville and Texas Southmost College. "So they would seek out a midwife rather than go to a hospital.

"In Mexico, outside of urban centers, that's the way every baby is delivered," Zavaleta added. "It's become engrained in the culture."

But local midwives say the State Department's policy is changing the cultural norms that once guaranteed a steady stream of business.

""I don't know why they're accosting us," said Esther Covarrubias, a practicing midwife in Weslaco. "Now, the only people who come back are people looking for records...very few come to deliver their babies."

Like many surviving midwives in the Valley, Covarrubias learned the trade from her mother, who delivered a large portion of the children in the family's neighborhood.

When the Texas Midwifery Act made regulations on midwives more stringent - including training sessions and forced cooperation with Emergency Medical Services - Covarrubias and her mother abided. The midwives who refused to comply either stopped practicing or moved their operations underground.

Before those regulations were enforced, Zavaleta said, "anybody could hang up a shingle that said ‘se atiendan partos.'"

Midwifery's unregulated days are long over. Now, in addition to checks on the citizenship of people delivered by midwives along the border, the profession is fending off more direct criticism.

In April, the American Medical Association introduced a resolution asserting that "the safest setting for labor, delivery and the immediate post-partum period is in the hospital."

In the 21 states where certified professional, or lay, midwives are allowed to practice, the resolution was considered an unwarranted attack.

"People should know that this is a safe place to have their children," Saldaña said. "But now, a lot of people are afraid."

In addition to lay midwives like Saldaña, a number of nurse midwives now practice in Texas, many of whom have advanced nursing degrees and operate out of birthing centers. At Holy Family Birth Center in Harlingen, certified nurse midwife Nancy Sandrock says that new regulations have not affected business, though the center has been fielding questions about the new passport policy.

Mary Saldaña, on the other hand, is fighting to keep her practice afloat.

Saldaña hangs her midwife certification next to the bed where she has delivered hundreds of babies since the 1960s. Next to the credential, there is a photograph of Saldaña and 25 other Brownsville midwives, taken in the late 1970s. Of the group, Saldaña is the only woman still practicing.

"This is me. I wouldn't be Mary Saldaña if I wasn't a midwife," she said. "And I do it right."


For decades along the border, midwifery was utilized as an alternative to expensive hospital visits. But to many, the Valley's midwives were considered more than purveyors of a practical service.

They were pioneers, some say: women who established their own careers and earned their own incomes long before such practice was common. A portrait of ‘Don' Virginia Reyes Esparza, considered one of the area's most important - and most prolific - midwives, hangs prominently in her granddaughter's San Benito living room.

In the 1910s, Esparza began delivering babies in Ranchito, near what is now Military Highway. Her career spanned more than 40 years in South Texas.

"There was no hospital nearby," her granddaughter Virginia Seguro recalled. "And so she became an important person in town."

"People would knock on our door in the middle of the night and say, ‘we need ‘Don Virginia.'"

In addition to hundreds of Ranchito residents, Esparza delivered all 10 of her grandchildren - some of whom are now beginning the application process for a U.S. Passport.

Because their passport applications indicate a midwife-assisted delivery, they will likely receive a request from the government for a number of obscure documents, including evidence of their mother's pre-natal care and a newspaper announcement of their birth. It's a turn of events that Don Virginia's grandchildren never imagined.

"People would come from everywhere, and my grandmother was always there for them," Seguro said. "She was born with a special star ... a special instinct."




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