Transforming “Dangerous Practices”: Modernizing and Medicalizing Midwifery in Post-Revolutionary Bolivia

Dr. Luis Hurtado has defined the 1950s in Bolivia as a period of “consolidation and expansion” of health services and a pivotal moment of medical professionalization. This process was shaped by political circumstances and social realities and linked to the medicalization of childbirth and appropriation of traditional healing practices like midwifery. Historically, the “cultural hygienization” of reproduction was designed to cleanse birth from midwifery’s racial stigma and remove birth from female hands and make it the domain of medical specialists. MNR leaders often described midwives as “ignorant, dirty and superstitious women” whose “dangerous practices” created “bad birth conditions” that put mothers, families, and the nation at risk. They also assumed that unlicensed healers were the source of high national infant and maternal mortality rates. Though previous governments attempted to discredit and restrain midwifery, these attempts largely failed due to a lack of infrastructure and personnel capable of regulating the practice. Under the Movimiento Nacionalista Revolucionario (MNR) in the 1950s, however, midwifery-training programs in schools opened by the revolutionary government incorporated midwives into the state and extended maternal and infant health services in a way previously impossible.

 MNR health officials also promoted hospitals births as more regulated, sanitary, and efficient than home births. The rural home, constructed as a backward, unhygienic, and culturally inappropriate birthing space, was juxtaposed against a clean, modern, and efficient delivery room. Home birth supposedly exemplified rural women’s ignorance of their civic responsibility and represented lack of medical control over national reproduction. Likewise, untrained midwives were envisioned as obstacles to national progress and medical modernization. However, the process of training midwives presumably erased the cultural and racial stigma associated with indigenous, rural, and traditional medical practices, transforming them into nationalized medical professionals who could acceptably practice medicine on Bolivian citizens.