Birthing the Children of the Revolution: The Practice of Midwifery in Mexico City, 1920–40

After the revolution in Mexico ended in 1917, governments implemented programs to improve the disastrous health conditions of the Mexican population, particularly focusing on reducing infant mortality rate through social and physical hygiene interventions. The Department of Public Health and the National University reformed medical schools to train medical staff including midwives and nurses, and established certification policies to license them and bring their expertise to the population. In Mexico City, the overwhelming task of bringing this type of medical practitioners to all Mexicans found opposition at free schools, whose faculty and graduates challenged the medical model of the revolutionary state. Free schools proposed what they called a “practical” training approach, which focalized theory content to prepare students for hands-on learning with patients. Founders of medical schools independent from government regulations—free schools—argued this model would bring medical services to all Mexicans earlier. The Free School of Obstetrics and Nursing (1920-1936) trained midwives in this model. Using midwives’ clinical records, manuals of domestic obstetrics, and academic obstetrical textbooks, this paper contrasts delivering practices at home and in clinical settings in Mexico City. It suggests that the free schools’ training model gave their midwife students and graduates more autonomy and independence than historians had assumed. The model equipped mostly female midwives with tools to evaluate pregnancy and deal with simple and difficult births. Entitled with their training, they challenged medical authority, generally represented by male doctors, particularly at home where collaborating with patients, female midwives and their patients resisted the introduction of a model of state medicine they perceived invasive and unhygienic. With the professional identity free schools formed, midwifery graduates offered another model of obstetrical attention that coped with a national public health problem, a model that challenged the authority of the revolutionary state in Mexico.