In Guatemala, indigenous women are the group most affected by maternal deaths. They account for 66% of maternal deaths, although indigenous communities only make up 43% of the population. Nim Alaxik is an organization that advocates for safe and quality maternal care for indigenous women.

Photo of 5 members of the Nim Alaxik association holding a banner.
Members of the Nim Alaxik association © Edinio Quex


Most indigenous women live in rural areas and face a greater poverty level. They have a higher maternal mortality rate due to their limited access to health care. Also, when visiting a hospital, indigenous mothers are often patronized by hospital staff and may even experience a lack of respect. Lastly, hospital services are primarily provided in Spanish only, which affects the quality of care and the overall experience of indigenous women who are not fluent in Spanish (given that most indigenous people do not speak Spanish as their first language).

This discriminatory approach to health care leads many indigenous women to give birth at home rather than in a hospital, with the assistance of a comadrona, a traditional midwife from their community who speaks their language and is respectful of local customs. Comadronas are well-respected leaders in Guatemala’s indigenous communities. They conduct deliveries using rituals that are culturally relevant to indigenous women, such as abdominal massages, traditional steam baths (temazcal), prayers, and the ceremonial burial of the placenta. Overall, comadronas are the primary source of information in the countryside, where women often have to commute for hours to get to the nearest hospital and where ancestral beliefs are an integral part of the community’s everyday life.

THE two central health systems in Guatemala

There are two central health systems in Guatemala:

  • the formal health system run by hospitals and clinics, and
  • the traditional health system based on ancestral knowledge and operated by comadronas.

The government of Guatemala formally acknowledges the role of comadronas in improving indigenous women’s health. However, it is still difficult to officially include comadronas in the public health system. They are commonly distrusted by hospital staff and continue to face a lack of political support from public institutions, particularly from the Ministry of Health. Consequently, it is hard for comadronas and their patients to enforce their rights.


“Feminists in Action” supports and funds the “Association of Guardians of the National Movement of Granny Midwives Nim Alaxik” (Asociación Guardianas del Movimiento Nacional de Abuelas Comadronas Nim Alaxik), an organization that strives to empower comadronas. Nim Alaxik wants the ancestral know-how of comadronas to be recognized, and more generally, they are fighting against discrimination towards indigenous communities.

The commitment of Nim Alxik also has a political component: as ancestral authorities engaged in the health system of indigenous communities, comadronas lobby public authorities to have more recognition for their work while calling for a more horizontal alignment of the two healthcare systems of Guatemala.


Nim Alaxik is conducting a project that empowers comadronas to reduce unwanted pregnancies via training workshops. These workshops are meant to increase the expertise of comadronas, who can then pass their knowledge on to their families and the younger generations in their respective communities, who often have limited access to information on sexual and reproductive health.

Overall, this project offers friendly spaces that can help change the practices, behaviors, biases, and patriarchal and sexist prejudices related to the body and sexuality.

By blending tradition and modernity, or ancestral knowledge and modern techniques, the Guatemalan comadronas play a vital role in bettering indigenous women’s access to sexual and reproductive health and making sure they experience a violence-free maternity.

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