Frontera NorteSur May 2002

Kauffman describes MLL as "awesome, incredible, beautiful, powerful and hard." "It's amazing to be part of birth," she says and sees it as wonderful that mothers "share that intimate space with you."

Talking about the births she has been part of, Kauffman can describe many inspiring moments and mothers. One woman very much desired a natural childbirth (one without pain-killing or other drugs) but her labor went on for some time and the woman was in a lot of discomfort. Her family became worried and urged her to go to the hospital to get pain medication. However, the woman refused as she wanted to remain true to her original vision of a natural birth. Later, the woman gave birth at Maternidad and both she and the midwives involved were proud of her efforts.

The pride of natural childbirth is something that extends beyond MLL, says Kauffman. In Ciudad Juárez, fathers and family are often left out of the birth process. At MLL, friends and family including parents, partners, children and others can be present at a birth. According to Kauffman, this often has a transformative effect on partners and relationships, especially when men see women go through labor.

Birth along the border

Maternidad La Luz also plays a particular role in border culture, economics and health. While founder and director Kaley is waiting on the results of a study to discover where her clients live, she has traditionally estimated that 1/3 live in El Paso, 1/3 live in Cd. Juárez and 1/3 are from Cd. Juárez but are living temporarily in El Paso.

Founder Deborah Kaley and students from Earlham College.
Photo courtesy of Patty Lamson.

For El Paso residents, MLL is seen as an affordable, high-quality birth option, especially by people without insurance. Depending on one's income, a birth at MLL costs between US$455-$550.

For women living in Cd. Juárez, Maternidad La Luz is seen as one of the best places in the region to go for quality prenatal and birth services, says Kauffman. Women also like the respect they are given at MLL. Finally, women like that their children get US birth certificates when they are born in El Paso.*

For Mexican women living in El Paso without documents, MLL is also a natural choice as the center is not concerned with its clients' legal status. "The border is very fluid," states Kauffman, noting that while it might not seem so from Washington D.C. there are many social, economic and family dynamics that keep people going back and forth across the border between El Paso and Cd. Juárez.

Mothers speak

An example of the complex and fluid border dynamic that Kauffman mentioned is apparent in the case of expectant mother Diana Torres. Torres had her first child, a girl, at Maternidad La Luz in 1997 because it was inexpensive compared to El Paso hospitals, she said. In 2000, she had her second child there because she liked the care and respect that she received from MLL midwives during her first birth. Now, Torres is back at the birth center and is expecting her third child in late June, 2002.

For Torres, it is important that her children receive US citizenship at birth. Although she lives with her family in Cd. Juárez, her husband is a US resident and has always said that their children would be born in the US because citizenship offers them more long-term opportunities.

"Births have always been a special occasion for me, not a medical emergency"

Carmen Alarcón, an MLL clinical administrator, has five children, all of them born with the assistance of midwives and none of them in hospitals. Her third child, a girl, was born at MLL in 1987 and was the fifth child ever born at the center. That baby, now a young woman, will turn 15 in two weeks and the midwives will be invited to her quinceañera.

"My daughter has grown up with MLL," said Alarcón, an El Paso native.

When Alarcón was pregnant with her first child, her mother told her to go find a midwife because that is what people in her community had done for generations. However, Alarcón noted that she herself was born in a hospital. Her mother said that this was because at that time hospital services were cheaper than the sack of potatoes that would have been traded for the services of a midwife.

After working for 15 years at MLL, Alarcón says, "I think like a midwife now." Her conversations and even her jokes extend to the subject of midwifery and natural child birth.

While Alarcón clearly loves her work at Maternidad, she speaks most enthusiastically about having given birth there. About those experiences Alarcón says, "Births have always been a special occasion for me, not a medical emergency. Midwives created that for me through the presence of friends, music and food."

While she would like to become a midwife through MLL's training program, Alarcón feels that she cannot take away time from raising her kids, ages 18, 16, 14, 13 and 12. Having worked for so long at Maternidad, Alarcón knows the toll that classes and 24-hour shifts can take on students.

Direct-entry midwifery training

The midwives trained at MLL come from many backgrounds although very few of them were medical professionals before attending the school, according to current student Jennifer Smolinsky. This means that students become direct-entry or lay midwives and after completing class work and delivering a certain number of babies, the midwives can take the North American Registry of Midwives (NARM) exam to become certified professional midwives.

In just her first few months at Maternidad, Smolinsky has taken classes in anatomy, physiology, breast and Pap-exam, blood drawing, immediate post-partum care, breast feeding and other areas. She has class three days a week for three hours each day in addition to assisting at births and delivering babies on 24-hour shifts. There is also weekly peer review in which midwives talk about all of their births from the previous week.

In a statement that could have been made by a new mother, and that shows parallels between the rigors of child birth and an MLL education, Smolinsky describes the school and the process of becoming a midwife as, "Really intense, a lot, a lot of work, it's great. I'm tired. It's wild. It's really beautiful."

"The act of giving birth in the United States opens the possibility for children to choose citizenship and place of residence and work in a binational region. In this article it is postulated that said phenomenon forms part of the "maternal care" that a certain sector of the border population develops guided less by economic rationale than by the context of life and the dynamic of border interaction.

"The results obtained from a survey of more than 220 women in these cities demonstrates that the most important explanatory factor of this practice has been the women's desire that their children be able to access the US educational system, probably at higher levels."