I was honored to spend almost 40 years as a Labor and Delivery nurse, OB Educator and hospital Birthing Center Director.   I started my career and had my own two children in the mid 1970’s. This is at the time of the feminist movement when, among other things, women were demanding to be included in their childbirth plan which always included a support person, often a husband but anyone of their choosing.  They wanted to be educated in childbirth, often in how to have a “natural” childbirth. They wanted to be in a comfortable, homelike setting vs. a sterile room that looked just like an operating room.  I became convinced along with other health care providers throughout the country, that we could have a new hospital model for both low risk and high risk women that included education and combined the safety of a hospital setting with the comfort of home.  This model has been sustained throughout our country now for decades because of higher patient/family satisfaction, cost-effectiveness, and better outcomes for mothers and babies. 

Discovering Curamericas Global:

I recently heard the Executive Director of Curamericas, Andrew Herrera, speak passionately at my church about how this organization is improving outcomes for mothers and children in very underserved areas world-wide.  Because of my background, I thought their approach made so much sense and said, “maybe I can volunteer here!” (You can too, click here to learn how) I learned in more detail about the organization and its work. 

Parallels with the U.S. Birthing Model

My first impressions about the similarities between the US hospital model that I knew and the Curamericas model were confirmed.

For instance:

1. Just like U.S Birthing Centers, Curamericas has established  birthing centers (Casas Maternal Rurales) in the community that are accessible, affordable and most of all acceptable.  Rather than deliver at home, women can bring their traditional midwife (comadrona) or other assistant to join the trained staff 24 hrs. a day.  The physical environment is homelike and familiar.   And, systems are in place to transport the mother to a hospital in case of an emergency the staff cannot manage.   
2. I taught “childbirth education” classes that also included newborn care.  Curamericas added Care Groups to its methodology that uses trained volunteers to educate women and mothers in their homes.  They provide simple “health promotion messages,” about things as basic as proper handwashing ,to women, many of whom are illiterate.
3. We women of the 70’s started to find our voice and become more empowered.  Through Care Groups especially, the indigenous Mayan women are starting to “find their voice” in a male-dominated culture.

Community-Centered

Beyond these observations, I was struck with how Curamericas created its programs.  In the beginning, Curamericas used a “bottom up vs. top down” approach. It partnered with and trained the people there and engaged the community to establish trust. I learned that indigenous Mayan women often had been reluctant to leave their homes because they felt disrespected and discriminated against. The community itself seems to be so invested in what it is doing, which will lead to sustainability in the long run, another goal of Curamericas.

Finally, I was impressed by the rigor of the scientific approach led by Dr. Perry and other professionals in implementing interventions and documenting outcomes.  Here are a few evidence-based outcomes from the Guatemala project area as published in the International Journal for Equity in Health. You can read the full peer-reviewed article supplement here.

Maternal deaths:  declined from 519/100000 in 2018 to to355/100,000  in 2020, to 0/100,000 in 2022

Nutritional status:  levels of stunting in under-2 children declined from 74.5% to 39.5%.

Empowerment in Women:  various interventions showed a statistically significant increase in women’s empowerment. 

I am proud of what I did in my career here at home to make a difference.  And I strongly believe in what Curamericas Global is doing world-wide in its mission to partner with underserved communities throughout the world to save and improve lives of mothers and children.

Congratulations!!

Kathy Austin, MSN, RN, NEA-BC

Durham, North Carolina

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