Traditional Birth Escorts?

Type:

Book Chapter

Author:

Megan D. Cogburn

Published:

2025

Publisher:

Routledge

Today in rural Tanzania, traditional midwives (TMs) are grappling with the effects of the call to end their roles as birth assistants; instead, they must escort women to biomedical healthcare facilities for birth. Based on 15 months of ethnographic field research spent in community with mothers and TMs in Mpwapwa district in 2016, 2019, and 2020, this chapter offers a new look at the work and needs of TMs in Tanzania to consider how they are interpreting and understanding the global and national policies surrounding their roles. In this chapter, I show how the government mandate for TMs to become birth escorts exacerbates the structural vulnerabilities of TMs, who express nostalgia for their historical caring roles and desires to continue their homebirth work, and not just to escort women to understaffed and under-equipped biomedical facilities. TMs seek acknowledgement for the time they spend caring for and escorting laboring women, which, I argue, is a form of unrecognized labor that TMs bear due to longstanding structural inequalities in rural health care. TMs’ words and actions ultimately highlight their need to conceal in order to heal—to continue to provide home-based care for pregnant women and mothers, even as they are fearful and saddened by the punitive bans and threats against their practices.

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