Reason: Baby Born in U.S. Is Automatic Citizen : Midwives Flourish on Rio Grande

A month ago, Irma Ramirez walked heavily up a dirt path to a small house typical of many in this border town. She had come to give birth to a child, her ninth, and was well on the way.

The woman who greeted her, Eufemia Lopez, was likewise no stranger to childbirth.

Outside the one-story, clapboard Lopez house, scrawny chickens pecked at tufts of thin grass beneath a sign that said: “Se Atienen Partos. “ In the local idiom: “Birthing done here.” Lopez is a partera, a midwife.

Midwives flourish along the border for a simple reason: A baby born in America is automatically a U.S. citizen.

So, if a Mexican mother times it right, she can give that precious gift to her offspring with no more trouble than a brief trip across a bridge. Records are unreliable, but the best estimate in this one Texas county, across the river from Matamoros, Mexico, is that up to half of the midwife deliveries are to Mexican nationals.

Irma Ramirez’s nationality was not recorded. Tragically, it doesn’t matter. She died giving birth to her ninth child. So did the child, a boy.

“How many babies are buried in backyard graves we have no way of knowing,” Antonio Zavaleta said.

“I do know,” he added, “that Hispanics have the highest birthrate in the nation and the lower Rio Grande Valley has the highest birthrate among Hispanics. The problem of untrained, unregulated midwives is going to get worse unless something is done.”

‘Sort of Accepted’

Zavaleta is a 38-year-old professor at Texas Southmost College in Brownsville. He is also the chairman of the city’s Lay Midwife Advisory Board, which he started eight years ago as a way of getting something done.

“Until then,” he said, “nobody gave midwifery a second look. It was just sort of accepted, the way things were.”

Zavaleta grew up in Brownsville. But he had been away from home, away from the border and its customs, for 10 years. He returned not only with a doctorate in anthropology (his specialty: folk medicine) but also a fresh look at old ways.

He persuaded the City Commission to enact an ordinance requiring lay midwives, parteras, to complete a course of training and to pass a test to get a license. It also sets out procedures. One is to require the expectant mother to be first examined by a doctor.

These requirements, however, end at the city limits of Brownsville.

Lopez, after a hearing, lost her license--not necessarily because of the deaths but for failing to follow prescribed procedure. This, however, will be nothing more than an inconvenience.

“I will move outside the city to the county,” she said. “I don’t want to do that, but I will have to.”

When she does, it will leave only seven licensed lay midwives in the city compared to about 40 in the county--and hundreds more all along the border, where requirements for a license are no more than filling out an application and paying a fee.

To prove the point, Zavaleta dropped by the courthouse one afternoon and picked up one himself.

“Cost me five bucks,” he said. “All I need to do now is rent a house trailer, park it outside the city limits and hang up a sign. I could make a lot more money than by teaching in a junior college. It doesn’t matter that I’ve never delivered a baby or had an hour of training. It’s outrageous, dangerous and unscrupulous.”

These are the parteras who operate out of their homes. Elsewhere in this valley are clinics that provide excellent obstetrical care by registered nurses further trained as Certified Nurse Midwives. At the two branches of Su Clinica Familiar (“Your Family Clinic”) in nearby Raymondville and Harlingen, a dozen nurse-midwives deliver about 1,300 babies a year. The patient pays what she can afford, usually less than a partera’s fee.

But the clinics can’t begin to meet the needs of the burgeoning border towns. Besides, the clinic’s staff members ask questions, keep records. They also follow up every birth with a house call.

‘Many ... Recent Arrivals’

“Many of our people are recent arrivals,” Zavaleta said. “They don’t speak English. They are confused. They are poor. Parteras seem less threatening to them, so that’s where they go. Unless we can get them regulated throughout the state, and the regulations enforced, not much will change.”

So the parteras exist in a sort of shadow world of the border following codes and customs of their own.

Registering births, for example. A midwife license, so easily come by, is all that is necessary to register a birth. This is supposed to be done within five days of delivery, but. . . . “Think of it as collateral,” Zavaleta said. “Until the mother pays the midwife, the child does not get registered. No registration, no citizenship. There are kids walking around who are as much as two years older than the date on their birth certificates.”