Pre-Columbian Midwifery Practices
Throughout history and across all cultures women have arguably held the most significant role in society: motherhood. This role has required every culture group to create medical practices, as well as religious and spiritual beliefs to cope with and understand the processes of pregnancy and labor. The goal of this research is to examine the ways in which pregnancy was viewed in Mesoamerica, and how pregnant women were cared for in both Aztec and Maya cultures of Mexico and Guatemala. I will look at pre-Columbian midwifery practices and beliefs that were in place in these areas, and analyze similarities and differences that existed between Aztec and Maya practices relating to this topic. Lastly, I will look at how Mesoamerican spiritual beliefs involving caves could relate to women and pregnancy. This research is composed of a variety of sources including books, academic journals, and scholarly articles written by both professional historians and authors.
The view that Aztec and Maya people often took on pregnancy and birth explains why they had many deities related to fertility and childbirth. The Aztecs had a patroness for their midwives, named Teteoinnan. “Xochiquetzal (sexuality and feasting) and her counterpart Tlazolteotl (carnal transgression, filth, and absolution from sexual wrongdoing)”  were two Mesoamerican dieties that were related to sexual acts, pregnancy, and birth. The wording that was typically used to describe pregnancy and birth provides another clue for the feelings and views towards the process. The word for pregnancy was often “designated by words with roots meaning “death” , and it was thought that the infant in utero was “from the Mictlan, [which was] a realm associated with the underworld and death” . When referring to giving birth, Sahagún recorded that the Nahuas word for giving birth was miquizpan, meaning “time of death” , and it is thought that there was an “association of giving birth [and] with experiencing death” . Clearly the people understood that there was a strong correlation between pregnancy and death in ancient Mesoamerica, possibly due to a higher mortality rate during the birthing process.
The views between pregnancy and death that were held by Aztec and Maya cultures in the previous paragraph demonstrates the importance that must have been placed on midwives and their medical practices in ancient Mesoamerica. It was their job to ensure the safe delivery of the infant, while also ensuring the survival of the mother. “This demanded that a formidable ritual, pharmacological, and mythical knowledge”  be passed from midwife to midwife. One of the practices that Mesoamerican midwives utilized to care for their patients was the steam bath. “Before, during, and after childbirth, a midwife enters the steam bath with the parturient and administers a series of massages and herbal remedies to speed delivery and facilitate postpartum recovery” . There are reports from the seventeenth-century that “suggest that [Maya] childbirth took place in the steam bath rather than in the house (a practice also followed by the Aztec for difficult births)” . Typically, pre-Columbian Mesoamerican women gave birth in their own house, but the steam bath gained importance, especially in Maya midwifery practices. The steam bath rising in importance could be due to the midwife and medical belief that correlated the mother’s health and survival with heat. The midwife would give “the mother a steam bath or a [heated] chocolate drink to replenish the heat loss caused by birth” .
Steam baths were also used for spiritual and religious purposes. There were deity patrons of steam baths for both Aztec and Maya cultures, “including Francisca Batz’bal and the Mam for the Tz’utujiil Maya and paired male-female earth lords”  that ensured the health and safety of both the mother and child. After the birth, these deities needed to be thanked for their help, so the midwife would bury the afterbirth as an offering to them. The steam bath may have held even more significance because the “hearth of a steam bath is called xictli, which also means “navel” [which] equates the steam bath structure with the warm, moist womb of the mother goddess” . Therefore, it may have been believed that the person was entering “the womb of the earth mother, [to leave] healthy… like a new-born baby” . This means that the steam bath was used as a form of purification, as well as rejuvenation for the mother after birth.
In the unfortunate case that the mother did not live through the birth of her child, the Aztec people believed that “a special destiny awaited the souls of women who died in childbirth. These women were considered equal to warriors who died in battle...They too had sacrificed their own lives so that a new life could come into the world” . It was also thought that their souls went to “the sun in the sky, [which was usually reserved] for warriors who died in combat, [or] people [who were] sacrificed to the sun” . The trial that these women went through to bring their child into the world was recognized and honored. The Aztec people understood that these women went through an ordeal that is similar to battle. They knew that labor and delivery was a difficult trial and that the process posed a similar risk that battle does.
The relationship between death, the underworld, the gods, and the birthing process is evident in Mesoamerican cultures, particularly in Maya culture. It makes sense then that there would be a correlation between birthing and cave use, because pre-Columbian Mesoamerican people commonly considered caves to be the “juncture between the ordinary world and the underworld” . The Maya believed caves were sacred sites, possibly even where their deities and gods resided. Due to this, many of their sacred mountains were built on top of caves. The Maya “Quiche believed that they originally emerged from a cave” , which elevated caves to being the place of man’s creation. The Aztec also believed that “the ancestors emerged from a fertile hill known as Chicomoztoc (Place of Seven Caves)” . Due to the ideas that the caves are the center of creation, it is strange that women were often excluded from sacred cave sites and the rituals that occurred there, and that only men were allowed to take part in rituals. Stranger still is the Aztec belief that “caves were also “passageways” to the underworld, and that rituals performed in caves could symbolically transport human beings into the realms of the world below” . It is surprising then that women are thought to have somehow retrieved their growing infant from the underworld, but they could not take part in rituals to “transport” themselves there. How, then, were they able to do this?
It is often mentioned that women were not allowed within caves because it was thought that women have “a cave, a gorge”  inside of them, referring to the female reproductive system. Additionally, it has been reported that the Maya “equated [stalagmites] with penises…[and] if a woman was walking in a cave in a native skirt and stepped over the stalagmite, it would expose her uncovered genitalia to the phallic stone” . This action of stepping over the stalagmite could cause her to become pregnant. Therefore, women had to be careful when going into caves because “there are always spirits in there and things they do not know and they could end up pregnant” , especially if they aren’t accompanied by a man because “a man is a protection” . These cave spirits seem to be regarded as somewhat temperamental beings because “cave spirits not only provoke illness but cure it” , meaning that they could cause pregnancy, illness, or injury if they wished to. It is described in the Book of Lamentations that the cave spirits could even cause death. Even though the Book of Lamentations is a fictional work, it is based on real cultural context and cultural history, which is valuable to understand the past. In the book, a female character has an experience with a cave, and notes that “she knows obscurely that the day she crosses [the cave’s] threshold she will die” . Upon visiting a cave in the Jakaltec and Chuj areas, Kieffer notes the behavior of the alcalde rezador with his group. “[The alcalde rezador] set up candles on a stone altar...and began asking permission to enter the cave” . The prayer was meant to ask for permission from the gods and spirits that resided there, as well as to ask forgiveness for any unintended offense. This was an act of respect that was done to please the cave’s spirits so that no undesired problems occurred.
The process of pregnancy and birth in pre-Columbian Mesoamerica has a spiritual based belief system on how to properly handle the situation through midwifery practices to ensure the survival of both the mother and the baby. The ancient Maya and Aztec had very similar beliefs and feelings towards the process, both medically and spiritually. There is evidence that some of these practices have been passed on from midwife to midwife and are still used today. There is also evidence showing that the spiritual beliefs surrounding caves are still influencing people in Mesoamerica. The overall themes during both Maya and Aztec midwifery practices was ensuring the health of the mother and baby, as well as needing to satisfy the gods and thank them for their help. Caves have an interesting correlation between female reproduction and spiritual beliefs that are strong throughout pre-Columbian Mesoamerican cultures. Caves had an important role in both Maya and Aztec religion, that goes back to the point of the creation of their people. This fact cannot be ignored because it strongly parallels women creating life when they are pregnant and when they become a mother. However, the fact that women are unable to enter caves is a confusing aspect of Mesoamerican religion. It is understandable that they believe there are spirits and deities living within these caves and that they could be harmful. However, due to women’s vital role in the creation of life, it is strange that women are not the primary performers of rituals within these sacred caves.