In the mist-shrouded mountains of Colombia’s Chocó region, a 62-year-old woman named Luz Marina Córdoba has delivered more babies than she can count—over 200, by her estimate. No one keeps official records. There is no hospital, no clinic, no doctor for miles. There is only Luz, her steady hands, and the knowledge passed down from her grandmother. She is a partera, a traditional midwife, and for communities cut off from the modern healthcare system, she is the difference between life and death.
Desperately underserved
Colombia’s rural areas are a patchwork of neglect. In the Pacific coast departments like Chocó, Nariño, and Cauca, paved roads are a luxury. Ambulances—if they exist—take hours to navigate muddy trails. According to the Ministry of Health and Social Protection, over 80% of municipalities in Chocó lack a single obstetrician. Maternal mortality rates in these regions are three times the national average. For a woman in labor, reaching a hospital can be a 12-hour ordeal on a motorcycle taxi or a dugout canoe.
This is where midwives step in. The National Association of Traditional Midwives of Colombia estimates that around 10,000 parteras are active nationwide, many of them Afro-Colombian or Indigenous. They are the backbone of maternal care in the countryside, handling deliveries, prenatal checkups, and postnatal support. They charge next to nothing—often bartering services for food or a chicken. And they are doing it without government support.
“If it weren’t for the midwives, women would die giving birth. It’s that simple.” — Dr. Ana María Restrepo, rural health researcher at the University of Antioquia
Tradition meets modern medicine
Midwives aren’t just relying on old wives’ tales. Many have undergone training programs run by NGOs like Médicos Sin Fronteras (Doctors Without Borders) and the Colombian Red Cross. These programs teach infection control, identification of high-risk pregnancies, and emergency referral protocols. But the relationship with the official health system remains fraught. Doctors often dismiss midwives as archaic, while midwives accuse the state of abandoning them.
“They want us to follow their rules, but they don’t give us any resources,” says María del Pilar Sánchez, a partera from the Guapi River region. “We need gloves, antiseptic, a way to transport a bleeding mother. We get nothing.” The Colombian government did pass a law in 2020 recognizing traditional midwifery as part of intercultural health, but implementation has been slow. Budgetary excuses and bureaucratic inertia have left the law mostly on paper.
Hard numbers
The contrast between urban and rural Colombia is stark. In Bogotá, a woman giving birth has access to neonatal intensive care units and skilled obstetricians. In rural Chocó, the maternal mortality rate stands at 112 deaths per 100,000 live births—compared to 51 nationally. The World Health Organization recommends at least four antenatal visits; in some rural areas, half of pregnant women have zero. Midwives provide the only continuous care many women ever receive.
A 2023 study by the National Institute of Health found that communities with active midwives had a 30% lower maternal mortality rate than those without. Yet midwives receive no salary from the state. Their work is unrecognized in medical records. They are ghosts in the system, delivering babies that officially don’t exist.
Bridging the gap—but at what cost?
The government’s failure to integrate midwives is a policy disaster. Instead of leveraging these grassroots providers, it has sidelined them. Some argue that funding midwife networks would save money—training a partera costs a fraction of building a rural clinic. But politicians prefer ribbon-cutting ceremonies for empty hospitals in towns where no doctor will ever live.
For now, midwives like Luz Marina keep going. She rises before dawn, walks two hours to a pregnant woman’s hut, and stays for days if needed. She has no cell signal, no backup, no pension. She does it because she has to. “These are my people,” she says. “Who else will come?”
The verdict
Colombia’s midwives are not a quaint tradition—they are a lifeline. And they are being strangled by neglect. The government can either recognize and resource them, or continue to let rural women die preventable deaths. The choice isn’t complicated. It just requires the will to act.
