Since 2009, two of Madre y Niño’s founders, Deborah Bell and Kimberly Garcia, have been partnering with the Guatemalan Ministry of Health to teach midwives about obstetrical emergencies and deliver essential birth supplies in remote areas of Guatemala.
Most Guatemalan women give birth at home with midwives, who are respected community leaders, attending 60% to 75% of all births and up to 90% in rural areas. The national maternal mortality rate is 73 per 100,000 live births, and more than double that in rural areas.
Information gathered from the midwives during educational sessions has been evaluated and shared through dissemination of the findings at local, regional, national, and international professional conferences and published in peer-reviewed journals listed here.
Selected Bibliography
- Garcia, K, Armstrong, C, Johnson, J, Taylor-Swanson, L, Iacob, E, Madsen, K, Flynn, E, Taft Nelson A. (2025). Evaluation of Educational Activity About Preeclampsia With Traditional Midwives in the Remote Petén Department of Guatemala. Journal of Midwifery & Women’s Health, 15 November 2025. DOI: 10.1111/jmwh.70050
- Garcia, K, Armstrong, C, Flynn, E, Rodriguez, A, Taylor, B, Iacob, E, Gonzalez, Z. (2025). Educational Activity with Guatemalan Lay Midwives about Helping Babies Breathe. Journal of Health Care for the Poor and Underserved, in print.
- Taylor-Swanson, L, Armstrong, C, Johnson, J, Iacob, J, Citkovitz, C, Kocher, Z, Madsen, K, Flynn, E, Taft Nelson, A, Tu, W, Howell, C, Garcia, K. (2025) Observational Cross-Sectional Study with Guatemalan Lay Midwives about Acupressure Use for Preeclampsia. Medical Acupuncture, May 25; 00: (00) 1-8. DOI: 10.1089/acu.2024.0190
- Garcia, K, Armstrong, C, Iacob, E, Flynn, E. (2025). The Lived Experience of Guatemalan Lay Midwives’ Interaction with Communities and Families regarding COVID-19. Health Care for Women International, DOI: 10.1080/07399332.2025.2519476.
- Garcia, K, Alvarez, G, Iacob, E, Kepka, D. (2025). Focus Groups with Guatemalan Community Leaders about Barriers to Cervical Cancer Prevention and Control. Health Promotion Practice, 0: 1-10. DOI: 10.1177/15248399241309897.
- Garcia, K, Flynn, E, Alvarez, G, Iacob, E. (2024). Program Evaluation of Educational Activity with Guatemalan Birth Attendants about Helping Babies Breathe. Hispanic Health Care International, 0: 1-8. DOI: 10.1177/15404153241295553.
- Garcia, K. Armstrong, C, Iacob, E, Flynn, E, Rodriguez, A, Simmons, M, Gonzalez, Z. (2024). Pretest Posttest Evaluation with Lay Midwives in Remote Guatemala after Educational Activities about COVID-19. Remote and Rural Health, 24(3):8387. DOI: 10.22605/RRH8387. Epub 2024 Jul 20. PMID: 39034488.8387
- Taylor-Swanson, L, Taylor, B, Bell, L, Boccino, J, Dillard, M, Howell, CS, Geppelt, C, Taft Nelson, A, Citkovitz, C, Alvarez, G, Wen, T, Garcia, K. (2024). Volunteer Primary Care Providers’ Experience with Referring Guatemalan Patients for Acupuncture Care in a Pilot, Integrative, Health Care Clinic. Medical Acupuncture, August 1;00 (00): 1-6. DOI: 10.1089/acu.2023.0140
- Taylor-Swanson, L, Taylor, B, Bell, L. Boccino, J, Dillard, M., Howell, S,, Geppelt, C, Taft Nelson, A, Citkovitz, C, Alvarez, G, Wen, T, & Garcia, K. (2024). Training Guatemalan Lay Midwives in Acupressure for Preterm and Post-term Labor. Medical Acupuncture, August 1: 00: 1-8. DOI: 10.1089/acu.2023.0139
- Garcia, K. (2024). San Raymundo: Focus Group about Comadronas’ Response to Obstetrical Emergencies in Urban Guatemala. Journal of Transcultural Nursing, 1-7. DOI: 10.1177/10436596241253864
- Garcia K, Iacob E, Dean-Smith M, Royce E, Alvarez G, Kepka, D. (2024). Low Levels of Lifetime Pap Test Receipt Among Vulnerable Guatemalans. Journal of Cancer Education, 39(3):264-270. DOI: 10.1007/s13187-024-02405-0. Epub 2024 Feb 20. PMID: 38376746.
- Garcia, K, Gee, J. (2023). Pretest-Posttest Evaluation of Change in Knowledge and Knowledge Retention after Educational Activities with Low-Literacy Lay Midwives in Urban Guatemala. Journal of Academy of Health Sciences.
- Taylor-Swanson, L, Taylor, B, Bell, L, Boccino, J, Dillard, M, Howell, CS, Geppelt, C, Taft Nelson, A, Citkovitz, C, Alvarez, G, Wen, T, Garcia, K. (2024). Training Guatemalan Lay Midwives in Acupressure for Preterm and Post-term Labor, Medical Acupuncture, in press.
- Taylor-Swanson, L, Taylor, B, Bell, L, Boccino, J, Dillard, M, Howell, CS, Geppelt, C, Taft Nelson, A, Citkovitz, C, Alvarez, G, Wen, T, Garcia, K. (2024). Volunteer Primary Care Providers’ Experience with Referring Guatemalan Patients for Acupuncture Care in a Pilot, Integrative, Health Care Clinic, Medical Acupuncture, in press.
- Taylor-Swanson LJ, Tu W, Howell CS, Dillard MP, Bell L, Nelson AT, Geppelt C, Boccino JM, Taylor E, Alvarez G, Citkovitz C, Johnson K, Garcia K. (2023). Delivering Acupuncture Therapy in an Interdisciplinary Global Health Setting in Guatemala: Pilot Study and Lessons Learned. Med Acupunct. 2023 Aug 1;35(4):163-169. DOI: 10.1089/acu.2023.0023. Epub 2023 Aug 14. PMID: 37609548; PMCID: PMC10440642.
- Garcia, K. (2022). An Observational Study of Teaching Methods with Low-Literacy Comadronas in Urban Guatemala. Canadian Journal of Midwifery Research and Practice, Volume 21, Number 3.
- Garcia, K., and Kilanowski, J. (2019). Senales de Peligro: Guatemalan Lay Midwives’ Perceptions of Responding to Obstetrical Complications. Journal of Transcultural Nursing, 31(6) 547-553.
- Garcia, K., Dowling, D., Mettler, G. (2018). Teaching Guatemalan Traditional Birth Attendants about Obstetrical Emergencies. Midwifery, 6(62), 36-38
- Garcia, K., Morrison, B, Savrin, C. (2012). Teaching Guatemalan midwives about postpartum hemorrhage. Journal of Maternal and Child Nursing, 37(1), 42-47.
- Garcia, K., Kilanowski, J., Morrison, B. (2012). Focus group with Guatemalan traditional midwives about postpartum hemorrhage. Online Journal of Cultural Competence in Nursing and Healthcare, 2(2), 1-10