At the 10th anniversary celebration of the Maternal Health Task Force, The Global Maternal Health Symposium, we awarded 10 Maternal Health Visionary awards to professionals who have shown impact, innovation, inspiration, leadership, and future vision in the field of Maternal Health. This blog series highlights the work of these maternal health visionaries. Click here for a version of this post en español.
Maternal Health Visionary: Dr. Linda Valencia
Dr. Linda Valencia was raised in a family full of women in rural Guatemala, strong women who overcame poverty to make something of themselves. Linda’s mother became a lawyer, and Linda was determined to follow in her family’s footsteps. With a family full of women, gynecology seemed like the perfect option. In an early demonstration of her persistence, Linda won a scholarship to study medicine at the University of San Carlos of Guatemala, worked hard, and completed her gynecology residency at a large public hospital.
Traditionally, obstetrics and gynecology in Guatemala was male-dominated, but Linda quickly rose to the top of her class, eventually becoming the second female Head of Residency for gynecology in the hospital’s history. This position both opened doors and gave Linda a wider view of the hospital system, leading to two experiences that changed the course of her career and led her to her life’s work at Planned Parenthood.
As part of her new position, Linda was sent to a course on clinical quality in maternal and neonatal care offered through Johns Hopkins. The course was an eye-opener for Linda, and she began to see the link between the terrible maternal health outcomes she was seeing in the hospital and the health status of women in general in Guatemala. That same year Linda lost a patient, a mother of seven with an unwanted pregnancy who arrived at the hospital with severe sepsis after a clandestine abortion (currently abortion is legal in Guatemala only to prevent risk to the life of the woman). Linda didn’t understand. She asked herself: “how could women take these risks that are so terrible they end up losing their lives?”
With her typical tenacity, Linda set out to understand and to act. What she found in the early 2000s, was a system that failed women and situated Guatemala as the country with the second highest maternal mortality in Central America (after Nicaragua). Hospitals didn’t have enough providers to care for the women who had complications, and to make matters worse, they were often inaccessible to rural women. For many women, the trip to the nearest hospital would take 3 or 4 hours. As Linda describes:
“If a woman decided to give birth at home and had a hemorrhage or placenta accreta, they would have to take her to the hospital on foot, on a horse or a donkey, or even carried on her husband’s back. Obviously, by the time she got to the hospital she was dead.”
Linda saw that the poor, rural, indigenous women were the most likely to suffer from complications-either in childbirth or in an unsafe abortion.
To not act was not in Linda’s character. She joined the Ministry of Public Health in Guatemala and worked to implement quality sexual and reproductive healthcare in all 36 maternity hospitals in the country, which included a national post-abortion care program. To implement this program, Linda and her colleagues took a system that more often than not treated a woman with post-abortion complications like a criminal and transformed it into one that treated these women with dignity.
After several years at the Ministry of Public Health, Linda had the opportunity to join Planned Parenthood Global in Guatemala. She was impressed by their dedication to help women prevent unplanned pregnancies, access safe abortions and get quality post-abortion care. Planned Parenthood was planning to expand their work in Guatemala and hired Linda as their first local doctor in the country. Linda began to build a large network of nonprofits, clinics, and women’s organizations to expand access to sexual and reproductive healthcare.
Linda understood that in order to reach the most vulnerable women-indigenous women, rural women, and those affected by the armed conflict in Guatemala, she would have to think outside of the clinic or hospital. She worked with traditional healers, training them to recognize warning signs and stocking them with life-saving medicines. She set up local community health centers in hard to reach areas. She worked to bring back midwifery as an important component of maternity care, setting up a training program in Guatemala City to train rural women to be midwives in their communities of origin. The midwife training program is currently in its third year, and Linda is proud to have been the professor for the very first class.
Linda’s work and the work of others in have improved maternal mortality in Guatemala, but the work isn’t done. Corruption and the culture of machismo are huge barriers to achieving quality sexual and reproductive healthcare according to Linda. Corruption in government siphons funds from the public health system and creates unnecessary hurdles to legislative change. When asked what is needed to improve maternal mortality, Linda is clear:
“We have to be more aggressive…We must fight corruption; we must continue humanizing maternity care; we must keep training midwives; we must empower traditional midwives; we must continue to education women and girls about sexual and reproductive health.”
Linda’s closing message to the world is simple: Don’t forget Guatemala. Don’t forget Guatemalan women. They still need the world’s attention and the world’s help to ensure the health of all women and babies.