Guardianas

Dispatches from the Association of Midwives Rosa Andrade / Despachos de la Asociación de Parteras Rosa Andrade

by Asociación de Parteras Rosa Andrade (ARPA) , edited by Noemí Delgado and Luz Del Carmen Salama-Tobar, translated by Emma Lloyd

A collection of testimonies from midwives in El Salvador who delivered babies during the twelve-year-long civil war and who, today, who continue to care for the reproductive health of their communities.

This bilingual edition includes thirty color photographs and five black-and-white illustrations.

During the twelve-year-long Salvadoran civil war, mothers and guerrilla fighters attended births out of necessity. While fleeing airstrikes, in caves and beneath mango trees, with no electricity or running water, these women became parteras—community midwives—and began to care for pregnant people in rural areas and refugee camps who could not access medical care. In 1994, in the wake of the armed struggle, the Association of Midwives Rosa Andrade (APRA) was born.

Compiled from oral histories gathered in 2019 by Salvadoran American birth worker Noemí Delgado, this bilingual anthology weaves together testimonies from twenty members of APRA to tell a collective story of midwifery and community care in revolutionary El Salvador. In Guardianas, the beauty of the testimonies, and the care with which they were collected, come together to safeguard a vision of a world rooted in fierce bravery, dignity, and ancestral wisdom.

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Durante los doce años de guerra civil en El Salvador, madres y guerrilleras asistieron a parturientas. Mientras se refugiaban de ataques aéreos, dentro de cuevas y bajo árboles de mango, sin electricidad o agua corriente, estas mujeres vueltas parteras comenzaron a cuidar a personas embarazadas en áreas rurales y campos de refugiados que no podían acceder a cuidado médicos. En 1994, tras la lucha armada, nació la Asociación de Parteras Rosa Andrade (APRA).

Compilado de historias orales recolectadas en 2019 por la trabajadora de partos salvadoreña-estadounidense Noemí Delgado, esta antología bilingüe entreteje testimonios de veinte miembros de la APRA para relatar un cuento colectivo de partería y cuidado comunal en El Salvador revolucionario. En Guardianas, la belleza de los testimonios, y el cuidado con el que fueron recolectados, juntos resguardan una visión del mundo enraizado en coraje feroz, dignidad y conocimiento ancestral.

Collected in

Reproductive Health, Reproductive Justice Women in Translation

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$18.95

Publish Date: 2025-06-17

ISBN: 9781644214763

Pages: 272

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Publish Date: 2025-06-17

ISBN: 9781644214770

Pages: 272

“Through deeply personal testimonies, Guardianas tells the remarkable story of the midwives of APRA, who provided vital care during El Salvador’s Civil War and continue to champion holistic health and transcendental solidarity today. This book powerfully celebrates their resilience, sacrifices, and enduring commitment to preserving ancestral practices in the face of violent repression. Guardianas stands as an inspiring testament to the indispensable role of midwives in safeguarding life, culture, and community even against formidable odds.”

– Dorothy Roberts, author of Killing the Black Body

“Guardianas documents the efforts and struggles that midwives in El Salvador have been making to help women to be in control of birth-giving and refuse hospitalization. Built through the memories of women who lived and worked through the ‘counterinsurgency’ war, Guardianas is a powerful, inspiring testimony of communal solidarity and resistance. It is a book we need to read, as across the world we face a relentless war against the main conditions of our reproduction.”

– Silvia Federici, author of Caliban and the Witch and Wages Against Housework

“With no running water, in the rain, in the dark, under gunfire, by a mango tree, next to a wood fire . . . the midwives or parteras of El Salvador have persisted since before the brutal civil war, safely assisting birthing mothers. Yet since then, despite doctors and hospitals being unable to replace the parteras' compassionate community service, partería has been pushed aside by the healthcare system. This passionate project is the tribute the parteras deserve and a call to reforms that will far better serve both midwives and mothers.”

– Deirdre English, coauthor of Witches, Midwives, & Nurses: A History of Women Healers

“Guardianas is a beautiful homage to the pivotal role parteras have played throughout Central American history. Midwives are the engines of communities, engines that run on love and trust. No government or medicine school should ever think that midwives are the problem to child mortality. I hope those opposed to parteras read this book, I know they will forever change their perspectives. I needed this book to exist, I'm a different person after reading these important testimonies rooted in Indigenous wisdom.”

– Javier Zamora, New York Times bestselling author of SOLITO

“For survivors and descendants of colonial violence, what is more miraculous than the birth of a child, whose first breath holds the possibility of a future that is free? This powerful, poignant collection of testimonies by El Salvador’s midwives, who have lived through the grave horror of war, document their courageous work of ushering in new life, in a land where the people have known mass death. Their words defy the patramyths of power built on the erasure of Indigenous people. Their truth, their knowledge, and their immense love for their people comes alive in Guardianas.”

– Tanaïs, author of the Kirkus Prize-winning In Sensorium: Notes for My People

“Guardianas offers us back the listening that has been stolen from us by medicalized birth systems and alienated healthcare. In this book we get to listen to elders, warriors, guides whose love, care and support for the autonomy of people giving birth models the world we deserve.”

– Alexis Pauline Gumbs, author of Survival Is a Promise: The Eternal Life of Audre Lorde and M Archive: After the End of the World

“This is a book about cultural preservation and feminist labor, about safety and access, about whose histories get celebrated and whose get suppressed. These testimonies show the Salvadoran Civil War from an angle that is not often discussed. It is an homage to the women who have stepped up to serve their communities when nobody else would.”

– Christopher Soto, author of Diaries of a Terrorist and editor of Nepantla: An Anthology Dedicated to Queer Poets of Color

“The parteras of the Asociación de Parteras Rosa Andrade are part of a fierce midwifery legacy based on defense of their peoples and the collective good of their community. This collection of dispatches and testimonios from the frontlines of war, pandemics, violences, and colonialism reminds us that traditional midwifery should be accessible to the people. It is not based on ego or a title, but on the love and care midwives hold for their peoples. My Macehual elders say that those who are designated by elders and communities as guardianas, or as guardians and protectors, carry the special charge of protecting the ancestral knowledge that has protected and guided our peoples. Like much of Indigenous midwifery throughout the Americas, this effective framework that guides APRA is eclipsed, threatened, and disciplined by the medical model that denies the wisdom of midwifery care. Much as it emerged and re-emerged out of necessity, this ancestral knowledge must be protected and respected as a presiding and useful intelligence for these times.”

– Dr. Patrisia Gonzales, author of Red Medicine: Indigenous Rites of Birthing and Healing and Traditional Indian Medicine: American Indian Wellness

“Guardianas is a riveting, gritty, and extraordinary collection of testimonies to read. It's both an understanding of the great perils faced not just in El Salvador, but in the Global South, under the shadow of the dark machinations of colonization—as well as the powerful depiction of the internal strength of womanhood. This book is about the resilience of mothers and caretakers, like the great Salvadoran laborers and farmers who toil the land, these brave women protect and herald in new life. The cycle of death is so present in these pages, but the violence of the world around them doesn't shift the priority of the work, they are steadfast, moving with grace, sharing the bloody realities of birth, life and death. Guardianas is a prayer, it is a powerful and necessary book.”

– Fariha Róisín, author of Who Is Wellness For?

“Doula and Fulbright fellow Delgado sheds light on changing childbirth conditions in rural El Salvador in this powerful debut report. In 1994, 30 midwives, many of whom delivered children in precarious and dangerous conditions without formal medical training during El Salvador’s 12-year-long civil war, banded together to form the Asociación de Parteras Rosa Andrade, which provided free care for pregnant women in rural communities. Seventeen years later, in response to a UN declaration on development that mandates certain goals be met in order for the country to receive international aid, El Salvador implemented a plan mandating all births take place in a hospital. This led to a crackdown on midwives, despite the fact that their practices look after women in rural towns who can’t afford a trip to the hospital. Delgado collects testimonies from generations of the group’s midwives, whose accounts paint a poignant picture: they criticize conditions in the country’s hospitals as rife with unnecessary procedures, describe the intricacies of their care and their deep devotion to local communities, express fear over the threat of jail if they continue to attend births, and bemoan the lack of education they have access to because of their criminalization. This raises thought-provoking questions about reproductive justice at the margins of society.”

– Publishers Weekly

blog — August 04

One has spilled blood, but they’ve given us no recognition

Below, you’ll find an excerpt from Guardianas: Dispatches from the Association of Midwives Rosa Andrade, a bilingual collection of testimonies from midwives in El Salvador, edited by Noemí Delgado and Luz Del Carmen Salama-Tobar, and translated from Spanish by Emma Lloyd. The midwives you’ll hear from delivered babies during the twelve-year-long civil war and, today, fight to protect their ancestral role in the midst of ongoing repression.

Compiled from oral histories gathered in 2019 by Salvadoran American birth worker Noemí Delgado, this bilingual anthology weaves together testimonies from twenty members of APRA to tell a collective story of midwifery and community care in revolutionary El Salvador. In Guardianas, the beauty of the testimonies, and the care with which they were collected, come together to safeguard a vision of a world rooted in fierce bravery, dignity, and ancestral wisdom.

"I began attending births in the war. But first was my mom, I was really young then, delivering twins. I learned watching the mid-wife, the same one who delivered me, and when we assisted my mom I saw how she did it. That time one of the babies had already been born when the midwife got there, because they were twins. I was about thirteen when I helped my mom deliver the twins. After that, we left for the war when I was nineteen.

I was a cook with the guerrillas and sometimes worked with the gente de masa, and that’s where it became really necessary because many girls got pregnant, or with the gente de masa there’d always be a pregnant woman. I had to help them deliver, with nothing, with just some rubber bands to clamp the cord. We didn’t have scissors, and sometimes we cut the cord between two stones.

In the war I was married, widowed, and after that I gave birth alone. I had two [kids] before the war, and the other two during the conflict. I delivered alone during the war, in a cave, beneath a rock. Only my daughters were there. After I gave birth alone, other compañeras and compañeros who we were with would come looking for me and I attended the births of the women who got pregnant during the war. After that we left for Mesa Grande [a refugee camp in Hon-duras]. We went back in ’87 and from there I started delivering babies again, they’d look for me because they realized I attended births.

In the war they killed my husband, they killed one of my daughters, too many family members. My daughters were shot, and one still has a splinter of the bullet. My daughter was eleven when they shot her. I had a bit of shrapnel also but it’s come out now. They also broke my hands."

—ÁNGELA LUZ BARAHONA DE ÁVALOS
Copapayo, Suchitoto

"Look, it’s been hard. We left escaping the war, and we had to leave every last little thing behind, doors wide open you’d say, [the army] took everything, I mean everything. In the war I delivered two babies, a girl and a boy, on the same day, October 31st, under gunfire. Gunfire! No, no, see here, it’s taken its toll on us. That’s why we left for Palacios de San José Guayabal. Palacios de San José Guayabal is where we went to take shelter, and we slept on the ground. A man came there and asked my husband if I would go help this woman deliver and I didn’t want to, “No, no I can’t,” and “I can’t do it.” “Look, just go make the effort,” he said. And I went, and that shooting, BOOM on one side, BOOM on the other side, and me seeing it all, ay how do I do this. There didn’t even used to be plastic [to protect us], not even an umbrella, just those sacks that fertilizer comes in—we threw those over us and I went with the man and we had to walk a long ways crouching under the bullets.

After that, they realized that I had attended that birth and they came to call me for another, and when I arrived the baby had already been born on just a little patch of sand, just the placenta was left and I stayed there and took care that the placenta was birthed. Since I already had the tie and the scissors on hand I cut the cord and just put a little alcohol and cut the boy’s umbilical cord and brought the little boy [over] cradling him in my arms and I told a man to go find a hammock for the mother. There, in that place, I think I delivered four babies. I helped my niece give birth for the first time.

From there things got worse because the death squads were persecuting people, especially going after anyone from Suchitoto, and we were from Suchitoto . . . we who hadn’t done anything, didn’t owe anything. So we left for Soyapango, but back then the Universidad Don Bosco wasn’t there, and there was no Unicentro, there were only fields of sugarcane. We lived by the side of the road, that’s where we lived, but it was all sugarcane. There I had to attend other births as well, and as I had already delivered several births, I took charge. The women who could would pay me a little, but if she didn’t have anything then she would say “Dios se lo pague,” God will pay."

—FREDELINDA ANTONIA RECINOS DE CERÓN
Aceituno, Suchitoto

"It came that I had to leave my home—I left all alone, just me and my kids because I was already a widow. A friend came and got me out because he said that he didn’t want to learn later that they had killed me. He was a comrade who was with some of the guerillas and he got me out of Los Apoyos. He took me from the house without me bringing anything, not one little thing from the house, just my kids and one or two pieces of their clothing. We left that night, about one in the morning. And right as we got out, getting across the Lempa River, you could hear the convoys come full of soldiers, coming to finish off every last person. But thanks to God there was someone who came to get me out, otherwise I would’ve died along with every single other person. After that they took us to a place we could stay. When I wanted to go back, the house was already destroyed. There wasn’t any way left to make a life, and so I had to stay with the compañeros [guerrillas] who were fighting, fighting for our lives.

Living in the guerrilla camps I attended births not knowing—not knowing how. But thanks to God there was a doctor and he arrived and told me, “You’re going to be with me during the birth because today I’m here but tomorrow who knows.” The very first birth I attended the baby was breech. I said to the doctor, “Doctor, she’s coming feet first.” “Don’t worry,” he said. And he helped the little girl be born. Then the placenta came out and he said, “Go ahead, today you’re going to cut the umbilical cord.” He wanted me to learn. And thanks to God, I did a good job.

After that it came that I had to help a girl deliver on my own, because she said to me, “No, I don’t want the doctor here. You come instead.” “Okay, if that’s what you want,” I said. I think she didn’t want the doctor to see her, out of embarrassment. I accepted becoming a midwife because my conscience already inclined me towards wanting to give others a hand, because the ones who suffer are always us women. And so that led me to keep fighting as a midwife, and I still am fighting—as long as God keeps me alive and I can walk.

Before that experience [attending births], I had already had my daughter, and I had also given birth in the camp, under a mango tree. There was a woman there at that time who was a midwife and she helped me deliver in the camp. When I fled home, I had five kids with me. But then things got worse. They killed one first, and then another. And it was after that that I had my daughter.

When I incorporated [in the war] I was about thirty-eight, that was when I had to leave my home. In the camps I worked as a cook, preparing food for the compas, the comrades. They let me join the camps and I said, “I have children and I can’t abandon them.” “They’ll be here in the camps, they’ll be taken care of here,” they told me. When the first one died he was seventeen, the other died at fourteen."

—TOMASA JOVITA TORRES
Mazatepeque, Suchitoto

"I was born in 1942. When I started attending births I was about seventeen. I started without any official instruction because people would come looking for me. And they told me I was really valuable because I also healed wounds during the war. Already anyone would come say to me, “Hey, go along to this house.” I learned it all with my body, nothing more. I asked an older midwife how to cut the umbilical cord. “See here,” she said, “measure four fingers from the belly button.” I said to myself, Well four fingers is too much, three will do fine, and so I cut using three fingers.

During the fighting, maybe because of all the gunfire, women would go into labor: “Come,” they’d say to me. You’d do what you could there attending the births. I got hit by a bullet and that same day we had to go with a young man who had told me to come help a woman give birth and I had to stay there with the bullet; I still have the shrapnel. That’s how it was: losing blood, I delivered a baby.

That was a critical time. What we did was give food to the guerillas. But maybe sometimes while bringing food the soldiers would arrive, and we’d be in the crossfire. I helped a girl deliver in the middle of a clash, they had started shooting. It was sad. We didn’t make any noise. There in silence, no noise, only the walls protecting us. The girl giving birth didn’t cry, she just endured. It’s been hard. One has spilled blood, but they’ve given us no recognition."

—MARÍA MARTINA LUCERO
Primavera, Suchitoto

Guardianas is a bilingual collection of testimonies from midwives in El Salvador who delivered babies during the twelve-year-long civil war and who, today, fight to protect their ancestral role in the midst of ongoing repression.

This edition includes thirty color photographs and five black-and-white illustrations.

Out of necessity, women in El Salvador began attending births during the twelve-year-long civil war, when pregnant people in rural areas and guerrilla camps could not access medical care. From their mothers and older midwives, these women learned partería—traditional midwifery that was once the norm in El Salvador and has since been prohibited. After the official end to the war, the parteras became central fixtures in the “repopulation” of their country, building new communities, often without electricity or running water or hospitals. In 1994, out of this organizing, the Association of Parteras Rosa Andrade (APRA) was born. Today, the founding members of APRA, along with a younger generation training with them, continue to fight for the reproductive rights of thousands of people living in the municipalities of Suchitoto, Cuscatlán.

Collected in 2019 by Salvadoran American birth worker Noemí Delgado, Guardianas weaves together testimonies from twenty members of APRA to tell a collective story of:

- the experiences of midwives, mothers, guerrilla fighters and “gente de masa” during the armed conflict that took approximately 75,000 lives;

- the role of the midwife during the period of repopulation after the signing of the Chapultepec Peace Accords, when thousands of displaced Salvadorans were finally allowed back into their homeland;

- the brutal obstetric violence that people giving birth in hospitals routinely face, and how this mistreatment compares to care provided by a midwife;

- the extreme repression Salvadoran midwives have faced since 2011, when the health ministry prohibited home births;

- the ancestral nature of partería, an earth-based art practice that is passed down between generations, and derives from an extensive body of knowledge about safe and empowering births.

This anthology is both a safeguarding of the caretaking traditions of partería as well as a broader invitation to consider the role of birth work in organizing against war, imperialism, and corporate power. Here, the beauty of the testimonies—and the care with which they were compiled—ultimately come together to upend our ideas of what a medical ethnography can be and what an oral history can do.