Rural midwife Francisca Raquec, 65, walks after attending a pregnant patient in Patzun, Chimaltenango, 85 km west from Guatemala City. May, 2008
Rural midwife Francisca Raquec, walks to the childbith of Margatita Coxoca, 25, with her childbirth instruments on her head in El Llano village. August, 2008
Rural midwife Francisca, tries to get out from a patien house after attending a pregnant woman in Patzun, Chimaltenango, 85 km west from Guatemala City. June, 2008
Francisca, touches pregnant patient Patricia Aju s belly, 19, next to her husband Paulino Ishen, during a prenatal control in El Llano village, Chimaltenango, 88 km west from Guatemala City. May, 2008
Rural midwife Francisca Raquec, waits to burn Margatita Coxoca s, 25, placenta, hours after the childbirth in El Llano village, Chimaltenango, 88 km west from Guatemala City. She also gave birth to the four children sitting next to her, Margatita Coxoca s kids. September, 2008
Rural midwife Francisca Raquec, 65, attends Sara Raquec s, 19, childbirth, inside her house. September, 2008
Francisca Raquec, rests next to Guillermo Raquec Aju, 23, who accompany her wife Sara Raquec, 19, during her childbirth inside their house in El Llano village, Chimaltenango. September, 2008
Francisca Raquec, attends Sara Raquec s daughter during her childbirth inside her house. September, 2008
Francisca attends Sara Raquec s daughter during her childbirth inside her house in El Llano village, Chimaltenango. September, 2008
Rural midwife Francisca, attends Sara Raquec s son during her childbirth inside her house in El Llano village. September, 2008
Francisca, is illuminated by Guillermo Raquec Aju, 23, during the weigh of Sara Raquec s son, in El Llano village, Chimaltenango, 88 km west from Guatemala City. September, 2008
Rural midwife Francisca, gets ready after attending Sara Raquec s, 19, childbirth, inside her house in El Llano village, Chimaltenango, 88 km west from Guatemala City. September, 2008
Rural midwife Francisca Raqueq, walks to attend a pregnant patient in Patzun, Chimaltenango, 85 km west from Guatemala City. June, 2008
Rural midwife Francisca Raquec, 65, talks to a patient in her home. August, 2008.

In Guatemala, the maternal mortality index is one of the highest in the hemisphere.  Here, midwifes attend six out of ten childbirths.  Midwives are respected and leading members of their communities.  Most of them have received trainings in hygiene and early detection of possible complications, but high mortality rates persist due to malnutrition, and the lack of suitable infrastructure in isolated rural areas.

Francisca was initiated in the 1980s, when she had to tend to a birth because her community was under siege due to a confrontation between guerrilla and military forces.

Patzún, Guatemala, 2008.