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The After-Graduation Series: Learning about women’s health and family planning in Guatemala with Manos Abiertas

Since the middle of February, I’ve been working as an apprentice at Manos Abiertas (in English, “Open Hands”), a local women’s health clinic and natural birth center. In addition to providing general women’s health care in both urban and rural settings of Guatemala, they also offer family planning and natural births. Manos Abiertas allows women in Guatemala an alternative to the standard options: going to over-crowded health facilities or paying high, usually unaffordable, prices for private care.

Founded by Hannah Freiwald, a professional midwife from Germany with over fifteen years of experience (and she’s attended over 1300 births at the last estimate), Manos Abiertas sees many women who’ve had a birth experience where they felt they had little or no control over their body. Others find it through TV advertisements or referrals from their friends and families. Both the current directors of the two Manos Abiertas clinics (one in the capital, Guatemala City, and one in Ciudad Vieja–very close to Antigua, Guatemala) came to the clinic after having their children naturally with Hannah.

You might be wondering–what exactly is Laura doing working in a women’s health clinic and natural birth center? From all I write about farming and composting, you might be surprised that I also have a passion for women’s health and family planning.  What does this have to do with sustainability studies? Well, let’s take a look at the United Nations Millennium Development Goal #7–Environmental sustainability. Combined with Goals 3, 4, and 5–Gender Equality, Child Health, and Maternal Health respectively–and a little explanation, you’ll have your answer. According to Family Health International (FHI), “Many women want fewer children, and 217 million have unmet needs for contraception. A family with fewer children needs less food, land, and water and puts less pressure on a country’s forests and tillable land. Moreover, family planning is five times less expensive than conventional green technologies for reducing atmospheric carbon dioxide that leads to climate change.” Let’s put this into context for Guatemala, where 28% of Guatemalan women report an unmet need for family planning (Population Reference Bureau, 2010). One of the main goals at Manos Abiertas is providing affordable health services for all women–even if it means providing services and medication for free. Even though they operate on a sliding scale, Manos Abiertas often operates at a loss. Funded primarily by Planned Parenthood Federation of America (PPFA), Manos Abiertas has served over 1700 women since opening in March of 2008.

With a fertility rate of 4.4 and with 42% of the population under the age of 15, Guatemala’s population is only increasing. It also doesn’t help that the government recently started an initiative to give 300 Quetzales (at about $7.5 USD for 1 Quetzal, that’s $40 USD) per month for each child per qualifying family.While this might sound like good governance, taken in the context of the country, it’s turned out to be like paying women to have more children. I just heard someone talk of a 47-year-old woman having another child just so she can receive the extra $40 a month to pay for food, rent, and other necessities to live. Combining all these factors–increasing population, high food costs, and land limitation–it seems to me that family planning is one of the best way to combat climate change around the globe.

I’ll write more about Manos Abiertas soon–plans for the future are helping to build a medicinal herb garden and learning to use these herbs to make tinctures, and also learning about the vast world of publicity and fundraising.

Laura Stephenson is a recent environmental science graduate from the University of North Carolina-Chapel Hill, focusing in environmental and community health. She is currently studying Spanish in Antigua, Guatemala. Laura writes the “After” Life of an Environmental Studies Student series, telling stories of the activities and endeavors of environmental science and studies students after graduation.

Posted on: May 6, 2011, 9:00 am Category: The "After" Life of an Environmental Studies Student Tagged with: , , , ,

11 Responses

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  1. Nothing can be more satisfying that having a job that helps, motivates and inspires other people. Keep up the good work!

  2. Laura Stephenson said

    Our new website for Manos Abiertas!! You can find us here:

  3. Laura Stephenson said

    Here’s a follow-up article on the relationship between family planning and the environment that a local family planning organization posted on their blog:

  4. Laura Stephenson said

    Hi Jan!

    Thanks for reading–I’ll have many more stories of these incredible women to come.


  5. Many thanks for sharing about these fabulous women & their sense of community.

  6. Laura Stephenson said

    Hi Hannah,

    Thanks for reading! Thanks to you, I’m learning something new everyday with Manos Abiertas.


  7. Laura Stephenson said

    Hi Sarah,

    There are a variety of ways to support Manos Abiertas, and we’re in the process of updating our website right now so it can all happen electronically. I’ll be sure to post where you can find the site on here when we’re finished.

    Thanks for your interest,

  8. Laura Stephenson said

    Hey Adriana,

    Thanks for this article! According to O’Neill et. al., “Aging can reduce emissions in the long term by up to 20%, particularly in industrialized country regions.” They go on to say that since the aging population is a lesser part of the labor force, they are contributing less to carbon emissions. I find that very interesting. Here’s where you can find access to the article–

  9. Adriana said

    amen. here’s a related read: O’Neill, B. et al. (2010). “Global demographic trends and future carbon emissions”. Proceedings of the National Academy of Sciences, 107(41): 17521-17526.

  10. Sarah said

    Wow! This is really incredible, is there a way that I can support Manos Abiertas?

  11. Hannah said

    I’m happy that I am not the only one who seems to be getting something out of your internship, Laura!!

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