Metaphors to cure by: Tojolab'al Maya midwifery and cognition.

The southern Mexican state of Chiapas has the highest concentration of indigenous peoples in Mexico and ranks first among all states for the percentage of births attended by nurses or midwives. Efforts to improve maternal and child health in this region, therefore, must engage indigenous midwives and healers in a meaningful way, which presupposes an understanding and respect for the area's rich ethnomedical traditions. To this end, the present paper synthesises findings of in-depth ethnographic fieldwork by the author among Tojolab'al Mayan midwives. Several cultural themes underlying cognitive models of reproductive health are presented. Results indicate that several prominent metaphors relating to natural cycles of agricultural growth, death and regeneration form a bridge that links human fertility and illness to a living, dynamic cosmology. As suggested by quantitative analyses presented here, these 'metaphors to cure by' provide clues that are likely to prove central to the translation of public health programmes and clinician-patient communication in this population.