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Rubi Rodriguez Nieto is a Mexican-born anthropologist, doula, and community organiser. She also manages the volunteer team at Birth Companions, a London-based charity that supports disadvantaged pregnant women, mothers and babies. She recently started RedMAMI: The Latin American Migrant Maternities Network to tackle systemic inequality in maternity care in her community.
In our conversation for The Fifth Wave, she reflects on her family heritage of traditional healing practices, her intellectual debt to Indigenous autonomous organisations, and outlines concrete pathways to providing migrant women with culturally aware and empowering maternity care.
What inspires your work in maternity care?
I grew up in a small town called Ciudad Valles, in Mexico. It’s a really culturally rich region with a strong presence of Indigenous communities. Even though I didn’t grow up learning an Indigenous language, our traditions are intertwined with their cultural practices.
I also grew up in a family of healers, with practices unconventional to Western medicine. I am marked by the way my grandma used to heal us with touch, with food, with songs, when we’d get ‘susto’ (startled), said to harm your spirit and make you vulnerable to illness. These beliefs are part of what it means to be a Mestiza woman1.
I then left my town to study anthropology at university, where I started thinking more deeply about my background and the complexities of cultural identity. Passionate about social justice, I got involved in environmental activism – which, in Latin America, tends to be about opposing mega infrastructure projects and supporting Indigenous communities’ right to self-determination.
One of those communities I’ve always admired are the Zapatistas. They are an autonomous group led by Indigenous people in Mexico’s southern Chiapas state, where they’ve now recovered a substantial amount of territory. They started out as the ‘Zapatista National Liberation Army’ with the explicit goal of freeing themselves from 500 years of colonial and capitalist oppression – a process they call ‘The Long Night’. They organised clandestinely, and in the 90s became an armed movement and started recovering their ancestral territories.
The movement is now over 30 years old. They function in mirror resistance to the intentional erasure, starving, discrimination and exclusion from political life of Indigenous people: so they have their own governance, currency, food, health and education systems. More recently, they’ve been raising funds to open surgery centres, because the children who were born in Zapatismo are now studying and preparing to take on more specialised roles in their communities.
I’ve visited and learned from those communities several times, and I always carry their teachings with me. One thing the Zapatistas say is “another world is possible”. We are made to believe that the current capitalist system is the only way. But after 30 years, they are still standing, proving it is possible through regaining power and organising. It’s a great message of hope.
Their political ideology inspired many of the principles of collective organisation and self-determination which infuse my work with mothers today. That’s the intellectual terrain I come from.
You ended up leaving Mexico. Why?
At university, my research focused on how Indigenous agriculture adapts to competition from bigger players. I started working in a community-managed forest, where locals used reforestation and other techniques to preserve their environment, as well as protesting the construction of a highway through their lands. We organised visits with schools and organisations from the nearby city, so they’d get a sense of the work and resistance involved in keeping their air and water clean. I also got involved in national political activism.
That was twelve years ago. In those years, it started becoming dangerous for anyone to be politically outspoken, particularly for journalists and women, and especially in Veracruz where I lived. My family received threats to my safety, my compañeros de lucha (fellow activists) were intimidated with physical violence. So I made the difficult decision to leave. It wasn’t paranoia – barely a year after I left, two known critics of Veracruz governor Javier Duarte were murdered in an atrocious massacre.
Has the situation gotten better with the new president, Claudia Sheinbaum?
It’s definitely not as bad. The historical vectors of instability haven’t changed much: we’re close to the US and their oversupply of guns, we have a perpetual debt to the World Bank. But Duarte is now in prison for corruption, so there was some level of accountability.
Greater transparency also has its downsides: Sheinbaum has a lot more eyes on her, and developing a country always implies trade-offs. For example, the Mayan Train project is quite controversial, because it brings dynamism and infrastructure to the long-forgotten South, but also raises serious environmental and safety concerns.
Your son was born in the UK. What was your experience with pregnancy and perinatal care?
At some point in life comes the ‘baby wave’. There’s something about sharing in that experience and not wanting to do it alone. As I left Mexico, most people my age I knew were having babies. I was in a very serious relationship, so it felt like the right time.
Another big drive behind my desire to become a mother was the Zapatistas. Their thinking is, the people who’d rather we didn’t exist are reproducing, so why wouldn’t we? If we want to stay alive, if we want to build the future we believe in, we need more Zapatistas. We need to grow as a community. This is an especially strong sentiment in Indigenous communities, just like in other groups that have survived attempts at forced sterilisation and eradication: we will not be erased.
I was seeing some people around me have children, and I thought, ‘I don’t necessarily want to live in a world where their kids are in charge of the country’. We want the children of the people that surround us to take part in building the future.
I had my son just over a year after I moved to the UK. It was hard, it was isolating, it was very lonely. Coming from Latin America, our culture of obstetrics is cut through with deep misogyny and violence, which makes the bar extremely low for the quality of care we feel we deserve. In Mexico, you are made to feel like you know nothing – the doctor knows. The way you eat is wrong, your weight is wrong, your exercise is wrong. Everything about you is wrong, and little by little, you get stripped of any power you had to advocate for yourself. Some women recall being treated ‘peor que una chancla’ – worse than a slipper.
Coming from that context, I was very grateful for my care in the NHS. I didn’t have to pay, I could be seen by a midwife, and she actually listened during our appointments. She made me feel safe and confident. However, when I gave birth, it was a different story. I wasn’t informed or supported enough, my history and background weren’t taken into consideration. Even though I spoke English, when someone gives you technical information very quickly in the middle of labour, it’s hard to feel like you truly know what’s going on. And I know now there were resources they could’ve shared, organisations they could’ve told me about to help me feel less alone.
It took me many years to finally acknowledge that my needs hadn’t been met. I always sort of said, ‘Yeah, I felt like a train ran over me, but it doesn’t matter, I have my baby!’
My highest point at the time was when I attended a breastfeeding group. I was about to have mastitis, and ended up cancelling my GP appointment. Theirs was all the help I needed. I showed up, interacted with a few people, got some advice, and everything was suddenly more positive. The mere fact of someone acknowledging that what I was going through was rough, that they were there – it changed a lot for me.
Later on, after I came out of the fog that is caring for a tiny baby, I needed to decide what to do with my life. Being a migrant and being a mother is similar in that way: as a migrant, you often have to rebuild a career from zero in a new context, and as a mother, your brain and body takes some time to guide you to who you are as a new person, with a child that fully depends on you. I looked into becoming a lactation consultant, but it required many years of training. I decided to become a doula.
I did two different trainings. The first one felt disconnected from my values: the trainers were renowned, the clients wealthy, and the whole thing made having a doula feel like a luxury item. The second one was amazing. The woman I trained with founded Doulas without Borders, so we had many shared concerns – coming from abroad, how do we empower someone to advocate for herself? If she’s never been given the opportunity to be the leading agent in her own medical care, how do we change that?
As a doula, you provide ‘culturally competent’ perinatal care to women in your community. What does that look like, in practice?
I’d pinpoint two layers of cultural awareness. One, as I mentioned, is awareness of the medical culture we carry in our luggage. Knowing that Latin America has some of the highest rates of C-section and obstetric violence, and understanding how that affects the way we relate to doctors, to medical environments.
The second is a decolonial awareness that for us, ‘health’ goes beyond Western perceptions. The hospital is an authority, in the same category as the state or the law. But then we go home, and our grandmothers, our mothers, our aunties see it differently. For example, the Indigenous understanding of health where I’m from is based on a balance between hot and cold. Any imbalance leads to illness.
So if you went outside without a coat, or early at dawn, your body was thrown off-balance. To heal, you need something hot, like nurturing food, to restore the balance. Warmth can also come from the act itself of someone caring for you, or through a ‘rubbing’ – we have a lot of touch-based healing. I once explained to a psychologist the way my grandma would press on specific spots in order to heal us, and she said, ‘Oh, that’s EFT!’ My grandmother didn’t finish primary school, but she had knowledge that’s since been theorised by Western medicine.
So cultural competency means understanding that we navigate between our traditional, home care, and our less-than-ideal relationship with medical culture. My clients continue to teach me about it every day: I can see them balancing these two paradigms when thinking about their own pregnant body or birth.
Could you describe the practice of the Rebozo ceremony?
In rural Mexico, a woman’s postpartum recovery process typically involves a woman healer, a mother, or an auntie coming to her house and giving her a bath of herbal water. It’s a sacred moment, meant for her to reconnect with her body as well as with higher forces. We don’t even call it a ‘ceremony’, it’s just what is done. I had my own back home when my son was 6 months old, and I wanted to integrate it into my own doula practice. As a Mestiza woman, I feel I have a responsibility to honour these Indigenous traditions that otherwise would be either forgotten or appropriated.
I start with a massage, connecting my energy to the person as a whole as well as my own guides, my abuelas, my ancestors. Then I prepare the bath, adjusting the herbs depending on how she wants to feel coming out of the ceremony. I use locally sourced (European) herbs – there are centuries-old postpartum healing traditions here as well, not just in Mexico!
The bath is a very tender moment – it’s as much for their bodies as their minds. Sometimes they want to chat or confide in me, sometimes they want me to pour water over them, sometimes they just want to sit in silence with the dim lights. One woman told me, ‘No one has even given me a bath since I was a baby, yet I do this for my kids every day.’ It’s a rare moment for them as a caregiver to receive the care they deserve.
You’ve just started RedMAMI, a London-based network of community support and resource sharing for Latin American women and mothers. What sparked its creation?
Discussions with friends about parenting issues specific to us Latin American migrant mothers. For example, one of my friends didn’t feel like people in the UK understood her fears around girls’ safety, rooted in her experience of being a woman in Latin America. We shared stories with each other of being a mother in a foreign country, of feeling different from others at the school collection or nursery.
Culturally, we’re more “huggy” and physically close with our kids: I had a (white British) therapist once tell me I didn’t set enough boundaries with my son because I let him sleep in my bed every once in a while. We’d just moved flats then, he was 8. I thought, ‘I used to sleep in my mum’s bed until much older!’
We realised that there are vital cultural elements to parenting that need to be acknowledged. Our culture of care is different, our culture of mothering. Our fears, too. That’s how the group was formed. We wanted to reduce the isolating feeling of, ‘is this normal? Am I doing this right?’.
Because of our specific relationship to medical culture, we also wanted to help each other exercise having a voice. We see each other in waiting rooms and discussion groups, try to look out for each other, but we don’t always have a space to share our experiences. RedMAMI is that space. It’s there to spread information, support women to be more empowered, in their own voice but also by having advocates in and outside the labour room, so they feel confident to demand better care.
Speaking of advocates in the labour room, a big focus of RedMami’s work is on interpreters. You cite the 2024 perinatal confidential enquiry, which reviewed the care of 24 recent migrant women with language barriers whose babies died. The study showed that while 96% of them needed an interpreter, only 27% used one. What are the main obstacles to accessible communication, and what are the consequences?
The first problem is that most midwives don’t seem to know what the process is to request an interpreter. And when they do, it’s often long and complicated, ill-adapted to the swift decision-making childbirth calls for.
The second is that they have a very limited amount of time to dedicate to each woman – and handling language barriers takes time. You might need to ask the attendant to repeat something two or three times, and by the fourth time, you just give up. Us migrant women, we have our pride, same as anyone else: we don’t want to come across as not understanding anything. So you say, ‘okay’. Your face is not saying ‘okay’. But the midwife doesn’t have time to pick up on your body language, she has three other women to attend to, she’s under-resourced and underpaid.
I’ve seen improvements in the last couple of years: I recently came across a specialist midwife who works exclusively with refugees and asylum-seekers. She works across four hospitals, so she’s obviously stretched, but it’s a start.
In terms of consequences, when you don’t fully understand what someone explains to you, it’s very difficult to know your options, feel confident to question things or ask for clarifications. It affects how you advocate for yourself, accepting procedures and medicalised pathways that you might not otherwise have wanted. If you have prior vulnerabilities in your history and didn’t feel confident enough to disclose them, that can also lead to tragic outcomes.
The other repercussion of women lacking accessible information is that some are going to seek out that information from friends and relatives, where the most traumatic stories tend to get shared the most – and fear does not aid a good birth outcome. Fear inundates your body with adrenaline, inhibiting the production of oxytocin which is essential to birth. What you need in the birthing room is to be fully present, confident, and trusting of the people caring for you.
What does it mean to be a part of RedMAMI?
We have two levels of participation. There are those who simply want to get support, meet other mothers, receive guidance and be better informed. That works through community events and a WhatsApp group. The second level involves organising the network and being part of the decision-making. It’s horizontal, anyone can bring their ideas to the table.
We also want to hold thematic workshops and create charts in Spanish and Portuguese to help walk women through ‘who’s who’ in maternity care. There is a lot of UK-specific terminology, like gas and air or health visiting, that we can help clarify. At this stage, we’re mostly determining what resources are needed: asking people about their needs, where they feel they struggle the most, and how we can help.
In the meantime, we’re holding each other, to feel less alone. We just had the first open meeting, and interestingly, the people who came were more on the giving than the receiving side of care. There was another doula, a lactation consultant, a pediatrician – all wanting to prevent other women from going through negative maternity care experiences. From feeling lost, unheard, unseen.
Thank you for all your insights and wisdom, Rubi. Finally, a question I like to ask all my guests: who do you care for, and who cares for you?
I care for Emilio, my son. He’s ten years old and an amazing little boy. My boyfriend cares for me, cooks for me. And even though most of them aren’t in the UK, the people who mostly hold me emotionally are my friends.
Of mixed Indigenous and European descent.
Regarding the topic of the article, what if trully culturally aware care, like Rubi’s insights suggest, transformed all perinatal services to be holistic and empowering for everyone?
This was fascinating, and the bathing ceremony sounds absolutely lovely.