REPLAY: EBB 283 - How Colonialism, Environmental Instability, & Politics Impact Birth in Puerto Rico with EBB Instructors, Tania Silva Meléndez and Tamara Trinidad González, CPM

Evidence Based Birth®

Rebecca Dekker

Pregnancy, Health & Fitness, Childbirth, Parenting, Birth, Medicine, Kids & Family, Doula, Obstetrician, Midwife

4.6 • 978 Ratings

🗓️ 17 September 2025

⏱️ 56 minutes

🔗️ Recording | iTunes | RSS

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Summary

In today's episode, I'm revisiting a deeply important conversation with Tania Silva Meléndez and Tamara Trinidad González, two inspiring birth workers and Evidence Based Birth® Instructors based in Puerto Rico.

Tania and Tamara share their personal journeys into birth work and what led them to become changemakers in Puerto Rico's birth community. They speak candidly about the immense challenges families face, from one of the world's highest cesarean rates to the ongoing impacts of colonialism and systemic barriers within maternal health care. You'll hear what it's like to provide midwifery services in an environment where midwives aren't officially recognized, and the impact this has on those seeking safe, respectful, and dignified care.

We also dive into the powerful grassroots and community-led efforts Tania and Tamara are leading, including legislative advocacy, innovative education, and direct, compassionate support for families striving to improve birth outcomes and claim reproductive rights on the island. Together, we explore both the heartbreak and the hope shaping Puerto Rico's current birth landscape, and highlight meaningful ways listeners can join in solidarity with these efforts.

Content note: obstetric violence, colonialism, infant death, abortion, poor outcomes, maternal health deserts, gender based violence

(03:03) Midwifery Leadership and Collaboration
(07:27) Journey to Home Birth Choices
(12:32) Puerto Rico Birth Control Campaign Impact
(13:57) Obstetric Violence and Doula Integration
(17:36) Midwife-Doctor Collaborative Care Solutions
(20:04) Hospital System Communication Challenges
(23:48) Puerto Rico: A Modern Colony
(27:46) Puerto Rico Investment Gentrification Issue
(33:30) Community-Led Family Support Initiative
(34:50) Youth Engagement Through Visual Education
(38:46) Puerto Rico Midwives Day Law
(44:14) Birth Summit Collaboration in Puerto Rico
(46:05) Midwife-EMT Collaboration Curriculum
(51:19) Puerto Rico Birth Rate & Hospital Crisis
(53:50) Supporting Midwifery and Access in Puerto Rico

Resources

If you are interested in joining with Tania and Tamara and volunteering your time or skills to help them reform the maternal health system in Puerto Rico, they are currently looking for volunteers with experience in law, public relations, funding, data collection, research, and writing. OR if you have resources, or access to connections that could help fund their work, please email [email protected].
Learn more about Caderamen, a nonprofit organization that has a service program that is called SePARE, which offers education and doula services, midwifery services and naturopathic medicine services, social workers, mental health by clicking here.
Learn more about the Asociación de Parteras of Puerto Rico here.
Learn more about Alimentación Segura Infantil, a community-based organization born after the impacts of Hurricanes Irma and Maria in 2017 to support breastfeeding and chestfeeding families in their lactation journeys by clicking here.
Learn more about Observatorio de Violencia Obstétrica in Puerto Rico here.
Learn more about Las Mingas de Aborto, an abortion doula collective that offers free support in Puerto Rico here.
Check out the work by Puerto Rican journalist Biana Graulau here.
Read more about the history of Puerto Rico:
- How to Hide an Empire by Daniel Immerwahr
- Puerto Rico: What Everyone Needs to Know by Jorge Duany

For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Transcript

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0:00.0	Hi, everyone, and bienvenitos. On today's podcast, we're going to talk with Tanya Silva Melendez
0:06.0	and Tamara Trinidad Gonzalez, birth workers and evidence-based birth instructors about giving birth and midwifery care in Puerto Rico.
0:14.8	Welcome to the evidence-based birth podcast. My name is Rebecca Decker, and I'm a nurse with my PhD,
0:20.8	and the founder of evidence-based
0:22.5	birth. Join me each week as we work together to get evidence-based information into the hands of
0:28.1	families and professionals around the world. As a reminder, this information is not medical advice.
0:34.6	See eBbirth.com slash disclaimer for more details.
0:38.3	Hi everyone and welcome to the evidence-based birth podcast. Today I'm so excited to share with you a replay from a very important episode we recorded with Tanya and Tomata. As a content note, this podcast episode does contain discussion of obstetric violence and colonialism.
0:56.3	I also want to give you a heads up that if you listen all the way to the end, we will give you
1:00.2	a current update on the situation in Puerto Rico that Partera Tamara was kind enough to send to us.
1:06.0	If you would like to read a transcript of this episode in Spanish, please visit the link in the show notes,
1:11.4	or you can watch the captions in Spanish on YouTube.
1:14.6	If desire to read a transcription of this episode in Spanish, visit the enlase in the
1:20.1	program, or you can see the subtitles in Spanish in YouTube.
1:25.3	And now I'd like to introduce our honored guests.
1:27.9	Tanya Silba Melendez, pronouns she-her, is a certified birth, postpartum, and abortion dula,
1:34.0	serving families in Puerto Rico since 2009.
1:37.5	She's also a certified childbirth educator and breastfeeding, chestfeeding,
1:41.0	education, and counselor.
1:43.3	Tanya supports all kinds of families with evidence-based information, empathy, and respect.
1:48.9	She hosts supports groups, teaches breastfeeding and chestfeeding classes, and childbirth
1:53.5	classes to expectant parents and birth professionals, both in her private practice and in the
	...

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