A special time for a woman, pregnancy can be especially complex for teens and even more if you don’t have a good understanding of the process taking place in your body. Helping pregnant women — especially Latinas — find answers to their questions is a job that OB/GYN specialist Mariana Amaya took on when she was doing her undergraduate major project in Yuma, AZ many years ago.
“I created a basic and simple lecture series about puberty to be delivered at parenting groups or schools,” Dr. Amaya told VOXXI. “I was amazed at the questions asked by grown women who didn’t understand the basics. They didn’t know how to control fertility or protect from sexually transmitted diseases.”
Dr. Amaya was born from Mexican fieldworkers who, now in their late 50s, continue picking lettuce in one season, cantaloupe in the next. Neither her mother nor her father finished high school but encouraged their four children to further their studies.
Dr. Mariana Amaya: Making a choice
“’There are not many options,’ my parents said to us. We either dropped from school and go work on the fields or, we went to school,” Dr. Amaya said.
“They took us to the fields. Seeing the physically demanding job, how hard they worked and how little they made… as a child, the decision was easy,” she recounts. “I opted for school. Actually, school was a pleasant experience. Teachers were understanding and supportive. Little did I know the impact that decision would have later.”
Dr. Amaya married another Mexican-American physician at age 25 and now has a private practice in downtown Phoenix. Around 85 percent of her patients are of Hispanic origin, mostly from Mexico, Guatemala and Honduras.
Being a first generation Mexican-American, Amaya is aware of the customs and traditions of the people that come to see her.
“I can use my background to relate to patients. I speak in Spanish with them. I try to relate from the knowledge I have of their culture,” she said.
Dr. Amaya focuses on teaching patients how to eat healthy
“In their country of origin, the mother teaches the daughter how to cook,” Dr. Amaya said. “But here in the U.S. grandmas are not around and mothers are working. There is nobody to teach youngsters and they go to fast food. They don’t even understand what creates obesity. They think it’s in their genes, not related to what you put in your mouth.”
“In their culture, exercise is not something you’re taught to do. Traditional diet is rich in carbohydrates. They drink sodas instead of water. I tell them, ‘choose this instead of that.’ But they go home and grandmas and moms tell them to do the opposite.”
According to Dr. Amaya, some beliefs can get in the way of staying healthy.
“I am concerned about nutrition during pregnancy. It’s not uncommon that Hispanic women gain excessive weight and then don’t lose back the weight,” she explained.
She offers education and support and encourages open communication.
Respect for their culture and traditions is especially important among Hispanics. Changing their beliefs about the origin of disease is difficult.
Dr. Mariana Amaya: ‘It’s costly to have a baby’
Dr. Mariana Amaya’s average client age is between 18 and early 20s with a significant number of teenagers and women in their late 30s.
Most of Dr. Amaya’s clients are covered by Medicaid, which means they are below the poverty level. About 25 percent are undocumented immigrants that either pay expenses out of their pocket or receive pro-bono services, except when they deliver at the hospital, since it’s considered a medical emergency.
But even when the services are pro-bono, “diabetics need to pay for their glucometer and medication, and they have to pay for blood tests or ultrasound. It’s really costly to have a baby,” Dr. Amaya says.
She doesn’t do home deliveries or work with midwives. “The hospital where I work—St. Joseph’s—allows midwives. But since we’re in private practice, and to avoid liabilities, we haven’t taken midwives. I believe though, that they provide a valuable service.”
Fostering sound decision-making
“Women in the community are sometimes not educated enough to understand they need prenatal care,” Dr. Amaya said.
Many of Dr. Amaya’s patients are single mothers and haven’t been on birth control.
“They are not educated enough to plan the pregnancy and in the Hispanic culture sexuality is taboo. They just don’t address the topic. Teens experiment and explore and then the moms raise the children.”
Dr. Amaya sees many cases of sexually transmitted disease. “A lot of Chlamydia,” she said. “They have hard time understanding where it comes from or their implications. Their husbands tells them that they got it from the toilet seat or because of sharing underwear.”
Trying to engage young women in an ongoing dialogue to foster responsible decision-making and resiliency is Dr. Mariana Amaya’s main goal. She believes she is a positive role model and that empowering teens to make healthy decisions will have a positive impact on their future.