“They study for six years. We study for generations”: Renegotiating birth, power, and interculturalidad in the Ecuadorian Amazon

This article explores how kichwa midwives negotiate interculturality as both cultural knowledge-holders and clinical practitioners. Kichwa midwives in the Ecuadorian Amazon face a dynamic set of barriers in their position as healers, birth care givers, and indigenous activists, including intercultural government policies aimed to delegitimize them, consistent othering in relationship to biomedicine, and shifting generational involvement in kichwa health practices. Midwives engage in a complex set of relationships with the state, relying on it for the “rights” to practice their knowledge, while simultaneously being undermined by the state's promise of interculturality. I demonstrate how kichwa midwives practice “strategic entanglement” as a form of resistance and argue for a renegotiation of the definition and role of interculturalidad in the context of state-controlled birth care.