PURPOSE:
This paper documents and analyzes a model of abortion accompaniment developed by midwives and acompañantas in an Indigenous context in western Mexico. The model aims to create abortion care processes that are safe, culturally grounded, and politically meaningful for women who choose to terminate a pregnancy in territories marked by structural violence, healthcare exclusion, and bodily transformations linked to agroextractive regimes.

DISCUSSION:
Implemented in Purépecha territories with a strong tradition of collective organization and struggles for self-determination, this model emerges in a context of extreme poverty, forced migration, systematic sexual violence (present in over 90% of cases), the persistent presence of organized crime, and chronic exposure to agrochemicals associated with monoculture agribusiness—all of which severely impact women's health and bodies.Adolescents (35–40% of abortion cases) and Indigenous women face multiple barriers to sexual and reproductive health services, including institutional racism, lack of linguistic and cultural appropriateness, and the historical delegitimization of community knowledge. Midwives act as political and health agents, defending bodily autonomy while revitalizing ancestral knowledge through dialogue with biomedicine.Their practice addresses institutional neglect while resisting the coloniality of knowledge and the body.

EVIDENCE WHERE RELEVANT:
The model centers a cosmovision that understands the body as spiritual and relational territory, where abortion is ritualized similarly to birth—not as a clinical event but as a transformative process requiring care, containment, and symbolic closure.This approach integrates pharmaceuticals with herbal medicine, ritual, and embodied practices. It includes emotional and physical preparation, pain and symptom management using local plants, symbolic acts (e.g., planting expelled tissue), and post-abortion care addressing physical, emotional, spiritual, and communal dimensions.

KEY MESSAGE:
Midwifery in Indigenous contexts is a political and collective healing practice. Abortion, redefined through community knowledge, becomes a pathway to restoring bodily autonomy, ancestral memory, and Indigenous women’s dignity amid systemic violence. Education - curriculum 2