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Kaqchikel midwives, home births, and emergency obstetric referrals in Guatemala: Contextualizing the choice to stay at home

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  • Berry, Nicole S.

Abstract

Maternal mortality is highest in those countries whose health budgets are restricted. Practical strategies employed in the International Safe Motherhood Initiative, therefore, must be both effective and economical. Investing in emergency obstetric care resources has been touted as one such strategy. This investment aims to insure significant improvements are made in regional health centers, and a chain of referral is put into place so that only problem cases are attended by the most skilled health workers. This article examines how this model of referral functions in Sololá, Guatemala, where most Kaqchikel Mayan women give birth at home with a traditional midwife, and no skilled biomedical attendant is available at the birth to make a referral. Ethnographic data is used to explore reasons why women do not go to the hospital at the first sign of difficulty. I argue that the problem frequently is not that Mayan midwives, their clients and families fail to understand the biomedical information about dangers in birth, but rather that this information fails to fit into an already existing social system of understanding birth and birth-related knowledge.

Suggested Citation

  • Berry, Nicole S., 2006. "Kaqchikel midwives, home births, and emergency obstetric referrals in Guatemala: Contextualizing the choice to stay at home," Social Science & Medicine, Elsevier, vol. 62(8), pages 1958-1969, April.
    • Handle: RePEc:eee:socmed:v:62:y:2006:i:8:p:1958-1969
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    References listed on IDEAS

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    1. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    2. Maine, D. & Rosenfield, A., 1999. "The safe motherhood initiative: Why has it stalled?," American Journal of Public Health, American Public Health Association, vol. 89(4), pages 480-482.
    3. Chapman, Rachel R., 2003. "Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk," Social Science & Medicine, Elsevier, vol. 57(2), pages 355-374, July.
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    Cited by:

    1. Siddiqui, Shayzal & Smith-Morris, Carolyn, 2022. "Professional competition amidst intractable maternal mortality: Midwifery in rural Pakistan during the COVID-19 pandemic," Social Science & Medicine, Elsevier, vol. 313(C).
    2. Pourette, Dolorès & Pierlovisi, Carole & Randriantsara, Ranjatiana & Rakotomanana, Elliot & Mattern, Chiarella, 2018. "Avoiding a "big" baby: Local perceptions and social responses toward childbirth-related complications in Menabe, Madagascar," Social Science & Medicine, Elsevier, vol. 218(C), pages 52-61.
    3. Brunson, Jan, 2010. "Confronting maternal mortality, controlling birth in Nepal: The gendered politics of receiving biomedical care at birth," Social Science & Medicine, Elsevier, vol. 71(10), pages 1719-1727, November.
    4. Smith-Oka, Vania, 2012. "Bodies of risk: Constructing motherhood in a Mexican public hospital," Social Science & Medicine, Elsevier, vol. 75(12), pages 2275-2282.
    5. Arps, Shahna, 2009. "Threats to safe motherhood in Honduran Miskito communities: Local perceptions of factors that contribute to maternal mortality," Social Science & Medicine, Elsevier, vol. 69(4), pages 579-586, August.

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