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Southern Anthropologist

Abstract

Some 72 percent of indigenous Mayan women in Guatemala, most of whom live in rural areas far from either a hospital or a clinic like Ixmucane, go to a comadrona, a traditional birth attendant (TBA). for obstetric care (MotherCare 1997). In a country that has the third highest rate of maternal mortality in the Western Hemisphere, comadronas are often the most acces­sible and affordable health-care providers for pregnant women. These comadronas save lives; Mayan maternal mortality rates drop from 3,539 deaths of 100,000 live births, among women who have only their families to attend them, to 146.3 out of 100,000 when a comadrona is present (Kestler 1995). Recent studies have suggested that comadronas are generally able to recognize the early warnings of complications in pregnancy during the period of traditional prenatal care, which begins between the fifth and the seventh month of preg­nancy, but have also reported that many Mayan women would knowingly undertake even a risky labor with a comadrona rather than seek out more medically advanced care at one of the thirty-five National Hospitals (Kestler 1995). Thus, of all the factors contributing to high rates of maternal mortal­ity among the indigenous Mayan population, problems related to the process of care-seeking are among the greatest. This, then, is the question under discussion: why is it that Mayan women in Guate­mala so rarely give birth in the hospital, even when there may be acknowledged dangers in doing so?

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