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Unsafe Motherhood

Unsafe Motherhood: Mayan Maternal Mortality and Subjectivity in Post-War Guatemala

Nicole S. Berry
Copyright Date: 2010
Edition: NED - New edition, 1
Published by: Berghahn Books
Pages: 260
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  • Book Info
    Unsafe Motherhood
    Book Description:

    Since 1987, when the global community first recognized the high frequency of women in developing countries dying from pregnancy-related causes, little progress has been made to combat this problem. This study follows the global policies that have been implemented in Solola, Guatemala in order to decrease high rates of maternal mortality among indigenous Mayan women. The author examines the diverse meanings and understandings of motherhood, pregnancy, birth and birth-related death among the biomedical personnel, village women, their families, and midwives. These incongruous perspectives, in conjunction with the implementation of such policies, threaten to disenfranchise clients from their own cultural understandings of self. The author investigates how these policies need to meld with the everyday lives of these women, and how the failure to do so will lead to a failure to decrease maternal deaths globally.

    eISBN: 978-1-84545-996-3
    Subjects: Anthropology, Sociology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-v)
  3. List of Figures
    (pp. vi-vi)
  4. Acknowledgments
    (pp. vii-x)
  5. Prologue. The Story of Rosario
    (pp. xi-xx)

    On a January morning in 2003 in the village of Santa Cruz La Laguna, Guatemala, Julio came to my house, overheated and out of breath. There was, he said, a ʺsmallʺ problem. His sister-in-law, Rosario, had just given birth to a baby boy, after which she had passed out. She was still unconscious.

    I had known Rosario for several years, and was very fond of her, as well as impressed by her ambition and intelligence. Rosario came from one of the most economically prosperous households in the village, and was one of the few young women to graduate from high...

  6. Introduction. The Specter of Death
    (pp. 1-22)

    This book is about maternal mortality, or pregnancy-related death, and its impact. My focus is to explore some consequences of how the global community has tried to prevent these deaths from happening. I argue that the global campaign to decrease maternal mortality has actually created barriers to reducing deaths and also threatens to make some of the very communities that it is designed to help even more vulnerable.

    In the more than twenty years that pregnancy-related death has been on the international agenda, our understanding of it has become overly circumscribed. Essentially, maternal mortality has been reduced to a medical...

  7. Chapter 1 Life, Birth, and Death in the Village
    (pp. 23-59)

    When I first arrived in Santa Cruz I wondered how living in the shadows of three enormous volcanoes for generations would impact people in the village. The longer I stayed in Santa Cruz, the more I began to regard the volcanoes as pictures on the wall—what was far more relevant in organizing our lives was that we lived perched high on a mountainside. The terrain leading to Santa Cruz was so steep that no road had been built connecting the village to the outside world. Rather, to get to Santa Cruz, you had to come by boat, and then...

  8. Chapter 2 Coming to the ER: Analysis of an Interaction
    (pp. 60-84)

    After I had observed about thirty obstetric emergencies enter the ER, I felt like I had a good enough idea of what was going on to start doing audio recordings. But before I could record I had to figure out how to set up my equipment. I brought the rather long microphone and the minidisc recorder that I would use and enlisted the help of the doctors, nurses, and others to create a setup. How and where would I suspend my mic? It needed to be placed somewhere inconspicuous, yet easy for me to reach. The more centrally located, the...

  9. Chapter 3 Global Safe Motherhood and Making Local Pregnancy Safer: The Spin and What It Covers Up
    (pp. 85-107)

    I was quite taken aback the day that I typed ʺsafemotherhood.orgʺ into my web browser, hit Enter, and the page was no longer there. Thinking that I had typed the name incorrectly, I tried again. I was only convinced that it was really gone after I searched for the address on Google, got the non-existent page, but was able to see what I was looking for in the cached page. Could the Safe Motherhood Initiative just disappear? What is the point of erasing the page? Why was it later recreated, but without any useful links to past pages or to...

  10. Chapter 4 The Indio Bruto and Modern Guatemalan Healthcare
    (pp. 108-129)

    Tuesday afternoon, four relatives (three males and one female) brought Petrona to the emergency room of the San Juan de Rodas Hospital in Sololá, Guatemala, for a birth-related complication. Petrona lived in the same neighborhood as Ramos, one of the auxiliary nurses who worked in the hospital. As Ramos wheeled her into the ER he related her information to the nurse on duty. Two days ago, Petronaʹs family came to find Ramos in the village because Petrona was not recovering after giving birth. He went to the house, and after seeing her condition Ramos told her family that Petrona had...

  11. Chapter 5 Everyday Violence: From a Kaqchikel Village to the Nation and Back
    (pp. 130-159)

    At the end of the second decade of Safe Motherhood, a number of international organizations joined together to sponsor the third conference on maternal mortality. The agendas of the past conferences in Nairobi and Sri Lanka focused on strategies and interventions to reduce maternal mortality. The Women Deliver conference, however, tried a different tack (Gill, Pande, and Molhotra 2007; 2007:196). The premise of the conference was that we already understood how to decrease maternal mortality—increase funding to maternal healthcare (including prenatal care, skilled attendance, and emergency obstetrics). What was lacking was the political will from donors and governments to...

  12. Chapter 6 Praying for a Good Outcome: Staying at Home during Obstetric Problems
    (pp. 160-189)

    The part of my research that seemed so counterintuitive and so compelling was this simple question: Why would a woman die at home rather than seek help for a birthing problem? Were the Kaqchikel people in Santa Cruz a group of ideological radicals who felt, as one observer often put it, ʺtradition is thicker than bloodʺ? Would they really rather die than break their traditions?

    Several of the alternative lay theories that I heard bantered among health workers were no more palatable. Was the Kaqchikel village structure so patriarchal that women had no choice and were just subjugated to the...

  13. Conclusion. Putting the ʺMaternalʺ Back in Maternal Mortality
    (pp. 190-195)

    In 1985, Maine and Rosenfield asked a pivotal question: Whereʹs the ʺmaternalʺ in ʺmaternal-child healthʺ? Why were we only focused on mothersʹ capacity to improve or endanger their childrenʹs health, rather than on the health of mothers in their own right? This simple question transformed our approach to maternal health and created a space for the international community to try to decrease maternal mortality. Yet over two decades later, our progress toward that goal is debatable.

    What can we learn about maternal mortality from focusing on what it means to be a mother, rather than by focusing on the biomedical...

  14. Notes
    (pp. 196-218)
  15. Bibliography
    (pp. 219-235)
  16. Subject Index
    (pp. 236-250)
  17. Index to Ethnographic Vignettes
    (pp. 251-251)