Hypertensive Mothers, Obstetric Hemorrhage, and Infections: Biomedical Aspects of Maternal Death Among Indigenous Women in Mexico and Central America

Abstract

Maternal death continues to be a major public health problem among indigenous women in Mexico and Central America. When compared with nonindigenous women in the same country, and in some cases the same region, indigenous women can have a severalfold increased risk of dying as a result of becoming pregnant. The large majority of these fatalities are preventable, but unfortunately many are the result of the factors described in the Three Delays Model of maternal death. There are many conditions, both direct and indirect, that can result in the death of a woman from pregnancy. However, in Mexico and Central America, the most prevalent causes are the hypertensive diseases of pregnancy, obstetrical hemorrhage, and infection. In order to understand the diverse nature of the causes of maternal death among indigenous women, it is important to have some knowledge of how and why these pregnancy-associated disorders develop. This chapter addresses the three most frequent causes of maternal death among indigenous women of Mexico and Central America—hypertensive diseases (including preeclampsia and eclampsia), obstetric hemorrhage (including uterine atony, placental abruption, retained placenta, and placenta accreta), and infection (including puerperal sepsis).