Abstract
BackgroundAn intercultural birthing house was established in the Highlands of Chiapas, Mexico, as an intervention to reduce maternal mortality among indigenous women. This birth center, known locally as the Casa Materna, is a place where women can come to give birth with their traditional birth attendant. However, three months after opening, no woman had used the birthing house.MethodsThis study reports on the knowledge, attitudes and practices related to childbirth and use of the Casa Materna from the perspective of the health workers, traditional birth attendants and the program’s target population. Structured interviews, in-depth interviews and focus group discussions were conducted with participants from each of these groups. Data was searched for emerging themes and coded.Results and conclusionsFindings show that the potential success of this program is jeopardized by lack of transport and a strong cultural preference for home births. The paper highlights the importance of community participation in planning and implementing such an intervention and of establishing trust and mutual respect among key actors. Recommendations are provided for moving forward the maternal health agenda of indigenous women in Chiapas.
Highlights
An intercultural birthing house was established in the Highlands of Chiapas, Mexico, as an intervention to reduce maternal mortality among indigenous women
Maternal mortality in Chiapas The indigenous population of Chiapas, México, has a high rate of maternal mortality: one study conducted in indigenous communities in conflict areas in Chiapas found that the maternal mortality ratio was 607/100,000 live births [1], compared to 73/100,000 live births for the state of Chiapas and 60/100,000 live births in all of Mexico in 2009 [2]
Nine of the health personnel reported working directly in maternal healthcare for indigenous women, one was an administrator involved in the planning of the Casa Materna, and the other was a nurse who aids in general consultations and gives vaccinations
Summary
An intercultural birthing house was established in the Highlands of Chiapas, Mexico, as an intervention to reduce maternal mortality among indigenous women. This birth center, known locally as the Casa Materna, is a place where women can come to give birth with their traditional birth attendant. Addressing the issue of improved access to maternal health for indigenous women is an important issue in all of the Americas, where 10% of the populations are reportedly indigenous [6]. Studies suggest that poor access to health care and preventative services is the norm for the indigenous population of Latin America and that services that do exist are culturally inappropriate [6]
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