Poor Birth Outcomes in Guatemala

It was really disheartening to hear about all the issues that rural women and birth attendants in Guatemala face. After reading the second chapter of MCH, I realize that I still have much to learn with how birth looks in different parts of the world. I am aware that not everywhere is going to have hospitals, birthing centers, or even skilled attendants handling the births.  That written, I did not think about a place where so little is known about birth, even those who are seen as the authorities on birth. Most of the examples of birth that take more of a cultural approach that we have seen knew for the most part the basics of pregnancy. For instance, the movie we watched with the black midwives, although the material used might not have been as advanced as a hospital they were extremely skilled and knowledgeable about how pregnancies should go and how to handle emergencies. Same thing goes for Monique in the book we read, even though the setting was rural and she lacked a lot of tools and medication she was skilled in what she was doing when it came to delivering a child. So, with reading this chapter it makes me wonder how the black midwives and Monique got to be so skilled. I am aware the aforementioned characters most likely went through extensive training and assisted on births before becoming so adept- but who taught their teachers? What I am asking is, how does that cycle start? How can you begin a tradition of being aware of things like a fetal heart rate, or what to do during hemorrhage and pass it down? Assuming there are no interventions such as MFM or the like. While pondering this, I came across the idea of an established tradition of birth is what the previous examples had and what the women in Guatemala lacked. I am sure no one came in and had a program of how to teach Monique’s predecessors, as that is not the norm in many parts of the world. In Guatemala, from what I have read, it appears there is really no tradition of birth, like in New Zealand where the community aspect of birth was extremely heightened. I did not get the same sense of the birth of a child being a community experience or really any experience. It seemed that there are traditional midwives who tend to those who are far removed from hospitals but nothing much past that. There are many factors that contribute to this such as illiteracy, no formal training, and the extremely low regard women are held in. I think having such a pronounced low place in society contributes heavily to poor maternal and fetal outcomes. So more community and better appreciation of women could be a solution outside of intervening and just bringing in technology and education.

One thought on “Poor Birth Outcomes in Guatemala

  1. I think it’s important to remember that this chapter in MCH and our reading of Monique and the Mango Rains painted a picture of only one area in Guatemala and Mali, respectively. If we consider national maternal mortality statistics, 1/190 women have a lifetime risk of maternal death in Guatemala (http://www.unicef.org/infobycountry/guatemala_statistics.html), while 1/28 women have a lifetime risk of maternal death in Mali (http://www.unicef.org/infobycountry/mali_statistics.html). Thus, maternal outcomes actually seem more optimistic in Guatemala than in Mali. I think informal education/training led to the skills and knowledge of these midwives/birth attendants. Generations of experience coupled with trainings/workshops from both NGOs and the government have resulted in current practices. However, the disparity in maternal outcomes between Guatemala and Mali is due to an array of socioeconomic, political, and cultural factors.

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