A qualitative study of conceptions and attitudes regarding maternal mortality among traditional birth attendants in rural Guatemala
2004 (English)In: British Journal of Obstetrics and Gynaecology, ISSN 0306-5456, Vol. 111, no 12, 1372-1377 p.Article in journal (Refereed) Published
OBJECTIVE: To explore conceptions of obstetric emergency care among traditional birth attendants in rural Guatemala, elucidating social and cultural factors. STUDY: design Qualitative in-depth interview study. SETTING: Rural Guatemala. SAMPLE: Thirteen traditional birth attendants from 11 villages around San Miguel Ixtahuacán, Guatemala. METHOD: Interviews with semi-structured, thematic, open-ended questions. Interview topics were: traditional birth attendants' experiences and conceptions as to the causes of complications, attitudes towards hospital care and referral of obstetric complications. MAIN OUTCOME MEASURES: Conceptions of obstetric complications, hospital referrals and maternal mortality among traditional birth attendants. RESULTS: Pregnant women rather than traditional birth attendants appear to make the decision on how to handle a complication, based on moralistically and fatalistically influenced thoughts about the nature of complications, in combination with a fear of caesarean section, maltreatment and discrimination at a hospital level. There is a discrepancy between what traditional birth attendants consider appropriate in cases of complications, and the actions they implement to handle them. CONCLUSION: Parameters in the referral system, such as logistics and socio-economic factors, are sometimes subordinated to cultural values by the target group. To have an impact on maternal mortality, bilateral culture-sensitive education should be included in maternal health programs.
Place, publisher, year, edition, pages
2004. Vol. 111, no 12, 1372-1377 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-112474DOI: 10.1111/j.1471-0528.2004.00270.xPubMedID: 15663121OAI: oai:DiVA.org:uu-112474DiVA: diva2:286134