[Book Chapter published in Schwartz, David (ed) 2018 Maternal Health, Pregnancy-Related Morbidity and Death Among Indigenous Women of Mexico & Central America: An Anthropological, Epidemiological and Biomedical Approach, Springer, pp.147-167]
Abstract In Chiapas, Mexico’s poorest state, indigenous Mayan women are twice more likely to die in childbirth than are non-indigenous women. To comply with international development goals and diminish Chiapas’ high maternal mortality rates, indigenous midwives are trained in detecting risk factors in pregnancy and birth, while women are encouraged to give birth in hospitals. This chapter analyzes the consequences of such policies, which might unintentionally exacerbate the structural violence indigenous women face in their lives. In Chiapas, 74.7 percent of the population lives in poverty and extreme poverty, compared to the national 43 percent rate. This extreme poverty, together with the lack of infrastructure and engrained racism, are all factors reproducing violence in the lives of poor women. In the state, the maternal mortality rate of women in reproductive age group has increased between 2010 and 2013, and that of indigenous women has almost doubled (1.7 times) over the same time period. Using an anthropological approach, this chapter examines the institutional and cultural changes in childbirth practices that are occurring in Highlands Chiapas, and sheds a light on the structural factors that expose Mayan women to unsafe births, increasing the likelihood that they will suffer mistreatment in childbirth.