Misconceived Mortality: Solitary Birth and Maternal Mortality Among the Rarámuri of Northern Mexico
This chapter discusses the relationship between solitary birth as practiced by the indigenous Rarámuri (Tarahumara) of Northern Mexico and efforts to decrease maternal mortality by ensuring that all births are attended by a skilled attendant. The on-the-ground impact of international and national health ideologies, which intend to eradicate the practice of solitary birth, may not be as hoped if and when cultural predilections are ignored. Indigenous Rarámuri have a long tradition of giving birth alone or with trusted family members, such as husbands and female relatives, and continue to do so even when living in an urban area where health care services are accessible. Hesitance among Rarámuri women to use reproductive health care services stems from the fact that such care is based upon western ideology that ignores and stigmatizes their own cultural worlds and belief systems. Fear of going to hospitals and clinics and associating with outsiders (non-Rarámuri) at birth can be stronger than fear of death or birthing alone. Contributing factors include reproductive health care focused on family planning, inaccurate statistical data, institutional racism, and lack of cultural awareness on the part of health care providers and policy makers. Some suggestions to improve reproductive care for Rarámuri women are provided.
KeywordsIndigenous women Maternal health Rarámuri Tarahumara Central America Mexico Chihuahua Solitary birth Indigenous pregnancy Stigmatization Pregnancy disorders Maternal death Maternal mortality Reproductive health Unassisted birth Contraception Traditional birth attendant Partera
- Bennett, W. C., & Zingg, R. M. (1935). The Tarahumara. Chicago: University of Chicago Press.Google Scholar
- Brambila, D. (1976). Diccionario Rarámuri-Castellano (Tarahumar). México, DF: Obra Nacional de la Buena Prensa.Google Scholar
- Espino Loya, S. (1987) Kuira. Chihuahua City, ENAH: Dirección General de Desarrollo Social, Dept. de Educación, Coordinación de Fomenta a la Expresión Cultural.Google Scholar
- Family Care International. (2002). Safe motherhood fact sheet. Retrieved from www.safemotherood.org.
- Ginsburg, F. D., & Rapp, R. (1995). Conceiving the new world order: The global politics of reproduction. Berkeley & Los Angeles: University of California Press.Google Scholar
- Janes, C. R. (2001). Free markets and dead mothers: economic transition and the collapse of health care in Mongolia. Paper presented at the Annual Meetings of the Society for Applied Anthropology, Merida, Mexico.Google Scholar
- Langer, A., Hernández, B., & Lozano, R. (1994). La morbimortalidad materna en México: niveles y causas. In M. Elu, A. Langer, & A. (Eds.), Maternidad sin riesgos en México (pp. 23–29). IMSS: México, DF.Google Scholar
- Lozano, R., Hernández, B., & Langer, A. (1994). Factores sociales y económicos de la mortalidad materna en México. In M. Elu & A. Langer (Eds.), Maternidad sin Riesgos en México (pp. 43–51). México DF: IMSS.Google Scholar
- Merrill, W. (1988). Rarámuri souls: Knowledge and social process in Northern Mexico. Washington DC: Smithsonian Institution Press.Google Scholar
- Miller, J. (2003). Birthing practices of the Rarámuri of Northern Mexico. PhD. Dissertation. Tucson, AZ: University of Arizona. Retrieved from http://hdl.handle.net/10150/289917.
- Miller, J. (2009). Husband-assisted birth among the Rarámuri of Northern Mexico. In M. Inhorn, T. Tjørnhøj-Thomsen, H. Goldberg, & M. la Cour Mosegaard (Eds.), Reconceiving the second sex: Men, masculinity, and reproduction (pp. 327–348). New York & Oxford: Berghan Books.Google Scholar
- Miller, J. (2010). Solitary, husband, and kin-assisted birth among the Rarámuri of Northern Mexico: Considerations for normal birth. Paper presented at the 5th International Normal Labour and Birth Research Conference Vancouver: University of British Columbia.Google Scholar
- Royston, E., & Armstrong, S. (Eds.). (1989). Preventing maternal deaths. Geneva: World Health Organization.Google Scholar
- Schwartz, D. A. (2015a). The pathology of maternal death—the importance of accurate autopsy diagnosis for epidemiologic surveillance and prevention of maternal mortality in developing countries. In D. A. Schwartz (Ed.), Maternal mortality: Risk factors, anthropological perspectives, prevalence in developing countries and preventive strategies for pregnancy-related death (pp. ix–xiv). New York: Nova Science Publishers, Inc..Google Scholar
- Schwartz, D. A. (2015b). Interface of epidemiology, anthropology and health care in maternal death prevention in resource-poor nations. In D. A. Schwartz (Ed.), Maternal mortality: Risk factors, anthropological perspectives, prevalence in developing countries and preventive strategies for pregnancy-related death (pp. ix–xiv). New York: Nova Science Publishers, Inc..Google Scholar
- Way, C. (Ed.). (2016). The Millennium Goals Report 2015. Geneva: United Nations.Google Scholar
- WHO, ICM & FIGO. (2004). Making pregnancy safer: the critical role of the skilled attendant. Geneva: World health Organization. Retrieved from http://www.who.int/maternal_child_adolescent/documents/9241591692/en/. Google Scholar