Misconceived Mortality: Solitary Birth and Maternal Mortality Among the Rarámuri of Northern Mexico

Abstract

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.