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Maternal Death and Pregnancy-Related Morbidity Among Indigenous Women of Mexico and Central America pp 147–167Cite as

Structural Violence: An Important Factor of Maternal Mortality Among Indigenous Women in Chiapas, Mexico

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Part of the book series: Global Maternal and Child Health ((GMCH))

Abstract

In Chiapas, Mexico’s poorest state, indigenous Maya women are twice more likely to die in childbirth than are nonindigenous 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% of the population lives in poverty and extreme poverty, compared to the national 43% rate. This extreme poverty, 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.

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Notes

  1. 1.

    Those numbers reflect deaths that have been reported and registered as maternal deaths. Research has indicated a severe underreporting of such deaths, partly due to the pressure to comply with MDGs (Freyermuth Enciso and Cárdenas Elizalde <CitationRef CitationID="CR29" >2009</Citation Ref>; Freyermuth, this volume).

  2. 2.

    The national goal for the country was 22.2, which Mexico did not reach (the 2015 national MMR was 38.2) (Objetivos de Desarrollo del Milenio #5 <CitationRef CitationID="CR55" >n.d</Citation Ref>.).

  3. 3.

    Disparities are even stronger for extreme poverty: 38 percent for Chiapas, 7.9 percent at the national level.

  4. 4.

    The fertility rate is much higher in rural areas: out of the forty-four parteras I interviewed, half had carried over four pregnancies.

  5. 5.

    Galtung (<CitationRef CitationID="CR30" >1969</Citation Ref>) identifies structural violence as violence that cannot be traced directly to an actor or institution. Structural violence is intimately linked to social injustice, which was at the heart of the Zapatista demands.

  6. 6.

    Partly reproduced from a post on Anthropology-News (El Kotni <CitationRef CitationID="CR21" >2016b</Citation Ref>).

  7. 7.

    Partera is the generic word for midwife in Spanish. It has been used to refer to indigenous midwives and professional midwives alike.

  8. 8.

    http://www.forbes.com/sites/niallmccarthy/2016/01/12/which-countries-have-the-highest-caesarean-section-rates-infographic/#f6d56744ff86.

  9. 9.

    The postpartum period is divided into the first or acute phase (the first 6–12 h), the second or subacute phase (2–6 weeks), and the third or delayed postpartum period (up to 6 months) (Romano et al. <CitationRef CitationID="CR62" >2010</Citation Ref>).

  10. 10.

    Carlita’s son was born in her home with the help of her grandmother, a recognized midwife in her community.

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  1. Anthropology Department, University at Albany AS 237, Albany, NY, USA

    Mounia El Kotni Ph.D.

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  1. Medical College of Georgia, Augusta University, Augusta, Georgia, USA

    David A. Schwartz

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El Kotni, M. (2018). Structural Violence: An Important Factor of Maternal Mortality Among Indigenous Women in Chiapas, Mexico. In: Schwartz, D. (eds) Maternal Death and Pregnancy-Related Morbidity Among Indigenous Women of Mexico and Central America. Global Maternal and Child Health. Springer, Cham. https://doi.org/10.1007/978-3-319-71538-4_8

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