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A qualitative study of conceptions and attitudes regarding maternal mortality among traditional birth attendants in rural Guatemala

  1. Mattias Rööst1,
  2. Sara Johnsdotter2,
  3. Jerker Liljestrand3,
  4. Birgitta Essén1

Article first published online: 13 SEP 2004

DOI: 10.1111/j.1471-0528.2004.00270.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 111, Issue 12, pages 1372–1377, December 2004

Additional Information

How to Cite

Rööst, M., Johnsdotter, S., Liljestrand, J. and Essén, B. (2004), A qualitative study of conceptions and attitudes regarding maternal mortality among traditional birth attendants in rural Guatemala. BJOG: An International Journal of Obstetrics & Gynaecology, 111: 1372–1377. doi: 10.1111/j.1471-0528.2004.00270.x

Author Information

  1. 1

    aDepartment of Obstetrics and Gynaecology, University Hospital MAS, Lund University, Malmö, Sweden

  2. 2

    bDepartment of Social Anthropology, Lund University, Sweden

  3. 3

    cDepartment of Community Medicine, University Hospital MAS, Lund University, Malmö, Sweden

*Dr B. Essén, Department of Obstetrics and Gynaecology, University Hospital MAS, SE-205 02 Malmö, Sweden.

Publication History

  1. Issue published online: 22 NOV 2004
  2. Article first published online: 13 SEP 2004

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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.

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