Reproductive Justice: South America

SOUTH AMERICA

ARGENTINA

2018′

Yanez, S. (2018). “We Aren’t All the Same”. The Singularity of Reproductive Experiences amidst Institutional Objectification in Argentina’s Maternal Health Services.  Journal of Feminist Scholarship 15 (Fall): 61-80. https://digitalcommons.uri.edu/jfs/ vol15/iss15/6

• Reproductive health services in Argentina are organized in ways that depersonalize, standardize, and fragment women’s bodies and lives

BRAZIL

2018

Brigagao, J., Gonvalves, R. and Nascimento, V. (2018). The language of risk, public policies, and childbirth in the municipality of Sao Paulo; A reading of data from the live birth system 2010 m- 2016. Frontiers in Sociology.  Accessed https://www.frontiersin.org/articles/10.3389/fsoc.2018.00012/full

• CONCLUDED: (material omitted) “In our analysis, we sought to demonstrate that this is a complex reality which cannot be reduced to just one argument, such as that this is due to women’s choices, or that the problem lies in the training of Brazilian obstetricians, or yet that it is due to the hospitalization of birth. On the contrary, we consider that it is all of these versions, connected in different ways in the day-to-day of health services that enact these realities.  At the same time we consider important to highlight that other studies of qualitative approach should be implemented considering their great potential to help deepen the understanding of the phenomena involving surgical surgical-cesarean births in Brazil.”

GUATEMALA

Indigenous Maya Midwifery  Org.  (2024). Accessed https://www.mayamidwifery.org/

• Since 1999, MMI Board members have served as an advisory and fundraising board to ACAM (Association of Midwives of the Mam Speaking Area). We have been working with this group of 40 Maya midwives from the beginning of their organization which was formed to address issues specific to indigenous midwives and the communities they served. 

2024

Every Mother Counts (2024). Inequality impacts the maternal health of Indigenous Guatemalans. Accessed https://everymothercounts.org/grants/guatemala-a-deeper-dive/

• In a country with one of the highest maternal mortality rates in its region, the country’s highest rates occur in rural regions, particularly where the majority of residents are impoverished Indigenous Mayans. Indigenous Mayan women are twice as likely to die from preventable pregnancy-related deaths than non-Indigenous women. Devastatingly, the national statistical averages of maternal mortality in Guatemala hide the disparities that exist between the wealthier urbanites and rural, marginalized populations.

Thokkar, V., (2024)  Modernizing traditional maternal care in Guatemala. Accessed https://www.thinkglobalhealth.org/article/modernizing-traditional-maternal-care-guatemala

• Another concern is the discrimination Maya patients endure within urban health-care systems. Many report experiencing disrespectful treatment that includes verbal abuse, raised voices, and derogatory comments, as well as the enforcement and poor explanations of medical procedures. Expectant mothers are particularly vulnerable, sometimes subjected to unnecessary cesarean sections and sterilizations without their informed consent

2023

Valdez, M., Stollak, I., Pfeiffer, E., Lesnar, B., Leach, K., Modanlo, N., Westgate, C. C., & Perry, H. B. (2023). Reducing inequities in maternal and child health in rural Guatemala through the CBIO+ Approach of Curamericas: 1. Introduction and project description. International Journal for Equity in Health, 21(Suppl 2), 203–203. https://doi.org/10.1186/s12939-022-01752-y   Accessed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976357/

• Curamericas/Guatemala established the first Birthing Center in the small town of Calhuitz in the municipality of San Sebastian Coatán in 2009. The facility provided a safe and clean space where a mother could come and deliver with a skilled birth attendant (a nurse or auxiliary nurse), assisted by a comadrona of the mother’s choice. It also provided a home-like atmosphere with a traditional Maya kitchen. Traditional birthing positions and rituals were encouraged. A traditional sweat lodge (chuj) where the mother could go after the delivery was also available
• Report # 2 available at https://www.researchgate.net/publication/368877999_Reducing_inequities_in_maternal_and_child_health_in_rural_Guatemala_through_the_CBIO_approach_of_Curamericas_2_Study_site_design_and_methods
• Report #3 available at https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-022-01755-9
• Report # 4 available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9973244/
• Report #5 available at https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-022-01757-7
• Report #6 available at https://link.springer.com/article/10.1186/s12939-022-01758-6
• Report #7 available at https://digitalscholar.lsuhsc.edu/cgi/viewcontent.cgi?article=1643&context=som_facpubs
• Report #8 available at https://link.springer.com/article/10.1186/s12939-022-01760-y
• Report #9 available at https://go.gale.com/ps/i.do?id=GALE%7CA739065437&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=14759276&p=HRCA&sw=w&userGroupName=nysl_oweb&aty=ip
• Report #10 available at https://go.gale.com/ps/i.do?id=GALE%7CA739065434&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=14759276&p=HRCA&sw=w&userGroupName=nysl_oweb&isGeoAuthType=true&aty=geo

2022

Asgari, N., Beg, H., Blumenthal, J., Fares, S., Marleau, H. and Wong, J. (2022). Bridging the maternal care gap: Mobile antenatal care in rural and Indigenous Guatemalan communities.  Accessed https://reachalliance.org/wp-content/uploads/2022/03/HPP-Guatemala-FINAL-1.pdf

• Cultural competency embedded within a community-led approach contributed to an efficient, impactful and sustainable healthcare intervention. The HPP utilized local staff to build trust and overcome barriers in reaching rural and Indigenous populations across Guatemala. Programs must consider culturally competent design when implementing programs targeting Indigenous and rural communities.

2019

Summer, A. Walker, D. and Guendelman, S. (2019). A review of the forces influencing maternal health policies in post-war Guatemala.  Accessed https://onlinelibrary.wiley.com/doi/abs/10.1002/wmh3.292  

• Society-centered forces promoted intercultural care with traditional birth attendants (TBAs). Both—sometimes conflicting—forces have influenced policymakers in the creation of maternal health policies in post-war Guatemala. Policymakers must constantly reconcile tensions between society-centered realities and international agendas when making policies. The reintroduction of professional midwifery in Guatemala presents a means of addressing both agendas: Increasing SBA and improving intercultural care.

2018

Fien-Helfman, S. (2018). Traditional Mayan maternal health practices in Guatemala; Reflections from a maternal health pilot in the Department of Solola, with a practical guide to history, beliefs and cultural practices of Comadronas in these communities.  Accessed https://www.researchgate.net/publication/327049681_Traditional_Mayan_Maternal_Health_Practices_in_Guatemala_Reflections_from_a_Maternal_Health_Pilot_in_the_Department_of_Solola_with_a_Practical_Guide_to_the_History_Beliefs_and_Cultural_Practices_of_Co

• To support the ongoing educational training of comadronas in Guatemala and, ultimately, contribute to further reducing the country’s MMR, the YIF and World Bank have derived 4 key recommendations.  The recommendations relate to the culture of the Indigenous/rural women as a means to reduce maternal mortality.

2016

Cosminsky, S. (2016). Midwives and mothers : the medicalization of childbirth on a Guatemalan plantation (First edition.). University of Texas Press.  Book: info at https://www.jstor.org/stable/10.7560/311387

Stollak, I., Valdez, M., Rivas, K. and Perry, H. (2016).  Casas Maternas in the rural highlands of Guatemala; A mixed-methods case study of the introduction and utilization of birthing facilities by the Indigenous population. Accessed https://www.ghspjournal.org/content/4/1/114

• In an isolated mountainous area of Guatemala with high maternal mortality, an NGO-sponsored approach engaged communities to operate local, culturally appropriate birthing facilities and is achieving high and equitable utilization. Likely success factors:
• Community engagement and ownership
• Close location of facilities
• Perceived high quality of services
• Engagement of traditional birth attendants in the birthing process and as advocates for facility use

United Nations Population Fund. (2016) Tapping into the power of midwives to reduce maternal mortality in Guatemala.  Accessed https://www.unfpa.org/news/pulled-tapping-power-midwives-reduce-maternal-mortality-guatemala

• According to UNFPA estimates, a well-trained and well-supported midwifery workforce in low-resource settings could help avert roughly two-thirds of all maternal and newborn deaths, and since 2009, UNFPA has helped train over 35,000 midwives in Guatemala.

2014

Giralt, A. (2014). Guatemala’s Indigenous maternal healthcare; A system in need of decolonization.  Accessed https://ojs.ual.es/ojs/index.php/RAUDEM/article/view/593/566

• The controversy surrounding Mayan Traditional Birth Attrendants is greater in rural areas, since this is primarily where these women work. Biomedically-trained professionals tend to frown upon the care provided by these iyoma.

2007

Wilson, evara Ellsworth (2007) “Your destiny is to care for pregnant women:! Midwives and childbirth in Nahualá. IN Health Care in Maya Guatemala: Confronting medical pluralism in a developing country, Walter Randolph Adams and John P. Hawkins, eds., pp. 125-147. Norman: University of Oklahoma Press.     BOOK info at https://search.library.wisc.edu/catalog/9910045837302121 

PERU

2018

Lossio, J., Iguiñiz-Romero, R., & Robledo, P. (2018). For the good of the nation: scientific discourses endorsing the medicalization of childbirth in Peru, 1900-1940. História, ciências, saúde–Manguinhos, 25(4), 943–957. https://doi.org/10.1590/S0104-59702018000500004CONCLUDED: “Throughout the 20th century, a series of changes took place in the way of conceiving childbirth, which went from being a natural reproductive phenomenon typical of the domestic and feminine sphere to a medical and professional matter of the institutional sphere. Through procedures such as the use of anesthesia, caesarean section, ultrasound and other technical-scientific interventions, rapid and important improvements and changes have been generated for the health and life of society and women. The medicalization of childbirth at the beginning of the 20th century was part of a broader process of state building and institutionalization of the common patriarchy in the region.”2021/span>

GardineGardiner, E., Lai, J., Khanna, D., Meza, G.,  de Wildt, G. and Taylor, B. (2021). Exploring women’s decisions of where to give birth in the Peruvian Amazon:  Why do women continue to give birth at home?  Open Access; peer reviewedpan style=”mso-spacerun:yes”>  https://doi.org/10.1371/journal.pone.0257135CONCLUDED: “Despite the WHO encouraging women to deliver in healthcare facilities with SBAs, women in the Peruvian Amazon continue to face barriers accessing IPC [10]. Several barriers found in this setting concur with the global literature including fear of hospitals, lack of transport and financial hurdles. However, barriers unique to this setting were also found; fear for children’s safety whilst in hospital and a fear of caesareans, partly due partners leaving women if interventions are required. Women in Loreto have also experienced abusive behaviour in health facilities. Changes to practice and facilities are required, including changes to the attitude of staff and modifications to ensure mothers and babies remain together postpartum. Further research should be conducted to assess the suitability of MWHs in the region and explore women’s barriers to IPC in other parts of Loreto”