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Threats to safe motherhood in Honduran Miskito communities: Local perceptions of factors that contribute to maternal mortality

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  • Arps, Shahna

Abstract

Despite global initiatives to lower rates of maternal death, barriers to safe motherhood persist, particularly in socially and economically marginalized communities. This article describes the risks that women in Honduran Miskito villages encounter during pregnancy and childbirth. Ethnographic data are used to examine emic understandings of the underlying causes of maternal death. Participant observation, four community discussions, individual interviews with 218 women and five midwives, and a maternal mortality survey were conducted during November 2004 through November 2005. Case studies are drawn from the 55 death histories collected during the survey to illustrate the factors that contribute to maternal mortality. Community members identified poverty, gender inequality, witchcraft, and sorcery as major threats to safe motherhood. All of these factors influence women's health-related behaviors; and therefore, each issue deserves attention from public health officials. Designing appropriate interventions to improve maternal health depends on understanding the forces that increase women's vulnerability during pregnancy and childbirth. Local perspectives of risk, even when they diverge from biomedical understandings, point to specific needs, issues to address, and avenues for effective intervention.

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  • Arps, Shahna, 2009. "Threats to safe motherhood in Honduran Miskito communities: Local perceptions of factors that contribute to maternal mortality," Social Science & Medicine, Elsevier, vol. 69(4), pages 579-586, August.
    • Handle: RePEc:eee:socmed:v:69:y:2009:i:4:p:579-586
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    1. Berry, Nicole S., 2006. "Kaqchikel midwives, home births, and emergency obstetric referrals in Guatemala: Contextualizing the choice to stay at home," Social Science & Medicine, Elsevier, vol. 62(8), pages 1958-1969, April.
    2. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    3. Chapman, Rachel R., 2003. "Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk," Social Science & Medicine, Elsevier, vol. 57(2), pages 355-374, July.
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