Characteristics of Maternal Death Among Mayan Women in Yucatan, Mexico

Deaths due to maternal causes remain an important biomedical, social, and public health problem. Developing countries report the highest number of maternal deaths, with the majority occurring in sub-Saharan Africa and South Asia, followed by Latin America and the Caribbean, and finally East Asia and the Pacific. The hypertensive diseases of pregnancy (preeclampsia and eclampsia), obstetric hemorrhage, and puerperal sepsis account for the majority of maternal deaths, with their relative prevalence varying according to the country. In the poorest areas, obstetric hemorrhage represents a tremendous challenge for the health delivery system. In Mexico, maternal deaths occur mostly during delivery or the immediate puerperium. In the state of Yucatan, located in southeastern Mexico, year after year there are maternal deaths of women living both at the municipal seat and in nearby communities. Even though there is a health system organized by levels of care, those people living in municipalities distant from the state capital do not have services to assist them during obstetric emergencies until a hospital is reached. Moreover, there are sociocultural factors that prevail in the cases of maternal death among indigenous women that need to be considered when designing and implementing preventive actions. In this chapter, we discuss the characteristics of maternal deaths occurring among indigenous Maya women in Yucatan, Mexico. In addition, we describe the maternal health needs, knowledge, and practice, not only from the perspective of the health personnel but also from that of other actors involved in the health-disease-care process of indigenous pregnant woman with obstetric complications.