Emergency Obstetrical Planning in Rural Guatemala: A Case Study

  • Beth Hallowell
Part of the Global Maternal and Child Health book series (GMCH)


This chapter shows how planning for obstetrical emergencies is a social process with sometimes unexpected outcomes. I argue that these changes are only visible through an anthropological lens—that is, through ethnographic data collection and analysis—highlighting the importance of anthropology for understanding shifts in public health, particularly maternity care. Using the concept of “reproductive governance” and drawing from ethnographic data collected in rural Guatemala, it demonstrates how emergency obstetrical planning rearranges social relationships in ways that impact care providers’ day-to-day experiences and the role of the state in public health initiatives.


Indigenous women Maternal health Guatemala Birth practices Rural Health system Indigenous pregnancy Maya Pregnancy disorders Maternal death Maternal mortality Reproductive health Comadrona Emergency Reproductive governance Emergency obstetric planning Prevention Tzutujil Training Nurses 


  1. Allen, D. R. (2004). Managing motherhood, managing risk: Fertility and danger in West Central Tanzania. Ann Arbor: University of Michigan Press.Google Scholar
  2. Benagiano, G., & Thomas, B. (2003). Safe motherhood: The FIGO initiative. International Journal of Gynecology & Obstetrics, 82(3), 263–274.CrossRefGoogle Scholar
  3. Berry, N. (2006). Kaqchikel midwives, home births, and emergency obstetric referrals in Guatemala: Contextualizing the choice to stay at home. Social Science & Medicine, 62, 1958–1969.CrossRefGoogle Scholar
  4. Berry, N. (2008). Who’s judging the quality of care? Indigenous Maya and the problem of “not being attended”. Medical Anthropology, 27(2), 164–189.CrossRefPubMedGoogle Scholar
  5. Berry, N. (2010). Unsafe motherhood: Mayan maternal mortality and subjectivity in post-war Guatemala. Oxford: Berghahn Books.Google Scholar
  6. Bridges, K. M. (2011). Reproducing race: An ethnography of pregnancy as a site of racialization. Berkeley: University of California Press.Google Scholar
  7. Chapman, R. R. (2010). Family secrets: Risking reproduction in central Mozambique. Nashville: Vanderbilt University Press.Google Scholar
  8. Cosminsky, S. (1977). Childbirth and midwifery on a Guatemalan finca. Medical Anthropology, 6(3), 69–104.CrossRefGoogle Scholar
  9. Cosminsky, S. (2001). Midwifery across the generations: A modernizing midwife in Guatemala. Medical Anthropology, 20(4), 345–378.CrossRefGoogle Scholar
  10. Cosminsky, S. (2012). Birth and blame: Guatemalan midwives and reproductive risk. In L. Fordyce & A. Maraësa (Eds.), Risk, reproduction, and narratives of experience (pp. 81–101). Nashville: Vanderbilt University Press. Retrieved August 5, 2013, from Google Scholar
  11. Davis-Floyd, R. (1990). The role of obstetrical rituals in the resolution of cultural anomaly. Social Science & Medicine, 31(2), 175–189.CrossRefGoogle Scholar
  12. Davis-Floyd, R. (1994). The technocratic body: American childbirth as cultural expression. Social Science & Medicine, 38(8), 1125–1140.CrossRefGoogle Scholar
  13. Davis-Floyd, R. (2004). Birth as an American rite of passage (2nd ed.). Berkeley: University of California Press.CrossRefGoogle Scholar
  14. Fordyce, L., & Maraësa, A. (2012). Risk, reproduction, and narratives of experience. Nashville: Vanderbilt University Press. Retrieved August 5, 2013, from Google Scholar
  15. Freedman, L. P., et al. (2007). Practical lessons from global safe motherhood initiatives: Time for a new focus on implementation. The Lancet, 370(9595), 1383–1391.CrossRefGoogle Scholar
  16. Goldman, N., & Glei, D. A. (2003). Evaluation of midwifery care: Results from a survey in rural Guatemala. Social Science & Medicine, 56(4), 685–700.CrossRefGoogle Scholar
  17. Gutiérrez, E. R. (2008). Fertile matters: The politics of Mexican-origin women’s reproduction. Austin: University of Texas Press.Google Scholar
  18. Hallowell, E. (2014). “Between the wall and the sword”: Reproductive governance and the technology of emergency in Guatemalan maternity care. Feminist Formations, 26(3), 100–121.CrossRefGoogle Scholar
  19. Hallowell, E. (2015). Emergencies that count: Pregnancy and economies of care. U.S. Dissertation. University of Pennsylvania, Philadelphia, PA.Google Scholar
  20. Hinojosa, S. (2004). Authorizing tradition: Vectors of contention in highland Maya midwifery. Social Science & Medicine, 59(3), 16.CrossRefGoogle Scholar
  21. Jordan, B. (1978). Birth in four cultures. Montreal: Eden Press.Google Scholar
  22. Mahler, H. (1987). The safe motherhood initiative: A call to action. Lancet, 1(8534), 668–670.CrossRefPubMedGoogle Scholar
  23. Mamo, L. (2007). Queering reproduction: Achieving pregnancy in the age of technoscience. Durham: Duke University Press Books.CrossRefGoogle Scholar
  24. Maupin, J. N. (2008). Remaking the Guatemalan midwife: Health care reform and midwifery training programs in highland Guatemala. Medical Anthropology, 27(4), 353–382.CrossRefPubMedGoogle Scholar
  25. MINGUA. (1996). Agreement on socio-economic aspects and agrarian situation concluded on 6 May 1996 between the presidential peace commission of the government of Guatemala and the Unidad Revolucionaria Nacional Guatemalteca. United States Institute for Peace. Retrieved from
  26. Morgan, L. M., & Roberts, E. F. S. (2012). Reproductive governance in Latin America. Anthropology & Medicine, 19(2), 241–254.CrossRefGoogle Scholar
  27. Paul, L., & Paul, B. D. (1975). The Maya midwife as sacred specialist: A Guatemalan case. American Ethnologist, 2(4), 707–726.CrossRefGoogle Scholar
  28. Roberts, E. F. S. (2012). God’s laboratory: Assisted reproduction in the Andes. Berkeley: University of California Press.Google Scholar
  29. Scarry, E. (2011). Thinking in an emergency. New York: W.W. Norton & Company.Google Scholar
  30. Schwartz, D. A. (2015). Interface of epidemiology, anthropology and health care in maternal death prevention in resource-poor nations. In D. A. Schwartz (Ed.), Maternal mortality: Risk factors, anthropological perspectives, prevalence in developing countries and preventive strategies for pregnancy-related death. New York: Nova Science Publishers.Google Scholar
  31. Taylor, J. S. (2003). Confronting “culture” in medicine’s “culture of no culture”. Academic Medicine, 78(6), 555–559.CrossRefPubMedGoogle Scholar
  32. Van Hollen, C. C. (2003). Birth on the threshold: Childbirth and modernity in South India. Berkeley: University of California Press.Google Scholar
  33. World Health Organization. (2015). Maternal mortality. WHO. Retrieved October 1, 2016, from

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Beth Hallowell
    • 1
  1. 1.University of Pennsylvania (former affiliation)PhiladelphiaUSA

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