Paper short abstract:

This paper explores discourses of risk in Chiapas. Using maternal mortality rates, the Mexican state presumes that birthing with a traditional midwife is unsafe. However, cases of obstetric violence create a counter-discourse, where for indigenous women hospitals are risky places to give birth.

Paper long abstract:

In Mexico, the State of Chiapas has one of the highest rates of maternal and infant deaths of the country (60.6 for 100,000 live births for a national rate of 42.3 in 2011). Following recommendations from the World Health Organization, Mexican policies push for the training of traditional midwives, which provides them with basic obstetrical knowledge and encourages them to refer their patients to hospitals. These trainings, conducted by government workers and medical doctors, are built on the premise that birthing at home with a traditional midwife is never safe, and that hospitals are the best place to give birth for all women - and poor, indigenous women in particular (Cominsky 2012, Smith-Oka 2013).

The Mexican state's particular construction of birth as a risky process, combined with monetary incentives to give birth in hospitals through conditional cash-transfer programs targeting poor women, constrain women's reproductive choices and disrupt Mayan women's birth practices. Birth is no longer a natural event where the woman is supported by her family, but becomes a risky practice performed by a technocrat, the obstetrician (Davis-Floyd 1992, Fordyce and Maraesa 2012).

In Chiapas, the discourse of risk has been used by indigenous women in a different way. The emerging discussion about obstetric violence in Mexico, and the heavy media coverage of cases of medical negligence in Chiapas, have provided indigenous women and midwives provide a counter-discourse of risk, in which going to the hospital becomes the riskiest way to give birth - alone and in a hostile environment.