Barriers to the use of maternity waiting homes in indigenous regions of Guatemala: a study of users' and community members' perceptions.

Maternal mortality among indigenous women in Guatemala is high. To reduce deaths during transport from far-away rural communities to the hospital, maternity waiting homes (MWH) were established near to hospitals where women with high-risk pregnancies await their delivery before being transferred for labour to the hospital. However, the homes are under-utilised. We conducted a qualitative study with 48 stakeholders (MWH users, family members, community leaders, MWH staff, Mayan midwives and health centre and hospital medical staff) in Huehuetenango and Cuilco to identify barriers before, during and after the women's stay in the homes. The women most in need - indigenous women from remote areas - seemed to have least access to the MWHs. Service users' lack of knowledge about the existence of the homes, limited provision of culturally appropriate care and a lack of sustainable funding were the most important problems identified. While the strategy of MWHs has the potential to contribute to the prevention of maternal (as well as newborn) deaths in rural Guatemala, they can only function effectively if they are planned and implemented with community involvement and support, through a participatory approach.

Public opinion on abortion in Mexico City after the landmark reform.

This article presents findings from three opinion surveys conducted among representative samples of Mexico City residents: the first one immediately prior to the groundbreaking legalization of first-trimester abortion in April 2007, and one and two years after the reform. Bivariate and multivariate analyses were performed to assess changes in opinion concerning abortion and correlates of favorable opinion following reform. In 2009 a clear majority (74 percent) of respondents were in support of the Mexico City law allowing for elective first-trimester abortion, compared with 63 percent in 2008 and 38 percent in 2007. A significant increase in support for extending the law to the rest of Mexico was found: from 51 percent in 2007 to 70 percent in 2008 and 83 percent in 2009. In 2008 the significant independent correlates of support for the Mexico City law were education, infrequent religious service attendance, sex (being male), and political party affiliation; in 2009 they were education beyond high school, infrequent religious service attendance, and ever having been married.