Reproductive and Maternal Health among Indigenous Women in Guatemala: A Cross-Sectional Study of Healthcare Access, Reproductive Autonomy, and Social Determinants
Sunwoo Choi *
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
Ayoon Lee
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
Rachael Hwang
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
Sohela Sekhon
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
Jolene He
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
Amy Lee
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
Olivia Y. Kim
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
Joshua Lee
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
Taewoo Kim
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
Solbeen Kim
Biomedical Sciences Division, STEM Science Center, Englewood Cliffs, New Jersey, USA.
*Author to whom correspondence should be addressed.
Abstract
Background: Indigenous women in Guatemala experience persistent reproductive and maternal health inequities shaped by geographic, economic, social, and cultural conditions.
Aims: To characterize reproductive and maternal health experiences among Indigenous women attending mobile medical clinics in Guatemala, with emphasis on healthcare utilization, family planning, reproductive decision-making, access barriers, and women’s health education.
Study Design: Cross-sectional descriptive survey.
Place and Duration of Study: Humanitarian mobile medical clinics in communities in the Chimaltenango region of Guatemala during a field medical mission. Methodology: An anonymous 10-item questionnaire was administered to 100 Indigenous female participants. Responses were summarized using descriptive statistics (frequencies and percentages) across reproductive history, maternal healthcare utilization, family planning, household decision-making, travel time, financial barriers, and prior health education.
Results: Most participants had children, and 25 reported first childbirth before 18 years of age. Sixty-six reported receiving pregnancy care primarily in a clinic or hospital; 53 reported prior use of family-planning or contraceptive methods. Forty-seven reported making reproductive decisions independently, while others reported partner, elder, or shared decision-making. Cost and transportation were each identified as the leading barrier by 32 participants, followed by distance (n = 21). Thirty-six reported avoiding reproductive or maternal healthcare because of cost, and 38 reported no previous women’s health education.
Conclusion: Maternal healthcare utilization among participants was shaped by more than service availability. Affordability, transportation, geographic accessibility, household decision-making, and education remained important components of reproductive and maternal health equity. Community-based and culturally responsive strategies should address these interconnected barriers while supporting informed reproductive decision-making.
Keywords: Indigenous women, Guatemala, maternal health, reproductive health, healthcare access, reproductive autonomy, social determinants of health, family planning.