Reproductive and Maternal Health among Indigenous Women in Guatemala: A Cross-Sectional Study of Healthcare Access, Reproductive Autonomy, and Social Determinants

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.