title: Practices related to postpartum uterine involution in the Western Highlands of Guatemala.
abstract: BACKGROUND
  Guatemala has the third highest level of maternal mortality in Latin America. Postpartum haemorrhage is the main cause of maternal mortality. In rural Guatemala, most women rely on Traditional Birth Attendants (TBAs) during labour, delivery, and the postpartum period. Little is known about current postpartum practices that may contribute to uterine involution provided by Mam- and Spanish-speaking TBAs in the Western Highlands of Guatemala.
  
  
  METHODS
  a qualitative study was conducted with 39 women who participated in five focus groups in the San Marcos Department of Guatemala. Questions regarding postpartum practices were discussed during four focus groups of TBAs and one group of auxiliary nurses.
  
  
  RESULTS
  three postpartum practices believed to aid postpartum uterine involution were identified: use of the chuj (Mam) (Spanish, temazcal), a traditional wood-fired sauna-bath used by Mam-speaking women; herbal baths and teas; and administration of biomedicines.
  
  
  CONCLUSIONS
  TBAs provide the majority of care to women during childbirth and the postpartum period and have developed a set of practices to prevent and treat postpartum haemorrhage. Integration of these practices may prove an effective method to reduce maternal morbidity and mortality in the Western Highlands of Guatemala.
authors: Department of Obstetrics and Gynecology, Boston University, Boston, MA 02118, USA. kari.radoff@bmc.org
authors: K A
authors: KA
authors: Radoff
authors: Lisa M
authors: LM
authors: Thompson
authors: K C
authors: KC
authors: Bly
authors: Carolina
authors: C
authors: Romero
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D006166:Guatemala / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008427:Maternal Health Services / Q000379:methods / Q000592:standards; D008428:Maternal Mortality; D008880:Midwifery / Q000145:classification / Q000379:methods / Q000706:statistics & numerical data; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D049590:Postpartum Period; D011247:Pregnancy; D012424:Rural Population; D014599:Uterus / Q000502:physiology / Q000503:physiopathology