Graduation Year


Document Type




Degree Granting Department


Major Professor

Heide Castañeda

Co-Major Professor

Jaime Corvin


Carhuaz, Maternal decision-making, Medical Anthropology, Participatory Action Research, Pregnancy


This thesis examines maternal decision-making regarding prenatal care and childbirth in the rural, north-central Andes in the province of Carhuaz. Semi-structured interviews (n=30) and participatory action research workshops (n=7) were conducted with local women to elucidate how they conceptualize, experience, and negotiate the shifting landscape of prenatal care and childbirth practices and providers. Semi-structured interviews with obstetricians, midwives, and social workers (n=9) were also conducted to compare perspectives and identify disconnects in knowledge and practices existing between these two groups in order to facilitate an open conversation on how to jointly improve the maternal experience and reduce maternal mortality and morbidity in rural Peru, where these risks are significantly higher than in urbanized, coastal areas.

In the face of changing practices and the influx of biomedical ideologies, women are faced with competing and conflicting bodies of knowledge as well as varying concrete and symbolic values and consequences of their decisions, which they must navigate and evaluate in a dynamic environment. Issues of ethnic and gender discrimination and financial and social coercion arose as prominent forces structuring risks and constraining maternal agency. However, women also found ways to both resist and accommodate these challenges, demonstrating the intricate and on-going negotiations that occur throughout gestation and the maternal experience. The results of this investigation illustrate the various and nuanced ways in which macro-level maternal health policies are manifesting on the local level and impacting the lived realities of rural, Andean women.