Activists working in villages in southern Mexico say they have documented at least 20 recent cases of women giving birth outside hospitals whose staff claimed there was no room. Photos and video of some incidents posted on social media sites have prompted outrage in Mexico and around the world.
Mexican health officials have said the cases are isolated and unavoidable due to overcrowding and limited resources at some rural health centers. But women's advocates appealed to the Inter-American Commission on Human Rights on Thursday, saying they believe there is a systemic problem of prejudice and callousness toward indigenous women in the Mexican public health system.
"These are not isolated cases. We have a pattern. We are not talking about one woman. There are many and nothing is being done to solve the problem," said Regina Tames, director of the Reproductive Choice Information Group, a non-governmental organization based in Mexico City.
Pablo Kuri Morales, deputy health secretary for preventive care, said most of the births in Mexico's health system occur without problems but he acknowledged that hundreds of women here still die every year during or immediately after they give birth, giving the country a maternal death rate more than three times that in the U.S.
"This is something the government of Mexico is worried about. Our stand now is to reject, disapprove and fight with all our strength any form of violence against women," Kuri Morales said.
The problem garnered national attention last year when a photo showed a 29-year-old woman of Mazatec ethnicity squatting in pain immediately after giving birth in October on the lawn outside the Rural Health Center of the village of San Felipe Jalapa de Diaz. The woman, Irma Lopez, and her son, Sabino Salvador, survived with no health problems, but the picture upset many Mexicans when it was widely shared on Twitter and Facebook and shown on the front pages of some national dailies.
News about the outdoor birth prompted two other women to go public with their own harrowing tales of having their babies born outside the same center. Less than a week later, authorities fired the director of another hospital after a video showing a woman giving birth in a waiting room was posted on YouTube. Television news channels in Oaxaca state showed a woman having a baby in the dark courtyard outside the General Hospital of Huajuapan de Leon. In another case, an 18-year-old indigenous woman gave birth in the bathroom of a shelter next to a hospital after allegedly being refused medical care.
"This probably has been going on for a while," said Tames. "What's new is that people are outraged and want to do something about it."
Earlier this month, President Enrique Pena Nieto urged hospitals not to refuse care to women in labor. Also, Oaxaca Gov. Gabino Cue recently announced a $550,000 investment to set up 50 new delivery rooms across the state.
But just this week, local media reported the case of a woman feeling contractions who had been sent away by a hospital and was only re-admitted after photographers began arriving.
None of the women or babies have died or suffered from major health problems, but Tames said authorities shouldn't wait for a death before adding more resources to understaffed rural clinics and hospitals.
Most of the cases that have gone public have occurred in Oaxaca. The largely rural southern state is among Mexico's poorest and suffers from high rates of obstetrical problems including preeclampsia, a condition that causes high blood pressure in women during pregnancy that can lead to kidney or liver failure.
A handful of similar cases have been reported in Puebla and Chiapas, also states with large indigenous populations and high rates of obstetrical problems and maternal deaths.
The human rights commission will study the cases heard Thursday and can send resolutions that are non-binding based on what it finds.
Although authorities fired the director of the first health center to draw attention to the problem, the Oaxaca state medical regulatory committee weeks later ruled that Irma Lopez's case was not the result of negligence and called the birth an unforeseeable event.
Lopez hopes the attention her case has brought to the state will help lead to better care for indigenous pregnant women.
"I hope that we find the support in the end. We are peasants and housewives."