Husbands and maternal health matters in rural Guatemala: wives' reports on their spouses' involvement in pregnancy and birth

This paper explores the content, prevalence, and determinants of husbands' involvement in two aspects of their wives' maternal health: (1) providing advice and care during pregnancy and (2) attending birth. Using primarily women's reports of their spouses' involvement taken from qualitative and survey data from a sample of rural Guatemalan households, I find that husband participation is relatively high compared to some expectations and that the dynamics of male involvement differ between the two aspects. The analysis of receiving advice or care from husbands during pregnancy, an analysis done only among women who experienced a complication during pregnancy, suggests that the type of prenatal care sought and the quality of the familial and marital relationships are important factors. On the other hand, husbands' attendance at birth seems driven more by men's availability and access to birth. Together, the data show that "male involvement" is not a singular behavior and point to ways to conceptualize its complexity. (C) 2002 Elsevier Science Ltd. All rights reserved.