After maternal death: interpretations of epidemiological surveillance professionals on deaths and family reconfigurations in Pernambuco (Brazil)

Abstract

Notions of family, their new configurations, and arrangements have recently occupied a central place in academic debates. Transformations in forms of care and family dynamics gain particular contours when observed through the lens of maternal death investigations. The maternal mortality ratio is an essential indicator of health quality and the degree of social inequality in a country, and in Brazil, this phenomenon persists as a historical public health issue, aggravated by social markers of difference such as race, class, territory, education, disability, and age. In Pernambuco, the high rates of maternal mortality reveal inequalities in access to services, obstetric racism, dehumanization of care, and the absence of bonds between women and health care spaces. Added to this are the effects of abortion criminalization, which punishes even those who could have had access to legal termination of pregnancy but whose lives were not spared. Based on ethnographic research conducted within the State Committee for the Study of Maternal Deaths of Pernambuco, I seek to understand how epidemiological surveillance professionals interpret the process of investigating deaths of women of reproductive age, the social impacts of maternal death, and the family reconfigurations observed in home investigations. I discuss the imaginary of “family disintegration” mobilized in these contexts and argue that maternal death expresses itineraries of abandonment, resulting from the reproduction of inequalities and persistent state neglect.