When the United Nations announced the Millennium Development Goals (MDGs) in 2000, approximately half a million women worldwide died each year from complications associated with pregnancy and childbirth. The fifth MDG aimed to reduce the maternal mortality rate by 75 per cent between 1990 and 2015, but by the target date, the goal had not been reached.

In The Limits of Trust Lisa Nicole Mills investigates the reasons why Mexico in particular did not meet its objective. Focusing on the states of Guerrero, Chiapas, and Oaxaca, where maternal mortality rates are the highest in the country, Mills looks into how MDG 5 has been implemented in Mexico, how it has been experienced by individuals and groups, what obstacles have been encountered, and what factors have facilitated improvements in maternal health. Using data gathered from interviews with NGOs, government officials, and health care workers, the book argues that government and feminist NGO efforts to build trust in the health care system have fallen short because of systemic failures to protect women’s rights and enhance the quality of health care.

In Mexico a woman’s risk of dying from a pregnancy-related complication is five times higher than in developed countries. The Limits of Trust explores the realities of implementing maternal health initiatives on the ground in rural, remote, and impoverished areas, and the steps that can be taken to successfully combat maternal mortality.

Lisa Nicole Mills is associate professor in the School of Public Policy and Administration at Carleton University.

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