This study investigated ethnic differentials in the use of pregnancy-related care and aimed to identify whether the differences persist when geographical access to services is equal. This study was based in the north-eastern Ch’orti area of Guatemala, an area characterized by a mixed ladino and Maya culture.

Logistic regression was used to explore the data. Unlike the DHS, classifying ethnic groups according to dress and language, this study introduced an alternative approach based on self-identification.

The results showed significant differences and a gradient in modern pregnancy care services among self-identified ethnic groups within the same town after controlling socioeconomic and cultural indicators. The DHS data did not permit the detection of ethnic diversity in the use of pregnancy care for this region.

The study concluded that differences in modern pregnancy care exist among self-identified ethnic groups with no outward markers of ethnicity and persist when equal access to services. For the majority of the population living in indigenous villages, pregnancy care remains traditional. This ethnic diversity highlights the importance of further extending affordable, high-quality, and culturally adapted maternal health care services in Guatemala.