According to the Spanish organization Intervida, the lack of medical attention available to indigenous women during pregnancy and birth makes them three times more likely than mestizo women to die in childbirth. Intervida says the elevated mortality rate is an indication of the danger faced by socially and economically marginalized indigenous women due to the scarcity and poor quality of health services and nutrition. Indigenous women also tend to have more children than women living in urban areas, with an average of five per family.