Since 1987, international organizations have accorded greater attention to the problem of maternal mortality, particularly with the inclusion of its reduction in the Millennium Development Goals. This article examines maternal health policies in Mexico, focusing on interactions between the international, national, and local scales and considering the case of local projects in two states, Chiapas and Guerrero. Although the discourse of maternal health expressed at the international level has facilitated the creation of networks dedicated to maternal health, the restructuring of health services in Mexico and the rescaling of their provision have often conflicted with the realization of this goal. The impact of decentralizing health services has differed according to (a) the timing and nature of decentralization; (b) the number and expertise of nongovernmental organizations (NGOs) working on maternal health issues, and the connections between these NGOs and international networks; and (c) the responsiveness of the state governments to maternal health issues.