Department of Social Medicine, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Facultad de Ciencias Médicas, Cátedra de Pediatría, Universidad Central del Ecuador, Quito, Ecuador.
Rev Bras Ginecol Obstet. 2021 Jan;43(1):14-19. doi: 10.1055/s-0040-1721353. Epub 2021 Jan 29.
Considering the increased frequency of maternal deaths reported from 2001 to 2005 for Indigenous and mestizo women from the Ecuadorian rural area of Otavalo, where the Kichwa people has lived for centuries, the objective of the present article is to describe how the efforts of the local health community and hospital workers together with a propitious political environment facilitated the implementation of intercultural childbirth, which is a strategy that respects the Andean childbirth worldview.
We evaluated a 3-year follow-up (2014-16) of the maternal mortality and the childbirth features (4,213 deliveries).
Although the Western-style (lying down position) childbirth was adopted by 80.6% of the pregnant women, 19.4% of both mestizo and Indigenous women adopted the intercultural delivery (squatting and kneeling positions). Both intercultural (42.2%) and Western-style (57.8%) childbirths were similarly adopted by Kichwa women, whereas Western-style childbirth predominated among mestizo women (94.0%). After the implementation of the intercultural strategy in 2008, a dramatic decrease of maternal deaths has been observed until now in both rural and urban Otavalo regions.
This scenario reveals that the intermingling of cultures and respect for childbirth traditions have decreased maternal mortality in this World Health Organization-awarded program.
考虑到 2001 年至 2005 年期间,厄瓜多尔奥塔瓦洛农村地区的土著和梅斯蒂索妇女的孕产妇死亡率报告频率增加,而基奇瓦人在那里已经生活了几个世纪,因此,本文的目的是描述当地卫生社区和医院工作人员的努力以及有利的政治环境如何促进了尊重安第斯分娩世界观的跨文化分娩的实施。
我们评估了为期 3 年的随访(2014-16 年),包括孕产妇死亡率和分娩特征(4213 例分娩)。
尽管 80.6%的孕妇采用了西式(仰卧位)分娩,但 19.4%的梅斯蒂索和土著妇女采用了跨文化分娩(蹲姿和跪姿)。基奇瓦妇女同样采用了跨文化(42.2%)和西式(57.8%)分娩,而西式分娩在梅斯蒂索妇女中更为常见(94.0%)。自 2008 年实施跨文化战略以来,奥塔瓦洛农村和城市地区的孕产妇死亡率至今已显著下降。
这种情况表明,文化的融合和对分娩传统的尊重已经降低了这个获得世界卫生组织认可的项目中的孕产妇死亡率。