Bedoya M/ Enfermería Investiga Vol. 8 No. 4 2024 (December - January)

POSTPONED MATERNITY: VOICES OF WOMEN WHO DECIDE TO ABORT IN ECUADOR

Gina Rosa Alonso Muñiz¹,2 https://orcid.org/0000-0003-0041-2956, Beatriz Elena Arias López3 https://orcid.org/0000-0002-3326-0402

¹Professor at the Southern State University of Manabí. Jipijapa, Ecuador.

²Coordinator of the Nursing Career at the Southern State University of Manabí Jipijapa, Ecuador

3Professor at the University of Antioquia. Medellin Colombia.

Creative Commons License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: July 20, 2023

Accepted: September 29, 2023

ABSTRACT

Introduction: Voluntary abortion is a topic in constant debate

because it invades the public and parliamentary spheres,

bringing with it discussions that go towards the political and

ethical aspects. For Ecuador, it becomes relevant due to the

restrictions derived from the norms that regulate the procedure.

In this sense, it is important to make motherhood visible from the

perspective of the women who decided to terminate the

pregnancy, in a social context that shows contrary edges to what

it has been culturally believed to be a mother. Objective:

Understand the way motherhood is understood from the

trajectories of women who have decided to abort in Ecuador.

Methods: Narrative biographical study in which 19 women of

legal age, who decided to abort at some point in their lives,

participated. The sample was made up of 19 women between 18

and 62 years old. The information was collected through in-depth

interviews, mostly virtually. Bertaux's proposal was used for data

treatment and analysis. Endorsement was obtained from the

Ethics Committee. Results: Being and the duty to be mothers

confronts women with tensions between a positive and

satisfactory motherhood and another as a dispossession of

themselves. Trends that are not necessarily exclusive emerge,

which take the form of sacrificial, omnipotent, burdensome,

imperfect and/or bad motherhoods. Conclusions: The meaning

that motherhood has for women is fundamental in their decision

to abort, to the extent that its social and cultural mandates

become additional pressure to sanction and criminalize their

decision to abort. This requires proposing a perspective of sexual

and reproductive health rights that allows nurses, and other

health actors, recognize these complexities and tensions to

assume their care task from a guarantee perspective, putting

women as the main focus.

Keywords: sexual and reproductive health, abortion, sexual and

reproductive rights, Nursing.

Corresponding author: Ph.D. Gina Rosa Alonso Muñiz. Email:gina.alonzo@unesum.edu.ec

Bedoya M/ Enfermería Investiga Vol. 8 No. 4 2024 (December - January)

INTRODUCTION

Sexual and reproductive health (SRH), like health in general, is

determined by various factors. Even though its correspondence

with the biological is obvious, the mediation of the social and

cultural context is essential (1-3). While biological bodies function

in certain ways, gender and the representations rooted in

patriarchal societies establish their own models of health,

science and behavior, with an impact on individual and collective

bodies (4). In this debate, women's rights have been

progressively recognized, without difficulty. The ideology of

femininity and the notions that it entails have permeated health

practices, as well as the process of health-illness-care-attention-

death (5), with latent threats and risks of violation of the

fundamental rights of women.

The attention regarding their SRH continues to be limited, with

poor quality, characterized by dependence on decisions of third

parties or institutions, and persistence of practices without

consent, based on logics of legitimized violence (6). The origin of

these systematic violations is found in the deep-rooted

representations and concepts around women, gender, sexuality

and their essential functions of gestating, giving birth,

breastfeeding, raising and revitalizing others in a personal, direct

and permanent way, in their daily survival and in death (7-9).

Within all these ideas, that of motherhood is covered with moral

judgments, whether religious, political or cultural. In some cases,

it is considered sacred and constant (10), but paradoxically

underestimated, as an instinctive response, which occurs

spontaneously and therefore has no value (8). The vision of “the

mother” is presented as a naturalized reflection of love,

unconditionality and, with it, the loss of autonomy of women (10),

conceptions that are inscribed in their bodies and lives, with

strong conservative and sexist aspects.

In this context, the exercise of women's fundamental rights may

be restricted, in particular sexual and reproductive rights, the

purpose of which is to guarantee that all people can live free of

discrimination, risks, threats, coercion and violence in relevant

decisions. So that they can enjoy a pleasurable, sovereign and

free sexual and reproductive life. This is reflected, among other

situations, in the norms and health practices provided by

professionals in the area, and ends up being expressed in the

setback in matters of SRH (11), where the autonomy of women

continues to be limited and widely debated.

Against this backdrop, abortion is one of the problems that

cannot be resolved. The criminalization and judicialization of

those who have performed abortions has increased in Ecuador.

The context of this research is pressured from various social

sectors to regulate the issue in line with international

organizations that point out violations of other associated rights,

such as health or intimacy (12).

Following these debates, this article aims to understand the way

motherhood is understood from the trajectories of women who

have decided to abort in Ecuador, that is, from the trajectories of

those women.

METHODS

Type of study. This work was situated in a feminist perspective,

a world view that recognizes women in society and confronts

systematic injustices based on gender (13). This philosophical

current promotes a social transformation in the contemporary

world, generating critical and reflective judgments capable of

changing realities (14), while calling into question the discourses,

dilemmas and problems that have not been answered. It aims to

create a science free of gender inequality, with a vision of

inclusion. Accordingly, the research is qualitative, it had a design

based on the narrative biographical approach (15) given the

relevance of understanding from the subjectivity of women the

phenomena that are intertwined with their SRH (16).

Place and Period. Ecuador, from March 2021 to March 2022

Selection criteria. Women of legal age who had decided to abort

at some point in their lives, who wanted to narrate their

experience freely and whose geographical area of residence was

Ecuador. Those with communication difficulties were excluded.

The approach to the participants was through contacts and social

networks, under the snowball strategy and through organizations

and activists that work for the defense of sexual and reproductive

rights, among them: Feministas Ec, Colectivo Zorras

Subversivas and the Blue Toad Community. A first contact was

established with the women to inform them about the objectives

of the research, informed consent and ethical safeguards, in

addition to completing a sociodemographic data sheet.

Sample. The sample was made up of 19 women between 18 and

62 years old, with an average of 32; residents of Quito, Jipijapa,

Portoviejo, Latacunga, Guayaquil and Atuntaqui. 47% were

university students, 35% were professionals from different

disciplines and 18% were housewives, which formed a sample

with significant access to education. Almost all declared their

ideological and practical adherence to the Catholic religion. The

sample was formed following the logic of convenience sampling

and achieving the formation of a homogeneous sample, with

minimal variation.

Bedoya M/ Enfermería Investiga Vol. 8 No. 4 2024 (December - January)

Data collection. In-depth interviews, with an average duration of

40 minutes and a frequency of three for each participant, which

were mostly carried out virtually through the Google Meet

platform, taking into account the conditions of the pandemic

specific to the period of development.

Data treatment and analysis. Bertaux's proposal (17) of the

“story of life” was accepted, which originates from everyday life,

arising from the dialogue between two people about a life event.

It starts with an intratextual descriptive approach, continuing with

an intertextual interpretive analysis. To do this, summaries

structured in matrices were used, which were then converted into

graphic representations or visual images of the identified themes.

Strategies such as comparison/contrast, pointing out patterns

and themes, triangulation and the search for negative cases,

were key in the process. This made possible to identify

metanarratives, such as the case of motherhood, whose results

and discussion are exposed below. No computer program was

used for the analysis process. On the contrary, manual data

processing was privileged.

Ethical aspects. Endorsement was obtained from the Ethics

Committee of the Faculty of Nursing of the University of Antioquia

according to Minutes CEI-FE 2020-21 of April 30, 2020 and from

the University San Francisco de Quito Minutes AVO-03-2021-

CEISH-USFQ. The ethical principles of the Declaration of

Helsinki corresponding to research with human beings were

followed (18). In the development of the research, pseudonyms

were used to protect the integrity and identity and maintain the

confidentiality of the participants.

RESULTS

From the generation of meta-narratives or collective narratives

resulting from the intertextual dialogue of the participants' stories,

it was possible to identify different maternal models, where the

being and the duty to be as mothers confront women with

permanent tensions between the idea of positive motherhood,

satisfactory, full of tenderness, with motherhood as a burden and

as the dispossession of themselves. In general terms, the

religious idea of motherhood stands out as a possibility of later

reward, a balm that allows sacrifice to be sustained, but also the

avoidance of guilt when faced with the decision to abort. Among

the participants' representations of motherhood, sacrificial

motherhood, omnipotent motherhood, motherhood as a burden,

perfect/imperfect motherhood and bad motherhood were

observed as trends present in the biographies, which are not

necessarily presented in an exclusive way but rather they overlap

at different times in their trajectories. This occurs depending on

the context and the transformations of the environment, whose

emphasis modulates decisions to interrupt or not their

pregnancies, which generates a varied spectrum to understand

women's decisions in relation to their sexual and reproductive

rights, as well as their diverse care trajectories.