knowledge and safe practices of traditional midwives in adolescent childbirth care in rural Ecuador

Abstract

Traditional midwifery continues to be a pillar in maternal care for rural and indigenous communities in Ecuador, although it faces limitations in training, biosecurity, and articulation with the health system. The objective of the study was to determine the level of knowledge and safe practices applied by midwives in the care of adolescent childbirth in the community of Cube, Quinindé canton. A quantitative, descriptive, observational, cross-sectional and retrospective study was carried out with a population of seven midwives, of which six made up an intentional sample. A structured four-section survey was applied, assessed with a four-point Likert scale, which explored sociodemographic characteristics, clean and safe childbirth practices, maternal and neonatal care, and actions in the immediate postpartum period. Most of the participants were 61 years of age or older, had a low level of education and were exclusively dedicated to domestic work. High adherence to safe practices such as hand washing, perineum hygiene, immediate drying of the newborn, skin-to-skin contact, cutting the cord with sterile material, neonatal surveillance, and promotion of early breastfeeding was evidenced. However, weaknesses were identified in the systematic use of gloves, handling of contaminated material, placental screening, surveillance for warning signs, and postpartum education. It is concluded that midwives have valuable knowledge, but they need to strengthen biosecurity measures and education through continuous training with an intercultural approach.