Studying the Women in Ecuador

BI Review 08/01/2001

Sandra Ordoñez studied the physical and emotional status of expectant mothers in Tunshi-San Nicolas, small village in Ecuador.

 

Sandra Ordóñez performed a study on the status of pregnant Ecuadorian women in the areas of education, housing, health care, hygiene, and nutrition. She also researched the attitudes and ideas that surround them in their villages.

The indigenous community of Tunshi-San Nicolás lies 10 kilometers south of Riobamba, Ecuador, in the central Andean corridor of the country. The village residents dwell at high altitudes near Mount Chimborazo, which towers 6310 m (20,700 ft) above sea level. The cool temperatures in this community of 510 inhabitants average 14–15ºC (57–59ºF), and poverty marks the agriculturally based society. Some of the men live and work in nearby Riobamba to earn money for their families, while their wives maintain the houses and fields and care for the children. Even in homes where men are present, women are economically obliged to participate in agricultural labors.

The women of Tunshi shoulder this double load to keep their families fed and cared for. The poverty of rural life requires continual effort and hard work from all family members to attain security; few excuses justify neglecting family duties. Women, when pregnant, do not have the means for a lifestyle change; their diets remain monotonous and their workloads strenuous.

The conditions under which pregnant women of Tunshi, Ecuador, must live concern the Benson Institute. To learn more about the physical and emotional status of expectant mothers in the village during the nine months from conception to delivery, Sandra Ordóñez Gavilánez began a research project to document the situation. As a nutrition student from the Universidad Politécnica de Chimborazo (ESPOCH) (Polytechnic University of Chimborazo ) in Riobamba, she used her thesis as part of her graduation requirements and as a help to the Ezra Taft Benson Agriculture and Food Institute in Tunshi.

The health status of pregnant women is a standing concern in the developing world. The World Health Organization reports that more than 500,000 women die from pregnancy and labor-related issues each year, primarily in poor countries. Approximately four million babies die in their first year of life; these infant deaths often have roots in poorly monitored pregnancies and deliveries (WHO, 1999).

At the time of Ordóñez’s study, 13 women were pregnant in Tunshi. She interviewed, weighed, and measured the expectant women in the analysis of their physical and mental condition, practices, and beliefs. The data collected covers a wide spectrum of factors that affect women and developing fetuses.

Education and Housing

The highest prevalence of malnutrition and other health problems in Ecuador occurs in marginal urban areas and in rural populations. As Ordóñez explained, low income levels lead to deterioration of housing, lack of education and stable employment, poor sanitation services, and a low-quality food supply. The effects of impoverished conditions are detected mainly in children and women of child-bearing age. Ordóñez partially evaluated the quality of life in Tunshi by classifying the education level of the mother and the family’s living arrangements.

Ordóñez weights an expectant woman.

A mother’s level of education is correlated with the quality of her maternal practices; therefore Ordóñez asked the women about their academic history. Among the 13 interviewed, only one lacked formal instruction and was classified as illiterate. The other women received various levels of schooling; only one began a secondary education, which she did not finish.

In general, the dwellings in the community are inclined toward environmental intrusion and contribute to the circulation of disease-causing agents. The majority of the floors consist of compacted soil, the roofs are of corrugated tin, and the walls are constructed with cement blocks. Among the interviewed women, 11 live in homes classified as medium-risk housing while the other two live in high-risk conditions.

Medical Attention

In general, the women interviewed in Tunshi do not receive professional prenatal and labor attention. Most commented that upon discovering they are pregnant, they do nothing different from their regular daily activities. A health clinic which is attended daily by a nurse and three times weekly by a doctor exists in Tunshi. Despite the proximity of professional help, the women feel pressured for time in their duties at home. They do not believe the attention is necessary, and many do not trust formal medical attention. A majority are attended by their mothers or relatives in their home during pregnancy and the birth process. Only two of the women, both expecting their first child, insisted on seeking professional advice upon discovering their pregnancy.

Due to transportation problems and common practice, most women in Tunshi do not receive medical attention during labor. One woman related that during the delivery of one of her children she was the sole adult at home when strong contractions forced her to lie down in the bedroom. While her two-year-old child was observing, she gave birth to the baby. Shortly after, she sent her 11-year-old son to get a zigzi leaf (a stiff leaf with sharp edges from a native bush) to cut the umbilical cord. She bathed the new child by herself. Several similar accounts can be heard in Tunshi and other rural villages.

Eating Habits

The average breakfast in Tunshi consists of a bean flour soup, tea, and barley flour or bread. Rice, potatoes, vegetables, and a broth made from the flour of a cereal or a legume constitutes lunch. The evening meal is simple, consisting of noodle soup with potatoes and occasionally cheese or egg, and tea. High-quality protein foods are not regularly consumed based on distaste and/or the fact that the people sell such foods in the market for profit. Fruits are also scarce in the area.

All of the women obtain food for consumption from family agricultural production and from the village store or the market in Riobamba. Most of the high-quality foods each family produces are sold in exchange for lower quality foods in higher quantities, a common practice in impoverished areas. For example, most of the families in Tunshi produce carrots, but they sell them for noodles and rice. The people do not suffer from hunger, but rather from malnutrition.

Ordóñez measures the waist line of a pregnant woman in Ecuador.

As further analysis of eating habits, Ordóñez measured the weight and height of 12 of the women (one participant opted not to participate in the measurement process). These measurements and the gestational stage were compared to charts prepared by the Ministry of Public Health in Ecuador to classify the women according to categories of normal weight, underweight, and overweight. Six of the women fell into the normal weight category, four received a classification of overweight, and two weighed less than the recommendation.

Hygiene in the kitchen

Time constraints are particularly detrimental to hygienic practices in rural Ecuadorian homes. Low levels of cleanliness often encourage the proliferation of disease-causing organisms, thus cleaning practices were considered in Ordóñez’s data collection as an indicator of pregnancy health risks.

Twelve of the women find time to clean cooking and eating areas of their houses only occasionally, allowing insects and germs to spread. They state that they are occupied from the early hours of the morning until the evening with agricultural labors and weariness keeps them from accomplishing the task.

Despite physical exhaustion, all of the women place high importance on hand-washing when handling food. Additionally, each woman in the study takes time to wash food before preparing it for consumption, yet eight do not boil culinary water due to the objectionable taste of boiled water or a belief that it is not necessary. Each woman in the study boils the milk her family drinks.

Social and Psychological Views

The indigenous women of this area hold varied opinions of their status as pregnant mothers. Ordóñez posed questions in the interviews concerning views of pregnancy on a social and emotional level. Because new babies in large families can be viewed as financial and temporal burdens, five of the women in the study reported to Ordóñez that they are unhappy with their pregnancies. Depression and sadness result from their negative opinions of the pregnancy. The other eight women in the study have more optimistic views of their pregnancies because the current size of their families is not so large that another child is a burden. Four of these women are expecting their first child.

Family planning can result in families of a desired size and can protect the physical and mental health of the mother. Ten of the women report that they have received counsel concerning family planning from relatives as well as from the village’s health clinic, though the other three have received no information about contraceptive practices. About three-quarters of the women in the study say that birth control methods are a great help to them, though they did not specify actual practices.

Fertility Ideal

Table 1 describes the age and family size distribution of the pregnant women in Tunshi. It also records the number of children each woman considers to be ideal. Note that four of the women are younger than 18 and six of the women have more children than they prefer.

Ordóñez commented in her thesis that adolescent mothers in general lack good housing, have a low income, live in substandard family and social organizations, consume poor-quality diets, and have fatalist attitudes toward pregnancy and life in general. In the Population Reference Bureau’s booklet “Family Planning Saves Lives,” Barbara Shane states that “babies born to young mothers are more likely to be premature, have low birth weights, and suffer from complications of delivery” (Shane, 1996).

To evaluate the community women’s opinions about early pregnancies, Ordoñez asked the study group the optimal age for a mother at the time of her first child. Eight of the women agreed that 20 is the best age to start a family, while three believe that the ages from 21 to 23 are more appropriate. Two of the group’s members stated that 18 is a mature age to begin having children. Those who are currently pregnant under 18 years old say they would prefer to be older as first-time mothers, thus minimizing the number of children they will have in their child-bearing years.

Ordóñez appraised the village women’s opinions of child spacing and maximum birth age in her interviewing as well. Most of the women think two to three years before having the next child is appropriate, considering both the mother’s health and the fact that the previous baby will be less in need of his or her mother. The group had no clear idea of the age when a woman should stop having children.

Table 1. Results of a survey of 13 women showing their ideal and actual number of children
AGE	IDEAL NUMBER	ACTUAL NUMBER
16	3	1
17	2	1
17	2	1
17	2	2
18	2	1
24	2	3
25	3	3
26	2	2
27	3	4
31	5	6
32	3	8
37	5	9
37	2	9

Conclusion

Thanks to the work of Sandra Ordóñez, the Benson Institute now has a better picture of life in Tunshi. The Institute’s programs can now focus on such things as improving the productivity of village agriculture so that hours dedicated to field labor will yield more, educating women on the importance of professional supervision during pregnancy, and emphasizing cleanliness and disease prevention. As said by Dr. N. Paul Johnston, the Institute director, in a recent Brigham Young University forum address, “We seek to identify the problems that exist in the community and as a result of our investigations, develop educational material that can be used . . . to teach participants how to change their lives to improve the nutritional status and agricultural productivity of the community.”

With the help of Ordóñez’s thesis and those of similar students, the Benson Institute identifies existing problems and formulates the best solution.

Works Cited

Shane, Barbara. Population Reference Bureau. Family Planning Saves Lives (Online). 3rd edition. Washington, D.C.: Sauls Lithograph Company, 1996. Available: http://www.prb.org/pubs/pdf/ fpslasen.pdf (1999, Sept. 27)

World Health Organization. Maternal and Newborn Health/Safe Motherhood (Online). Available: http://www.who.org/rht/msm/ (1999, Sept. 10)