Parto intercultural en la región andina: implicaciones para la salud materna en poblaciones indígenas y mestizas de América Latina
DOI:
https://doi.org/10.56048/MQR20225.9.4.2025.e1142Palabras clave:
Parto intercultural; salud materna; Mujeres indígenas; parteras tradicionales; sistemas de salud.Resumen
Introducción: La mortalidad materna continúa siendo un desafío en América Latina, especialmente en poblaciones indígenas y mestizas, donde persisten barreras estructurales, socioculturales y de acceso a servicios de salud. En este contexto, el parto intercultural surge como una estrategia innovadora que integra prácticas biomédicas con saberes ancestrales, garantizando una atención más respetuosa y culturalmente pertinente. Objetivo: Sintetizar la evidencia científica sobre el parto intercultural en América Latina y analizar sus implicaciones para la salud materna, con énfasis en la región andina. Metodología: Se realizó una revisión sistemática bajo lineamientos PRISMA, con búsquedas en Scopus, Web of Science, SciELO y Latindex, considerando publicaciones entre 2000 y 2025. Se incluyeron estudios enfocados en poblaciones indígenas y mestizas de países andinos. Resultados: La evidencia revisada muestra que el parto intercultural mejora la aceptabilidad y el acceso a servicios obstétricos, favorece la reducción de complicaciones materno-neonatales y fortalece la confianza comunitaria en el sistema de salud. Experiencias en Ecuador y Perú evidencian descensos significativos en la mortalidad materna tras la implementación de políticas interculturales, mientras que estudios en México confirman que el apoyo formal a parteras tradicionales aumenta la seguridad cultural. No obstante, se identifican limitaciones como resistencia institucional, adaptaciones superficiales centradas solo en la posición vertical, y persistencia de barreras idiomáticas, de género y económicas. Conclusiones: El parto intercultural constituye una estrategia de salud pública con potencial comprobado para mejorar la equidad y la seguridad materna en la región andina. Sin embargo, requiere fortalecerse para garantizar una atención integral, respetuosa y clínicamente segura.
Descargas
Métricas
Cited
DOI: 10.56048
Citas
Actis, V., Bedwell, C., Wakasiaka, S., & Lavender, T. (2020). Utility of the three-delays model and its potential for supporting a solution-based approach to accessing intrapartum care in low- and middle-income countries. A qualitative evidence synthesis. Global Health Action, 13(1), 1–23. https://doi.org/https://doi.org/10.1080/16549716.2020.1819052
Akter, S., Davies, K., Rich, J. L., & Inder, K. J. (2019). Indigenous women’s access to maternal healthcare services in lower- and middle-income countries: a systematic integrative review. International Journal of Public Health, 64(3), 343–353. https://doi.org/https://doi.org/10.1007/s00038-018-1177-4
Armenta-Paulino, N., Wehrmeister, F. C., Arroyave, L., Barros, A. J. D., & Victora, C. G. (2022). Ethnic inequalities in health intervention coverage among Mexican women at the individual and municipality levels. EClinicalMedicine, 43, 101228. https://doi.org/10.1016/j.eclinm.2021.101228
Armenta, N., Sandín, M., & Bolúmar, F. (2019). Indigenous language and inequitable maternal health care, guatemala, Mexico, Peru and the plurinational State of Bolivia. Bulletin of the World Health Organization, 97(1), 59–67. https://doi.org/https://doi.org/10.2471/BLT.18.216184
Bautista-Valarezo, E., Espinosa, M. E., Michels, N. R. M., Hendrickx, K., & Verhoeven, V. (2022). Culturally adapted flowcharts in obstetric emergencies: a participatory action research study. BMC Pregnancy and Childbirth, 22, 772. https://doi.org/https://doi.org/10.1186/s12884-022-05105-z
Betron, M. L., McClair, T. L., Currie, S., & Banerjee, J. (2018). Expanding the agenda for addressing mistreatment in maternity care: A mapping review and gender analysis Prof. Suellen Miller. Reproductive Health, 15, 143. https://doi.org/https://doi.org/10.1186/s12978-018-0584-6
Branche, T., Pouppirt, N., Nelson, L. T. D., & Khan, J. Y. (2023). Potential Implications of Emerging Nontraditional Childbirth Practices On Neonatal Health. Journal of Pediatrics, 261, 1–10. https://doi.org/https://doi.org/10.1016/j.jpeds.2022.12.040
Carvajal, R., Gómez, M., Restrepo, N., & Et al. (2018). Panorama académico y político que enfrentan las parteras tradicionales en América Latina. Revista Cubana de Salud Pública, 44(3), 1–16. https://www.redalyc.org/articulo.oa?id=21459232012
Cinari, O., Edmonson, S. B., & Juusela, A. (2025). Maternal morbidity and mortality from a population health perspective. In A. Juusela & Z. O. Amarin (Eds.), Labor and Delivery from a Public Health Perspective (pp. 1–25). In Tech. https://doi.org/https://doi.org/10.5772/intechopen.1009968
Dueñas, S. E., Zangiacomi, E., & Donadi, E. A. (2021). Intercultural childbirth: impact on the maternal health of the ecuadorian kichwa and mestizo people of the Otavalo region. Revista Brasileira de Ginecologia e Obstetricia, 43(1), 14–19. https://doi.org/https://doi.org/10.1055/s-0040-1721353
Dwivedi, R., Shamim, M. A., Dwivedi, P., Banerjee, A. R., Goel, A. D., Vyas, V., Singh, P., Dixit, S. G., Mohan, K., & Singh, K. (2024). Maternal and child health training of traditional birth attendants and pregnancy outcomes: a systematic review and meta-analysis. Journal of Epidemiology and Global Health, 14(3), 690–698. https://doi.org/10.1007/s44197-024-00300-x
Évora, M. A. (2025). Intersectionality and Birth in Latin America: A Research Protocol on Maternal Health of Indigenous and Afro-Descendant Women in La Guajira, Colombia. Social Sciences, 14, 15. https://doi.org/https://doi.org/10.3390/socsci14010015
Fair, F., Soltani, H., Raben, L., van Streun, Y., Sioti, E., Papadakaki, M., Burke, C., Watson, H., Jokinen, M., Shaw, E., Triantafyllou, E., van den Muijsenbergh, M., & Vivilaki, V. (2021). Midwives’ experiences of cultural competency training and providing perinatal care for migrant women a mixed methods study: Operational Refugee and Migrant Maternal Approach (ORAMMA) project. BMC Pregnancy and Childbirth, 21, 340. https://doi.org/10.1186/s12884-021-03799-1
Gabrysch, S., Lema, C., Bedriñana, E., Bautista, M. A., Malca, R., Campbell, O. M. R., & Miranda, J. J. (2009). Cultural adaptation of birthing services in rural Ayacucho, Peru. Bulletin of the World Health Organization, 87(9), 724–729. https://doi.org/https://doi.org/10.2471/BLT.08.057794
Gallegos, C. A., Waters, W. F., & Kuhlmann, A. S. (2017). Discourse versus practice: Are traditional practices and beliefs in pregnancy and childbirth included or excluded in the Ecuadorian health care system? International Health, 9(2), 105–111. https://doi.org/https://doi.org/10.1093/inthealth/ihw053
Gallion, V. (2025). La interculturalidad entre política y práctica: Un desafío de salud pública para la inclusión de las parteras y parturientas indígenas de los Andes del Perú. Archipélies, HS1, 1–21. https://doi.org/https://doi.org/10.4000/14376
Habib, H. H., Mwaisaka, J., Torpey, K., Maya, E. T., & Ankomah, A. (2023). Are respectful maternity care (RMC) interventions effective in reducing intrapartum mistreatment against adolescents? A systematic review. Frontiers in Global Women’s Health, 4, 1048441. https://doi.org/https://doi.org/10.3389/fgwh.2023.1048441
Hallor, E., Arteaga, E., & San Sebastián, M. (2024). Exploring the integration of Indigenous traditional birth attendants into the western healthcare system: A qualitative case study from the Amazon of Ecuador. Journal of Community Systems for Health, 1, 1–12. https://doi.org/https://doi.org/10.36368/jcsh.v1i1.1051
Hernandez, S., Oliveira, J. B., & Shirazian, T. (2017). How a training program is transforming the role of traditional birth attendants from cultural practitioners to unique health-care providers: a community case study in rural guatemala. Frontiers in Public Health, 5, 111. https://doi.org/10.3389/fpubh.2017.00111
Ibáñez-Cuevas, M., Heredia-Pi, I. B., Meneses-Navarro, S., Pelcastre-Villafuerte, B., & González-Block, M. A. (2015). Labor and delivery service use: Indigenous women’s preference and the health sector response in the Chiapas Highlands of Mexico. International Journal for Equity in Health, 14, 156. https://doi.org/http://dx.doi.org/10.1186/s12939-015-0289-1
Jones, E., Lattof, S. R., & Coast, E. (2017). Interventions to provide culturally-appropriate maternity care services: Factors affecting implementation. BMC Pregnancy and Childbirth, 17, 267. https://doi.org/10.1186/s12884-017-1449-7
Kuo, O. C. (2022). Reproductive Health Interventions and Programming Targeting Indigenous Women in Latin America: A Systematic Review [Universidad de Carolina del Norte]. https://cdr.lib.unc.edu/concern/articles/rv043444f%0Ahttps://cdr.lib.unc.edu/downloads/b5645237s
Llamas, A., & Mayhew, S. (2016). The emergence of the vertical birth in Ecuador: An analysis of agenda setting and policy windows for intercultural health. Health Policy and Planning, 31(6), 683–690. https://doi.org/https://doi.org/10.1093/heapol/czv118
Llamas, A., & Mayhew, S. (2018). “Five hundred years of medicine gone to waste”? Negotiating the implementation of an intercultural health policy in the Ecuadorian Andes. BMC Public Health, 18, 686. https://doi.org/https://doi.org/10.1186/s12889-018-5601-8
Guía Técnica para la Atención del Parto Culturalmente adecuado, Proceso de Normatización de SNS 1 (2008). www.maternoinfantil.org/archivos/smi_D589.pdf
Organización Panamericana de la Salud. (2022). Integrating traditional midwives into Bolivia’s health care system to promote culturally secure births and intercultural dialogue. https://www.paho.org/en/stories/integrating-traditional-midwives-bolivias-health-care-system-promote-culturally-secure?utm_source=chatgpt.com
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Espanola de Cardiologia, 74(9), 790–799. https://doi.org/10.1016/j.recesp.2021.06.016
Pesantes, M. A., Bazán Maccera, M., & Ponce Lucero, V. (2025). Intercultural maternal health in the Peruvian Amazon: An unenforced policy. Human Organization, 84(2), 234–246. https://doi.org/https://doi.org/10.1080/00187259.2024.2435614
Ponce, M., Flor, M., & Romero Encalada, I. (2025). Acompañamiento y parto intercultural en el primer nivel de atención. LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades, 6(3), 1347–1359. https://doi.org/https://doi.org/10.56712/latam.v6i3.4041
Quinatoa, E. V., Olalla García, M. H., Quinatoa Tamami, M. K., & Quinatoa Tamami, M. A. (2025). Parto humanizado intercultural en Ecuador. Anatomía Digital, 8(1), 92–110. https://doi.org/https://doi.org/10.33262/anatomiadigital.v8i1.3301
Roberti, J., Leslie, H. H., Doubova, S. V., Ranilla, J. M., Mazzoni, A., Espinoza, L., Calderón, R., Arsenault, C., García-Elorrio, E., & García, P. J. (2024). Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries. The Lancet Global Health, 12, e145–e155. https://doi.org/https://doi.org/10.1016/S2214-109X(23)00488-6
Rutledge, J. D., Kiyanda, A., Jean-Louis, C., Raskin, E., Gaillard, J., Maxwell, M., Smith, T., Kershaw, T., & Abrams, J. (2024). Recommendations for integrating traditional birth attendants to improve maternal health outcomes in low- and middle-income countries. International Journal of Maternal and Child Health and AIDS, 13, e019. https://doi.org/10.25259/ijma_16_2024
Sáenz, R., Nigenda, G., Gómez-Duarte, I., Rojas, K., Castro, A., & Serván-Mori, E. (2024). Persistent inequities in maternal mortality in Latin America and the Caribbean, 1990–2019. International Journal for Equity in Health, 23, 96. https://doi.org/10.1186/s12939-024-02100-y
Sarmiento, I., Paredes-Solís, S., De Jesús-García, A., Maciel-Paulino, N., Meneses-Rentería, A., Amaya, C., Cockcroft, A., & Andersson, N. (2024). Traditional midwifery contribution to safe birth in cultural safety: narrative evaluation of an intervention in Guerrero, Mexico. Community Health Equity Research and Policy, 44(4), 377–389. https://doi.org/10.1177/0272684X221120481
Sarmiento, I., Paredes-Solís, S., de Jesús García, A., Maciel Paulino, N., Serrano de los Santos, F. R., Legorreta-Soberanis, J., Zuluaga, G., Cockcroft, A., & Andersson, N. (2022). Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial. BMC Pregnancy and Childbirth, 22, 43. https://doi.org/https://doi.org/10.1186/s12884-021-04344-w
Sarmiento, I., Paredes-Solís, S., Dion, A., Silver, H., Vargas, E., Cruz, P., Pimentel, J., Zuluaga, G., Cockcroft, A., & Andersson, N. (2021). Maternal health and Indigenous traditional midwives in southern Mexico: contextualisation of a scoping review. BMJ Open, 11, e054542. https://doi.org/https://doi.org/10.1136/bmjopen-2021-054542
Souza, J. P., Day, L. T., Rezende-Gomes, A. C., Zhang, J., Mori, R., Baguiya, A., Jayaratne, K., Osoti, A., Vogel, J. P., Campbell, O., Mugerwa, K. Y., Lumbiganon, P., Tunçalp, Ö., Cresswell, J., Say, L., Moran, A. C., & Oladapo, O. T. (2024). A global analysis of the determinants of maternal health and transitions in maternal mortality. The Lancet Global Health, 12, e306–e316. https://doi.org/10.1016/S2214-109X(23)00468-0
Suárez-Máximo, J., & Meza-García, C. (2025). Análisis del concepto cuidado en el parto con enfoque cultural: revisión de literatura. Sanus, 10, e515. https://doi.org/https://doi.org/10.36789/sanusrevenf..vi21.515
Terentius, B. (2025). Cultural Influences on Labor and Delivery Practices. In A. Juusela & Z. O. Amarin (Eds.), Labor and Delivery from a Public Health Perspective (pp. 1–19). InTech. https://doi.org/https://doi.org/10.5772/intechopen.1007187
Valdez, J. J., Jackson, A. V., & Marshall, C. (2023). Association between primary Spanish language and quality of intrapartum care among Latina women: a secondary analysis of the Listening to Mothers in California survey. BMC Pregnancy and Childbirth, 23, 212. https://doi.org/10.1186/s12884-023-05526-4
World Health Organization. (2025). Trends in maternal mortality estimates 2000 to 2023: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. https://www.who.int/reproductivehealth/publications/maternal-mortality-2000-2017/en/
Publicado
Cómo citar
Número
Sección
Categorías
Licencia
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
®
Los autores se comprometen a respetar la información académica de otros autores, y a ceder los derechos de autor a la Revista MQRInvestigar, para que el artículo pueda ser editado, publicado y distribuido. El contenido de los artículos científicos y de las publicaciones que aparecen en la revista es responsabilidad exclusiva de sus autores. La distribución de los artículos publicados se realiza bajo una licencia 
