ECUADOR – Knowledge and attitudes of the laws of abortion and clinical practice guidelines of abortion in Ecuador between undergraduate medical students and gynecology and obstetrics residents

by Marcos David Imbago Jácome, Daniela Estefania Meneses Valle

Pontificia Universidad Católica del Ecuador Repositorio, 2018 (Thesis, abstract in Spanish)


Background In Ecuador, abortion is legal when the pregnancy puts the woman’s life at risk or when the pregnancy is the result of the rape of a mentally disabled person. In any other case, abortion is punishable by imprisonment from 6 months to 3 years. Between 2014 and 2017, 184 women were prosecuted for having an abortion.

Objective To establish the extent of knowledge and attitudes about the law on abortion and clinical practice guidelines on abortion in Ecuador among students from the 6th to the 12th undergraduate level in the Faculty of Medicine and post-graduates in gynecology and obstetrics in the 1st, 2nd and 3rd years of the Pontifical Catholic University of Ecuador between February and April 2018.

Methodology A cross-sectional study was conducted. The information was collected through an anonymous survey with 20 questions, which included the participant’s socio-demographic situation, knowledge about human rights, comprehensive sexuality education, interaction with people and patients who have had an abortion, knowledge of the clinical practice guidelines on abortion of Ecuador and attitudes towards abortion, which included whether to report a woman who has induced an abortion and whether these women should receive medical attention or not.

Findings A total of 279 participants were included, median age 23 years: undergraduate students between the 6th and 12th levels of medicine (76.3%) and post-graduates in gynecology and obstetrics in the 1st, 2nd and 3rd years (23.7%) were included. Of the total sample, 163 were women and 116 were men. 91% were single. Only 9.3% had children. Most identified as Catholic. The majority of undergraduate students (68.5%) and post-graduates (97%) thought manual vacuum aspiration was the most recommended surgical abortion option. Just over half the undergraduate students at 10th and 11th level thought that D&C was the best option. 92% of the undergraduate respondents and all the post-graduates believed that abortion has psychological sequelae. Regarding the abortion law in Ecuador, the younger undergraduate students knew the most about the law. Sixth and seventh level undergraduate students were against reporting a woman who has induced an abortion compared to the other groups in the sample. 28.8% of post-graduates expressed agreement with reporting these women.

Conclusions There is a lack of knowledge about the abortion laws in Ecuador among medical students and post-graduates in gynecology and obstetrics. Negative attitudes regarding abortion were found; e.g. a high proportion of post-graduates agreed that women who have had an abortion should be reported to the police, in contrast with younger students, who were mostly against this. The majority of participants did not express an opinion on this, however, and claimed to be neutral. The vast majority of respondents said they agreed that women seeking medical attention for complications of unsafe abortion should receive it. Medical career curricula should include abortion laws and up-to-date clinical guidelines and recommendations, to provide all the information required by medical personnel who will deal with abortion.