Ambivalent Sisterhood and Reproductive Care in Rural Areas: A Qualitative Study in the La América and La Unión Parishes, Jipijapa Canton, Ecuador

Abstract

In rural areas, ambivalent sisterhood is manifested in reproductive care when women's community networks provide vital and indispensable support for upbringing, childbirth, and domestic support in the absence of public health services, but at the same time they exercise social control that monitors, judges, and reproduces patriarchal mandates on sexuality, contraception, and the bodily decisions of their peers, with the aim of understanding how these informal care networks operate. The methodology employed a descriptive qualitative approach based on Reflective Thematic Analysis with 12 participants through community insertion, textile narratives, and semi-structured interviews. The results show that circulating knowledge constitutes a recent intergenerational construction initiated by adults to break the silence about menarche with their daughters. The informal network functions as a primary infrastructure that attends births, postpartums, contraceptive information and material support in early pregnancies, however, this network operates as an ambivalent device that, while protecting and replacing the State, exercises control and surveillance over the female body. On the other hand, formal medical intervention in high parities is mainly limited to late surgical sterilization. In conclusion, the ambivalence of the networks does not reflect failures of solidarity, but rather structural gender barriers and the lack of institutional protection in rural areas, requiring community nursing to strengthen these care capacities without perpetuating inequalities.