Creating continuity out of the disruption of a diagnosis of HIV during pregnancy

Abstract

We propose that appropriately educated nursing and midwifery staff could facilitate the 'meaning making' process that is required for newly diagnosed HIV positive persons to find a subjective sense of well-being in their lives.

Maternal-Fetal Attachment and Health Behaviors among Women with HIV/AIDS

“…However, the effect sizes observed in the relationships between the maternal-fetal attachment model and these maternal health behaviors ranged, respectively, from medium to medium-large. These findings offer only partial support to the study's hypothesis; however they add emerging credence to similar associations suggested in the qualitative research literature (Ciambrone et al, 2007;D'Auria et al, 2006;Kelly et al, 2012;Njie-Carr et al, 2013). It also suggests potential benefits in attending to the relationship a woman has with her unborn child perhaps as an additional component of her prenatal care to possibly help resolve her struggles with health behaviors.…”

“…Nonetheless, they reported that the health of the fetus, the desire to protect the fetus from their own infection, and the motivation to prevent mother-to-child transmission were the primary reasons women offered to account for their better adherence during pregnancy, compared to the period after childbirth (Ekama et al, 2012;Mellins et al, 2008;Michel et al, 2012;Nachega et al). Similar themes, such as getting tested and adhering to ART medication early in pregnancy to protect the health of the fetus and/or proactively guard the women's own health, clearly emerge among the findings of two, one national another international, qualitative studies (Kelly et al, 2012;Njie-Carr et al, 2012). The explanations and themes expressed by HIV-infected pregnant women participating in these studies closely allude to their experience of maternal-fetal attachment.…”

“…Simultaneously, the prospect of a new life may provide her with hope, optimism and motivation to live. The concerns to protect the unborn child from the threat of HIV may strengthen her determination to stay healthy and survive, or it may distract her from dealing with this devastating diagnosis (Kelly et al, 2012). The wide range of reactions of the newly HIV diagnosed women in the context of pregnancy may include fear of dying, and concern for the welfare of the fetus, mixed with a renewed sense of self-worth and self-confidence in the maternal role.…”

“…Implicit in this decision is her intention to take charge of her health, her future, and perhaps her dreams of becoming a mother (Kelly et al, 2012). A planned pregnancy brings along a strong attachment to the child she expects, an impetus to adopt healthy life styles, and a willingness to adhere to HIV treatments (Njie-Carr et al, 2013).…”

“…The explanations and themes expressed by HIV-infected pregnant women participating in these studies closely allude to their experience of maternal-fetal attachment. Kelly et al (2012) indicate that the themes of "motherhood" and "hopes for the new life of the unborn child" become a source for optimism and motivation to practice optimal maternal health behaviors, in the context of adversity. The present study used maternal-fetal attachment to conceptualize these themes and tested the hypothesized facilitative influence of maternal-fetal attachment on maternal health behaviors, before and after childbirth, in this population.…”