HIV-infected women's experiences of pregnancy and motherhood in Cape Town, South Africa

Abstract

Antenatal services provide a valuable opportunity for the uptake of prevention of mother-to-child transmission (PMTCT) of HIV interventions and antiretroviral treatment (ART) for maternal health. While knowledge of HIV status during pregnancy is beneficial to both mother and child, PMTCT programmes may focus more on prevention and the physical aspects of health than the psychosocial impact of HIV on pregnancy and motherhood. The objective of this study was to examine South African women's perceptions of HIV infection in pregnancy and how they related to motherhood in the context of HIV infection. In-depth interviews were conducted with 17 HIV-positive pregnant and 11 ≤ 6-month postpartum women to elicit perspectives on HIV-positive pregnancy and motherhood. For most women who tested in pregnancy, the primary rationale for testing stemmed from a concern for their children; and anxiety around the risk of vertical transmission was highly prevalent. Women did not perceive any superficial differences between themselves and non-infected pregnant women and they compared HIV to any other chronic condition. However, they voiced anxiety about being infected and were preoccupied with keeping their children safe, both in pregnancy and postpartum. They described a diminished sense of pride about motherhood and an additional burden of guilt associated with carrying a vulnerable child, which made pregnancy different for them in comparison to uninfected women. Feeding posed a particularly difficult issue because by choosing formula feeding, women were protecting their children, yet this seemed to diminish their status as a mother, while at the same time publicising messages about being infected with HIV. While women identified externally with the social value of motherhood, the burden of HIV infection was seen as a destabilising threat to their identity as mothers.

Disengagement of HIV‐positive pregnant and postpartum women from antiretroviral therapy services: a cohort study

“…First, women newly diagnosed with HIV in pregnancy were more likely to have disengaged from care compared to women who had been diagnosed previously. This echoes previous findings suggesting substantial challenges related to coping with an HIV diagnosis in pregnancy [ 22 , 27 , 32 ]. Women diagnosed with HIV during pregnancy may not be being adequately counselled regarding their HIV status and lifelong treatment.…”

Maternal Mortality and Female Literacy Rates in Developing Countries during 1970–2000: A Latent Growth Curve Analysis

“…Whereas the direct causes stem from obstetric complications of pregnancy, the indirect ones originate from health problems prior to the pregnancy. Ability to recognize threats to pregnancy and to make decisions with respect to the preservation of well-being constitute a preliminary step in the prevention of maternal deaths [36,37]. The next step involves enabling women to contact and avail themselves of appropriate health care services [38,39].…”