Perceptions and decision-making with regard to pregnancy among HIV positive women in rural Maputo Province, Mozambique – a qualitative study

Abstract

BackgroundIn preventing the transfer of HIV to their children, the Ministry of Health in Mozambique recommends all couples follow medical advice prior to a pregnancy. However, little is known about how such women experience pregnancy, nor the values they adhere to when making childbearing decisions. This qualitative study explores perceptions and decision-making processes regarding pregnancy among HIV positive women in rural Maputo Province.MethodsIn-depth interviews and five focus group discussions with fifty-nine women who had recently become mothers were carried out. In addition, six semi-structured interviews were held with maternity and child health nurses. The ethnographic methods employed here were guided by Bourdieu’s practice theory.ResultsThe study indicated that women often perceived pregnancy as a test of fertility and identity. It was not only viewed as a rite of passage from childhood to womanhood, but also as a duty for married women to have children. Most women did not follow recommended medical advice prior to gestation. This was primarily due to perceptions that decision-making about pregnancy was regarded as a private issue not requiring consultation with a healthcare provider. Additionally, stigmatisation of women living with HIV, lack of knowledge about the need to consult a healthcare provider prior to pregnancy, and unintended pregnancy due to inadequate use of contraceptive were crucial factors.ConclusionWomen’s experiences and decisions regarding pregnancy are more influenced by social and cultural norms than medical advice. Therefore, education concerning sexual and reproductive health in relation to HIV/AIDS and childbearing is recommended. In particular, we recommend maternal and child healthcare nurses need to be sensitive to women’s perceptions and the cultural context of maternity when providing information about sexual and reproductive health.

Socio-Cultural and Societal Demands Influencing Pregnancy among HIV Positive Women in Kakamega County, Kenya

“…Isaac Maru, Rose Olayo, and Mary Kipmerewo of passage to womanhood, fertility test, identity and marital function [7] thus, women living with human immunodeficiency virus (HIV) desiring biological children is on the rise.…”

The Pregnancy Experience Among Women With HIV: A Literature Review

“…Almost all participants conceal their HIV status from professional staff as well as partners/family and friends. Lack of disclosure about HIV status due to lack of courage and stigma, especially diaspora in the African community, domestic violence, poor relations and fears of being abandoned by a partner (11)(12)(13)16) and discrimination in society (13,15,16) (17)…”

“…In several studies it was reported that there was no support from a husband or partner and family in treatment (11)(12)(13)(14)16), such as a prohibition by a husband to take HIV drugs (14). and inadequate economic, preventing them from taking medication (13).…”

“…Participants consider pregnancy with HIV to be a dangerous disease and can cause death which will add to their concern if transmitting HIV to their baby (12,13,15,16).…”

“…this is the main motivation for women to start ART, they want to stay healthy and live longer so they can care for children (11), so have the chance to become parents (12) and fulfill her role as a mother (10), strengthening spiritual beliefs through prayer and accepting the situation of those infected with HIV HIV (10,15). However, experience in some women, they are often afraid due to deteriorating health and the possibility of HIV transmission to infants, women think that pregnancy with HIV is a disease that can cause death (16).…”