C.2.Social-Cultural Dynamics in HIV-positive pregnant women’s reproductive decisions Lilongwe,
by Belinda Thandizo Gombachika, Astrid Blystad, Chrissie N. Kaponda
Background: There is scant knowledge on experiences of HIV-positive pregnant women; their reproductive choices, their reflections about health and future for themselves and their children, and their actual handling of their precarious condition. This study aimed to generate knowledge to be applied by health service providers in planning policies and practices to improve reproductive choices and health care of HIV-positive pregnant women.
Methods: In-depth interviews were conducted in October 2003 with twelve HIV-positive pregnant women attending two antenatal clinics in Lilongwe, Malawi. The women were part of a project linked to the University of North Carolina (UNC) Lilongwe Prevention of Mother to Child Transmission of HIV (PMTCT) Project.
Results: The majority (9 out of 12) of the informants reported learning about their HIV-positive status after becoming pregnant, and had not considered themselves to be at risk of HIV. Regarding pregnancy decisions two were forced by their husbands to have a child (one woman knew her HIV-positive status before becoming pregnant), three wished to please their husbands (two woman knew their HIV-positive status before becoming pregnant). One became pregnant following default to a modern method of contraception, while the rest had wished to become pregnant). Only one woman wished to discontinue the pregnancy following the HIV-positive test results.
Conclusions: Socio-cultural obligations to have children appeared to outweigh fears and risks associated with the prospects of deteriorating health, the risk of giving birth to infected infants, and the fear of leaving children orphaned. Improved intervention strategies and diverse forms of support groups for HIV-positive pregnant women, which can address issues of pregnancy decision making, are in urgent demand.