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BMC Women's Health

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Open Access 01-12-2018 | Research article

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

Authors: Carlos Eduardo Cuinhane, Kristien Roelens, Christophe Vanroelen, Samuel Quive, Gily Coene

Published in: BMC Women's Health | Issue 1/2018

Abstract

Background

In 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.

Methods

In-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.

Results

The 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.

Conclusion

Women’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.

CD4 cells – also known as T-cells – are types of white blood cells that protect the body from infection. When a person is infected by HIV, the virus attacks and destroys the CD4 cell of the person’s immune system. The role of CD4 cells is to protect the immune system of HIV infected people (Castilla et al., 2005). Studies (Castilla et al., 2005; Barreiro et al. 2007) have shown HIV is suppressed when CD4 count is 350 cells and above. However, the risk of transmission can be minimised, but never eliminated.

Charms are set of portions traditionally used as indigenous contraceptives. They are prepared by mixing the pad used on the first menstruation with plants and staffed nail’s carcass and, placing it in a closed place or burring it (Capurchande et al. 2015).

Serodiscordant couple is a mixed-status in which one partner is infected by HIV and the other is not.

Family planning card is a document issued by the healthcare facility for women who adhere to modern contraception. Patients use this card to access contraceptives at the healthcare facility.

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Title: Perceptions and decision-making with regard to pregnancy among HIV positive women in rural Maputo Province, Mozambique – a qualitative study
Authors: Carlos Eduardo Cuinhane
Kristien Roelens
Christophe Vanroelen
Samuel Quive
Gily Coene
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Women's Health / Issue 1/2018
Electronic ISSN: 1472-6874
DOI: https://doi.org/10.1186/s12905-018-0644-7

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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