Abstract
M.A.
This study explores the experience of pregnancy from the perspective of HIV-positive women. To shed light on this phenomenon, the existing literature was examined and it was found that very few studies have investigated South African women’s experience in this context. Existing findings tend to focus on the day-to-day impact of HIV on a woman’s mothering role rather than on her experience of pregnancy in particular.
Pregnancy can be viewed as a process of growth, during which the relationship between the mother and her baby is prepared. For most women, acceptance of pregnancy is associated with the development of an attachment to the foetus. However, the nature of emotional support received during pregnancy can affect the development of the mothers’ attachment to the baby. Moreover, a pregnancy experience is coloured by a complex of personal needs and expectations, health status, as well as emotional, psychosocial and physical circumstances. In this regard, an HIV-positive status may influence an expectant woman’s perception of her health. Generally, being HIV positive and physically healthy is experienced as a complex psychological state, where a chronic sense of uncertainty can precipitate various somatic and psychological symptoms of distress. HIV-positive individuals who experience the most distress tend to have difficulty with initiating contact with sources of support.
The focal point of this study was to understand the psychological implications of pregnancy delineated by an HIV-infection, as well as the meanings that these mothers attribute to the experience. Accordingly, a phenomenological framework was adopted to investigate the lived world of the HIV-positive pregnant woman. Phenomenologically informed interviews were conducted with HIV-positive women in the last trimester of their pregnancies, with the aim of obtaining an in-depth account of their experience of pregnancy. These women all knew about their HIV status for at least three years before falling pregnant. The interviews of three of the four participants were transcribed, followed by analyses and descriptions that were guided by phenomenological principles. The findings offer a phenomenological description of themes that form part of the phenomenon of pregnancy in the face of an HIV-positive status for these women. Their experience of pregnancy was characterized by significant emotional distress fuelled by fear of disclosing their status to their children and health care staff, uncertainty about the future, as well as having significant worry about their own and the baby’s health. These mothers adopted a cautious, wait-and-see attitude toward the pregnancy and they coped by distancing themselves from negative affect. Because they did not want to burden their families, they carried much of their emotional distress on their own. HIV-positive pregnant mothers seem to be proactive in looking after their health, possibly as a result of antenatal care. However, they are vigilant about physical changes as well as markers of health, such as CD4 counts, and shifts can be anxiety provoking. Finally, pregnancy intendedness forms a significant part of the overall experience, where a pregnant mother may consider termination of an unexpected pregnancy on the grounds of her HIV-positive status. Negotiating the decision or ability to terminate, can also have an influence on the overall experience of the pregnancy.
In conclusion, an overview of the findings leads to tentative recommendations that may alleviate the emotional difficulties experienced by HIV-positive pregnant women. These findings need to be viewed in conjunction with the evaluation of the strengths and limitations. Although this study has yielded some findings that can contribute toward a deeper understanding of HIV-positive women’s experience of their pregnancies, a number of additional issues have arisen as a result of these findings. There is thus a need for further research on the topic and to this end, some suggestions for future research are offered.