Pregnancy decisions of married women living with HIV during wide access to antiretroviral therapy in southern Malawi

Belinda Thandizo Gombachika,Johanne Sundby

doi:10.4236/health.2013.512274

Belinda Thandizo Gombachika, Johanne Sundby

Open Access

https://doi.org/10.4236/health.2013.512274

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Journal: Health	Publication Date: Jan 1, 2013
Citations: 32	License type: CC BY 4.0

Affiliation: University of Malawi, University of Oslo

Abstract

Availability of antiretroviral therapy and prevention of mother to child transmission of HIV programmes have increased childbearing decisions in people living with HIV. However, pregnancy decisions of married women living with HIV have not been adequately reported in Malawi. In order to provide information to inform the development of antiretroviral and family planning services targeted to the unique needs of women living with HIV, this study explored pregnancy decisions of women living with HIV in rural southern Malawi. Twenty in-depth interviews on married women living with HIV selected purposively were conducted in two antiretroviral clinics of patrilineal Chikhwawa and matrilineal Chiradzulu districts in 2010. With their pregnancy and child rearing experiences, the women who got pregnant after a positive HIV diagnosis decided to never get pregnant again. Their lived experiences of motherhood when living with HIV play a major role in their pregnancy decisions despite free access to antiretroviral therapy, which has improved the quality of their life’s and survival. Societies in Malawi must accept this behavioural change by married women living with HIV and their needs for family planning. Health care workers must be knowledgeable and sensitive about it and assist women living with HIV who are willing to adapt their pregnant decisions based on living experiences.

Highlights

In Malawi just as in most other sub-Saharan African countries, a woman’s social status is directly linked to her ability to produce children
With all these experiences about pregnancy decisions following an HIV-positive diagnosis, their very strong determination to their decisions is evidenced from use of contraceptives
The findings show that with wide access to ART, women living with HIV (WLWH)’s pregnancy decisions are diminishing because of a positive HIV diagnosis contradicting with Cooper et al, [11]; Heard et al, [16]; Peltzer, [18]; Kakaire, Osinde & Kaye, [28]; MacCarthy et al, [29], but concurring with two longitudinal studies conducted in Malawi by Hoffman et al, [21] and Taulo et al, [22]

Summary

Introduction

In Malawi just as in most other sub-Saharan African countries, a woman’s social status is directly linked to her ability to produce children. This is reflected by the high fertility rate of 5.7 children, which is compounded by low contraceptive use and high-unmet need for contraception, in a situation where the HIV prevalence rate is high, 11% [1]. A woman in a matrilineal social system produces children for her own matrilineage. While in the patrilineal social system, women leave their natal household to live in their husbands’ compound after marriage (virilocal). Lobola symbolically transfers a woman’s reproductive capacities from her own patrilineage to that of her husband’s [5,7,8,9]

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