Understanding the Social Environmental Influences on Pregnancy and Planning for Pregnancy for Young Women in Harare, Zimbabwe.

Abstract

Social environmental influences on pregnancy-related practices and outcomes have been studied, yet few studies explore these influences qualitatively from the perspectives of women's personal social networks and the larger social networks that exist within their communities. This study sought to understand and describe the social environment related to pregnancy and planning for pregnancy in Harare, Zimbabwe from the perspectives of women's social networks, and its influence on pregnancy-related decisions and practices. Semi-structured, in-depth, qualitative interviews were conducted in both Shona and English with 24 key community stakeholders (6 healthcare workers, 6 school teachers, 6 family members of females aged 14-24years, and 6 community leaders) who lived or worked in 2 low-income, high-density communities in Harare. Data were analyzed thematically using NVivo 10 software. The social environment related to pregnancy and planning for pregnancy described by participants was deeply rooted in culture and cultural practices and centered on four themes: (1) pregnancy importance to the role of a woman in the community and the fulfillment of marriage, (2) pregnancy silence to prevent adverse pregnancy outcomes and adolescent and out of wedlock pregnancies, (3) patriarchal pregnancy culture, and (4) community support during pregnancy. Maternal health efforts in Zimbabwe should acknowledge cultural influences on pregnancy and address pregnancy silence to improve reproductive health communication, empower women to be partners in the pregnancy decision-making process, and include women's social networks.