莫桑比克马普托省农村地区艾滋病毒阳性女性对怀孕的认知与决策——一项定性研究

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

作者信息

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

机构信息

Department of Sociology, Eduardo Mondlane University, Maputo, Mozambique.

Vrije Universiteit Brussel (Brussels University), RHEA, Centre for Research in Gender, Diversity and Intersectionality, Brussels, Belgium.

出版信息

BMC Womens Health. 2018 Oct 11;18(1):166. doi: 10.1186/s12905-018-0644-7.

DOI:10.1186/s12905-018-0644-7

PMID:30305066

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6180632/

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.

摘要

背景

为防止艾滋病毒传染给子女，莫桑比克卫生部建议所有夫妇在怀孕前遵循医学建议。然而，对于这些女性如何经历怀孕，以及她们在做出生育决定时所秉持的价值观，我们知之甚少。这项定性研究探讨了马普托省农村地区艾滋病毒呈阳性的女性对怀孕的看法和决策过程。

方法

对59名刚成为母亲的女性进行了深入访谈和5次焦点小组讨论。此外，还对母婴保健护士进行了6次半结构化访谈。这里采用的人种志方法以布迪厄的实践理论为指导。

结果

研究表明，女性常常将怀孕视为生育能力和身份的一种考验。它不仅被视为从童年到成年的一种仪式，也是已婚女性生育子女的一项责任。大多数女性在怀孕前并未遵循推荐的医学建议。这主要是因为她们认为怀孕决策是一个私人问题，无需咨询医疗保健提供者。此外，对感染艾滋病毒女性的污名化、缺乏怀孕前咨询医疗保健提供者必要性的知识，以及由于避孕措施使用不当导致的意外怀孕，都是关键因素。