My life as Mae Tid Chua [mothers who contracted HIV disease]: Motherhood and women living with HIV/AIDS in central Thailand

doi:10.1016/j.midw.2014.04.003

Midwifery

Volume 30, Issue 12, December 2014, Pages 1166-1172

https://doi.org/10.1016/j.midw.2014.04.003 Get rights and content

Highlights

•
Becoming a mother permitted the women to have a meaningful life.
•
Motherhood prompted the women to stay alive for their children.
•
Reproductive needs of the women were questioned by health care providers.
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Women were advised not to breast feed their newborn babies as this could transmit HIV to the child.
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Women took into account their ability to care for their children in the future.

Abstract

Background

literature suggests that many women living with HIV/AIDS have a desire to become mothers and indeed many of them have done so (Thiangtham and Bennett, 2009, Barnes, 2013, Cogna et al., 2013, Lazarus et al., 2013, Ross, 2013, Yeatman and Trinitapoli, 2013). However, there is still a lack of knowledge about the lived experiences of Thai women living with HIV/AIDS who have become mothers. In this paper, we explored the experiences of pregnancy and birth, motherhood, and infant feeding practices among women living with HIV/AIDS in Thailand.

Method

in-depth interviews were conducted with 26 women living with HIV/AIDS in Thailand.

Findings

motherhood was considered desirable by women living with HIV/AIDS who participated in our study. Despite living with a serious illness, becoming a mother permitted them to have a meaningful life. Motherhood prompted the women to stay alive for their children. However, the women lived with constant anxiety about the condition of their infants. Reproductive needs of the women in our study were often questioned by their health care providers. Many were advised by their doctors and nurses not to breast feed their newborn babies as this could transmit HIV to the child. Most women took into account their ability to care for their children in the future and thus did not wish to have many children.

Conclusion

this paper contributes to conceptual understanding about the lived experiences of motherhood among women living with HIV/AIDS in Thailand. The findings have implications for midwifery care.

Introduction

Thailand is one of the Asian countries that have been hit hard by the epidemic of HIV/AIDS. Currently, about half a million (530,000) Thai people are living with HIV/AIDS (UNAIDS, 2012). Although Thailand has successfully reduced the spread of HIV among female and male sex workers and their clients, HIV seroprevalence among pregnant women has steadily increased (Thiangtham and Bennett, 2009, Liamputtong et al., 2012). In 2012, there are 210,000 women living with HIV/AIDS, aged 15 and over, living in Thailand (UNAIDS, 2012). Similarly to women in other parts of Asia, the majority of Thai women contracted HIV from having sex within monogamous relationships with partners who engaged in high-risk behaviour (Ainsworth et al., 2003, Liamputtong et al., 2012).

Literature suggests that many women living with HIV/AIDS desire to become mothers and indeed many of them have done so (Thiangtham and Bennett, 2009, Barnes, 2013, Cogna et al., 2013, Lazarus et al., 2013, Ross, 2013, Yeatman and Trinitapoli, 2013). Literature also suggests that women who are living with HIV/AIDS and who are mothers carry a triple burden of being HIV-infected; they are mothers of children who may or may not be positive themselves, and often are also caregivers to their partners who live with HIV/AIDS (Thomas, 2006, Hejoaka, 2009, Thomas et al., 2009). When a woman is labelled as having HIV, she is treated with suspicion, her morality is questioned, and often, blame is placed on her (Cullinane, 2007, Liamputtong et al., 2009, Thomas et al., 2009). Japanese women living with HIV/AIDS, for example, ‘are blamed for eschewing marriage and motherhood in favor of material pursuits’ (Cullinane, 2007: 255).

In this paper, we explored the experiences of pregnancy and birth, motherhood, and infant feeding practices among women living with HIV/AIDS in Thailand. Specifically, we investigated how these women perceived themselves as mothers, what experiences they had regarding their reproductive rights, and how they coped with infant feeding practices in their everyday life.

Section snippets

Methodology

This article is based on our larger project on the experiences of women living with HIV/AIDS in Thailand (Liamputtong et al., 2009, Liamputtong et al., 2012). A qualitative approach was adopted because qualitative researchers accept that, to understand people׳s behaviour, we must attempt to understand the meanings and interpretations that people give to their behaviour (Bryman, 2012, Creswell, 2012). This approach is particularly useful when we have little knowledge of the participants and

Participants characteristics

The majority of the women were aged between 31 and 40 years. Four were under 30 years of age and five were over 40. Most (25) were Buddhist and one was Muslim. Nineteen women were living with their new partners at the time of the interview, one was married, two were divorced, two widowed and another two were single mothers. Twelve women had primary school education, 11 finished secondary school education, and three had vocational college training. At the time of the interview, seven women

Discussion

Significant progress in HIV antiretroviral treatment (ARV) in recent years has improved the quality of life of many women living with HIV/AIDS (Liamputtong, 2013b, Liamputtong et al., 2014). These advances have allowed women with HIV/AIDS to change their expectations about motherhood and indeed, many of these women have children (Cooper et al., 2007, Hebling and Hardy, 2007, Agadjanian and Hayford, 2009, Nduna and Farlane, 2009, Thiangtham and Bennett, 2009, Cliffe et al., 2011, Cogna et al.,

Conclusion and implications for midwives

This paper contributes to conceptual understanding about the lived experiences of motherhood among women living with HIV/AIDS in Thailand. Motherhood was perceived as an important part of their lives, but because of their health status and other social circumstances, future childbearing was problematic for them.

Our study was based on a qualitative research with small number of participants. The findings cannot be generalised to all women living with HIV/AIDS in Thailand (Bryman, 2012, Creswell,

Acknowledgements

We are grateful to all the women who participated in this study. We thank Frances Happ who edited the paper for us. This paper is based on a collaboration research grant provided by the Faculty of Health Sciences, La Trobe University (Project No. 3.1).

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My life as Mae Tid Chua [mothers who contracted HIV disease]: Motherhood and women living with HIV/AIDS in central Thailand

Highlights

Abstract

Background

Method

Findings

Conclusion

Introduction

Section snippets

Methodology

Participants characteristics

Discussion

Conclusion and implications for midwives

Acknowledgements

Health Policy

Soc. Sci. Med.

Soc. Sci. Med.

Reprod. Health Matters

Soc. Sci. Med.

Australia. Midwifery

Midwifery

Soc. Sci. Med.

Soc. Sci. Med.

Women Birth

Soc. Sci. Med.

PMTCT, HAART, and childbearing in Mozambique: an institutional perspective

AIDS Behav.

‘I will not let my HIV status stand in the way’. Decisions on motherhood among women on ART in a slum in Kenya – a qualitative study

BMC Womens Health

‘I always wanted to see my babies grow up’: motherhood experiences for women living longer than expected with HIV/AIDS

Social support: proposing a conceptual model for application to midwifery practice

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Using thematic analysis in psychology

Qual. Res. Psychol.

Social Research Methods

Phenomenology and rehabilitation research

Fertility intentions of HIV-infected women in the United Kingdom

AIDS Care

Pregnancy and motherhood in the narratives of women with HIV infection living in the metropolitan area of Buenos Aires, Argentina

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The domestication of AIDS: stigma, gender, and the body politic in Japan

Med. Anthropol.

MOMS: formative evaluation and subsequent intervention for mothers living with HIV

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AIDS Care

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Understanding high fertility desires and intentions among a sample of urban women living with HIV in the United States

AIDS Behav.