Pregnancy decision-making among HIV positive women in Northern Vietnam: reconsidering reproductive choice

Abstract

The global HIV epidemic confronts pregnant women with hard reproductive choices. This paper offers a theoretically innovative and ethnographically sensitive exploration of the social processes through which 20 HIV positive women living in Northern Vietnam decide whether to continue or terminate their pregnancies. Arguing that human agency must be seen as an outcome of intersubjective engagements in shared social worlds, this paper explores how these women came to the decisions that they had to make and shows that women's choices were configured through everyday social relations, shaped through intimate engagements with husbands, parents, siblings, and in-laws. Based on the findings, it is recommended that pregnancy counseling is offered not only to the woman herself, but also, if she desires, involves members of her extended family.

Keywords:

• HIV
• pregnancy
• reproductive choice
• PMTCT
• Vietnam

Acknowledgements

This research was funded by the Danish International Development Assistance (Danida) and conducted under the auspices of the REACH project (Strengthening Population and Reproductive Health Research in Vietnam). Ethical approvals were obtained from the Scientific Committee of the Vietnam Commission for Population, Family and Children and by the Danish National Committee on Biomedical Research Ethics. The authors are grateful to authorities of Ha Long city, Quang Ninh province for their support during the research process and to all the women who participated.

Conflict of interest: none.

Notes

1. In Vietnam, PMTCT has been offered since 2004 in selected provinces. If a pregnant HIV positive woman receives the full PMTCT package, the risk that the infant will be infected is considerably reduced. However, even in well-resourced settings in Vietnam, the full package is not always offered (Anh et al. 2008).

2. A total of five women in our sample regretted their decisions. One – Tu – regretted that she continued her pregnancy, because eventually her child died from HIV; while four regretted having terminated their pregnancies. Only one of these women described the decision as ‘her own’, while four women said that they had submitted to the wishes of others.