Should women with HIV ‘be allowed’ to have children?
“Be allowed” is a misleading title. You can’t stop women from having children; if you could then there would be no more teenage pregnancies and parents would sleep comfortable assured that no accidents would befall their daughters—or their sons, but that’s another story.
I will be upfront and make my view clear. People are responsible for their own actions. The onus is on adults to do the right thing. The right thing is to get tested, take ARVs for prevention of mother-to-child transmission and adhere to all the procedures before, during and after birth to prevent transmission to the child. This is a loaded statement a lot easier said than done. I will get back to it later.
What spurned this discussion is an email a few weeks ago from Madalitso Mmanga who stressed “each woman has the right to have a child; it needs to have a string attached because that right is a shared right with the unborn baby. What is needed in Malawi [is that]testing for HIV be should mandatory.”
The emphasis I feel is on sharing the right with the unborn baby—this honestly and truthfully is accepting responsibility of being a parent to a child. This is probably a modern and naive view. I am sure if I speak to my aunties in the village they would say family planning in this sense is not a mindset easily adopted in traditional rural settings where girls are taught to please their husbands, with no questions asked.
As I write this, it has just dawned on me: maybe the issue comes down to women’s empowerment. It is about women knowing no matter what their status, they can be confident that their husbands, families and communities will accept them.
So to backtrack… Prevention of mother-to-child transmission is not simply about policing women with HIV. It’s wrapped up in a very complex environment of stigma, discrimination, women’s education (or lack of) and reliance on men for livelihood. So it’s complicated. Unless we break down all those barriers, Option B plus prevention of mother to child transmission will never deliver its full potential to reduce the transmission of HIV to children. But I wonder, given a choice of taking drugs to prevent HIV transmission to a child with the potential for abandonment by a husband and stigma from the community or pretend it’s business as usual with a high potential for transmission of HIV to a child, what do you pick?
