She wanted a child by thirty, and nothing was going to stop her – not even HIV. Ntutu Mxalisa knew that her child did not ask to be born, but, “I had to make the decision to bring this child into the world, so I have a responsibility to protect my child,” she said. As a woman she believes that she has the right to bear children, and the fact that she is living with HIV does not mean that she forfeits that right, as long as I know what I am letting myself into,” said Mxalisa.
Marion Stevens, the Women in Sexual and Reproductive Rights and Health (Wish) associate co-ordinator, said that “HIV positive women are entitled to sexual and reproductive health – and that includes having a baby. An HIV positive person can be a healthy parent and there is no ethical or legal reason why they cannot be.” Mxalisa remembers how a former colleague responded when she revealed that she was pregnant to her: “The first question she asked me is, ‘how can you do that being a public speaker, what message are you trying to send across to people that are looking up to you as a role model when it comes to living with HIV?’”
She wanted a child by thirty, and nothing was going to stop her – not even HIV. Ntutu Mxalisa knew that her child did not ask to be born, but, “I had to make the decision to bring this child into the world, so I have a responsibility to protect my child,” she said. As a woman she believes that she has the right to bear children, and the fact that she is living with HIV does not mean that she forfeits that right, as long as I know what I am letting myself into,” said Mxalisa.
Marion Stevens, the Women in Sexual and Reproductive Rights and Health (Wish) associate co-ordinator, said that “HIV positive women are entitled to sexual and reproductive health – and that includes having a baby. An HIV positive person can be a healthy parent and there is no ethical or legal reason why they cannot be.” Mxalisa remembers how a former colleague responded when she revealed that she was pregnant to her: “The first question she asked me is, ‘how can you do that being a public speaker, what message are you trying to send across to people that are looking up to you as a role model when it comes to living with HIV?’”
Negative responses and attitudes of health workers towards women living with HIV are widespread. The recently released Human Rights Watch report revealed that the Eastern Cape has the worst maternal mortality rates. The organisation carried out 152 interviews which all showed that patients are verbally and physically abused by public health workers. Before Mxalisa gave birth in January 2007 she inquired whether she qualified for a Caesarean section procedure to help her to give birth.
The information available at the time indicated that this was the best way to protect an unborn child from contracting HIV. Mxalisa recalls the nurses’ responses to her question, and said that they asked her a very strange question at the antenatal clinic. They asked Mxalisa what size shoe she wore, to which she replied that she wore a size six or seven. The nurses snapped back: “You will have no problem delivering your baby. You are going the natural way. We do not have the resources for you to go for Caesarean Section.” The nurses' response came from the assumption that if you have big enough feet, then you will have no problem with natural birth, because a bigger shoe size means that your hips should be big enough to manage a natural birth.
According to Stevens, there are a range of factors besides shoe size to take into account before birthing, and nurses are not always consistent when it comes to quality of care in terms of provision of non-judgemental services. She went on to say that most nurses are forced into working at an age when they have barely come to terms with their own sexuality, let alone when they are ready to provide for the sexual and reproductive health and rights of their clients. "It is no wonder that they are stigmatising – a lot of it comes out of their own fears and vulnerabilities. Our health system needs to figure out how to mitigate this large gap,” said Stevens.
Mxalisa knew that her dose of AZT (an antiretroviral) every three hours while in labour was her baby’s lifeline against HIV infection. Despite the intense labour pains, Mxalisa did not take her eyes off the clock, and when it was ten minutes before each dose of AZT, she would slowly lift herself out of bed, and stumble over to the nurse’s station. She would politely ask the nurses not to forget that she was due for her antiretroviral drugs in a few minutes. Then one of the nurses barked at Mxalisa: “You become very problematic when you come in with so much information because now you end up telling us how to do our job.” But looking back on her experience with them, Mxalisa chirped, “I was such a pain in the butt for the nurses.”
She recalls the moments leading up to finding out her daughter’s HIV status. Mxalisa took her daughter in for HIV testing at six weeks but it took her two months to finally find the strength to fetch her daughter’s results. She knew that she would blame herself if the results were positive. “I just cried”, Mxalisa said, and shook her head as if shaking away the painful memories, but “to my surprise my daughter tested HIV negative and I was crying; I was so overjoyed I couldn’t explain it. I just sat there crying and holding my baby.”
According to Professor Coovadia, a leader in maternal, newborn and child health, said, “There have been a few successes and the one that is not well known is the low transmission rate of the virus from the HIV-infected mother to her baby, and we know for all practical purposes as much about the science of transmission of the virus as we need to know.” Coovadia was referring to a recent report that suggests that the HIV transmission rate from an HIV-infected mother to her child, within South Africa is “down to about 3%.”
Her daughter remained her first priority, and thinking about her future encouraged Mxalisa to taker her medication. She is looking forward to her daughter's matriculation, graduation, 21st birthday and marriage, "so with all of those things going through my head I decided to start taking my medication,” she said. All mothers have those dreams for their children, but Mxalisa said that “those dreams become more real for you as the person who is living with HIV because you don’t know how much time you have to be with your daughter, especially when you are not taking antiretrovirals.” However, Mxalisa is on antiretroviral therapy and because of these drugs she will live to see all these milestones in her daughter’s life.
She boasts that her daughter is “the greatest treatment supporter you can ever find.” Women empowered with affirmative and accurate information can make life-affirming choices for both their and their unborn baby’s futures. Mxalisa works at the Raphael Centre where they provide information and support to people living with HIV. She uses her story to deliver life-giving knowledge and spread hope to other HIV-infected women.
Catherine Deiner is an Honours student at the Discovery Health Journalism Centre at Rhodes University
