Contradicting Maternity

Carol Long

Description

Drawing on rich and poignant interviews with mothers who have been diagnosed HIV-positive, Contradicting Maternity provides a rare perspective of motherhood from the mother’s point of view. Whereas motherhood is often assumed to be a secondary identity compared to the central figure of the child, this book reverses the focus, arguing that maternal experience is important in its own right. The book explores the situation in which two very powerful identities, those of motherhood and of being HIVpositive, collide in the same moment. This collision takes place at the interface of complex, and often split, social and personal meanings concerning the sanctity of motherhood and the anxieties of HIV. The book offers an interpretation of how these personal and social meanings resonate with, and also fail to encompass, the experiences surrounding HIV positive mothers. Photographs, academic literature and the accounts of real women are read with both a psychodynamic and discursive eye, highlighting the contradictions within maternal experience, but also between maternal experience and the social imagination. Contradicting Maternity will appeal to scholars, students and practitioners in psychology, the social sciences and the health professions. The sensitive and readable analysis will also be of interest to mothers, whether HIV-positive or not.

Sujets

• Médecine
• Spécialités médicales
• Médecine Générale
• Medical
• VIH
• AIDS
• Medical sociology
• History
• Syndrome d'immunodéficience acquise
• HIV

Informations

• Publié par: WITS University Press
• Date de parution: 01 juin 2009
• Nombre de lectures: 0
• EAN13: 9781868148417
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Contradicting Maternity

HIV-positive motherhood in South Africa
Carol Long
Wits University Press
1 Jan Smuts Avenue
Johannesburg
South Africa
http://witspress.wits.ac.za
Copyright © Carol Long, 2009
First published 2009
The publishers gratefully acknowledge financial support for this publication from the Faculty of the Humanities, University of the Witwatersrand, Johannesburg.
ISBN 978-1-86814-494-5 (Print)
ISBN 978-1-86814-841-7 (Digital)
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the express permission, in writing, of both the copyright holder and the publisher.
Photographs on pages 8, 9, 11, 14-18 copyright © Gideon Mendel and on pages 12 and 13 copyright © James Nachtwey
Cover artwork: Thula Mama by Karen Lilje
Cover design and layout by Hybridesign
Printed and bound by Creda Communications
Contents
Acknowledgements
vi
Preface by Juliet Mitchell
vii
1. Introduction
1
2. Facing the HIV-positive Mother
23
3. The Joys of Motherhood
54
4. Finding the HIV-positive Mother
81
5. Minding Baby’s Body
105
6. Mother’s Mind
127
7. Mother’s Body
145
8. Thula Mama
168
9. Contradicting Maternity
190
Appendix: Interview Content
209
Bibliography
211
Index
229
Acknowledgements
I would like to thank the mothers who generously shared their experiences with me and whose stories are told in this book. Thanks to the hospital for their humane and dedicated service despite the odds. Special thanks to Juliet Mitchell, who took me under her wing and guided me through this project with brilliance and compassion. To my family, particularly my parents Linda and Nigel, and to my dear friends who supported me through this process, I could not have done it without you. And to Michael, of course …
Sincere appreciation to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, for financial support and provision of an intellectual environment. Within the Faculty, the School of Human and Community Development has provided an intellectual home.
I would also like to thank the bodies who funded my PhD, upon which this book is based, including the Ernest Oppenheimer Memorial Trust, the Skye Foundation, the Cambridge Commonwealth Trust and the Smuts Memorial Fund.
Finally, thank you to the staff at Wits University Press, including Melanie Pequeux and Veronica Klipp, for making this book a beautifully presented reality.
Preface
One cold white day in Cambridge, England, Carol Long, an always shivering and very blonde young woman, told me she wanted to research the experience of being simultaneously given a death and life sentence. She proposed to interview women diagnosed pregnant and HIV positive at the very same moment; the test for pregnancy revealing the disease. Instantly my stomach contracted in identification with the unknown mother, but almost immediately, as Carol talked on and I questioned, I realised how very little I understood. My gratitude for the journey Carol took us on will always be immense.
The modest presentation of a central part of this journey here in book form is extremely welcome; the book captures the work’s importance. The importance is, of course, practical – aspects of policy, of psychological and political understanding can be re-thought: for instance, I was struck by the importance of community. The mothers talked to Carol and to each other in their hospital groups and medical check-ups – a stigmatised disease lived in social isolation and the privacy of the home changes somewhat by being shared, its pariah status slightly eroded. But beyond the implications for how to change attitudes and therefore the conditions of both HIV and motherhood, what I want to convey is a larger, more general sense of why this book truly matters.
It matters of course enormously to all the women for whom the mothers of this book speak. We, the readers, are almost certainly not these women; but, for all our sakes, we need to listen. If we do not, our ‘cultural anaesthesia’ will prevail: our knowledge of what Carol Long has heard as she asked and listened to the world’s catastrophes and its people’s trauma, will be without meaning. A meaningless knowledge diminishes us all. Instead of this Contradicting Maternity breaks through this anaesthesia, eroding the binaries of pain and pleasure, fear and joy, even death and life, us and them. It collapses our categories: the objects of research have become the subjects who address us with their big loves and small hates, with their lives and their impending deaths, their children’s heritage.
Professor J C W Mitchell Cambridge University, UK
1. Introduction

HIV prevalence among South African women attending antenatal clinics is estimated at 30.2 per cent: i.e. nearly one in three pregnant mothers is HIV-positive ( Department of Health, 2006 ). Because this is also the time when women are particularly motivated to test, many discover that they are HIV-positive only when they realise that they are pregnant. Hearing that one is pregnant may produce a variety of emotions and responses. Whether excited or scared or devastated, it is news that changes one’s life. In a context in which motherhood is highly valued, there is always recourse to the expectation that one will be admired by others and will experience joy and fulfilment. Hearing that one is HIV-positive produces very different kinds of emotions and expectations, particularly in an environment that is saturated by misunderstanding and horror at the social category of ‘HIV-positive’. The process of becoming both a mother and HIV-positive begins in the moment when the news is received, but proceeds through a series of confusions, prejudices and adjustments in which the process of becoming exists in an uneasy space between internal reality and external discourses. In this sense, it is transitional and paradoxical, with opportunity for painful splits.
This means that HIV-positive mothers enter into two contradictory identities simultaneously: the denigrated, abject and feared identity of being HIV-positive and the idealised identity of motherhood, with all its associations of purity and goodness. Both identities hold complex and competing personal and social meanings, with motherhood and HIV invoking powerful discursive positions. Both motherhood and HIV are created in a moment of intimate sexual contact, but both exist uneasily with sexuality. Motherhood, paradoxically, is associated with chastity rather than sexuality, exemplified in the archetypal Virgin Mary ( Kristeva, 1986 ; Warner, 1976 ). HIV becomes a metaphor for aberrant sexuality, whether justified or not ( Sontag, 1988 ).
Being diagnosed HIV-positive when one is pregnant means entering into these two contradictory identities, which independently hold complex meanings of loss and gain, creativity and destructiveness, and which collide in the same moment in time. Motherhood is the ultimate act of creativity, in which life is given form. The miracle of life, however, is reminiscent of the nearness of death ( Pines, 1997 ); creating another being evokes fears of destructiveness directed towards something so helpless ( Parker, 1995 ); while the gain of motherhood also involves loss of identity in the service of motherhood ( Oakley, 1980 ), as well as fears of the loss of one’s child. HIV evokes very different associations of creativity and destructiveness. Something has been created in one’s body that is trying to destroy one. This directly evokes the oppositions of life and death, particularly because outward signs of the virus cannot be seen for a potentially significant period of time before serious illness sets in. Questions of what one is to accomplish in one’s life, as well as how one is going to die – universal questions that most of us spend a fair amount of time avoiding – become more urgent with an HIV-positive diagnosis. These questions take on a particular quality in relation to the social significations of HIV; to morality, death and abjection; and to calls to ‘live positively’. With the promise of antiretroviral medication, the progression of the virus can be retarded, which may make a significant difference to one’s health. However, in the inner world where fear is as important as reality, the existence of the virus inside one’s body encourages one to contemplate death. In the social world of discursive meanings, an HIV-positive diagnosis is responded to with prejudice and rejection, regardless of how healthy or unhealthy one is.
Becoming an HIV-positive mother means that these opposites meet one another within one person, evoking love and hate, tragedy and joy, fear and hope simultaneously. HIV-positive motherhood also causes uncertainty regarding one’s own identity, one’s future and the future of one’s baby. Because HIV can possibly (but not probably) be transmitted from mother to child, uncertainty regarding whether one will transmit HIV to one’s child provides fertile and perilous soil for fantasy. This uncertainty occurs in the context of dominant discourses of motherhood that posit that the baby is all-important; the mother not at all. Making sense of oneself as a mother – for one’s baby, but also for oneself – means negotiating the strong emotional resonances of HIV-positive motherhood through very powerful and socially sanctioned discourses of both motherhood and HIV.
This uneasy existence of HIV-positive motherhood between these two wildly differing extremes may be part of the reason for the discomfort the HIV-positive mother provokes in the popular and scientific imagination. There seems to be a sense that, within the urgency of the HIV pandemic, HIV-positive mothers are not terribly important – or, at least, not as important as their children – or as women who, still innocent, are not yet infect