According to Greco (2008: 33), the reproductive event falls within the “wide field of women’s health, in which the social discourses regarding maternity, womanhood and the health-disease-medical care process coincide. These discourses, threaded by the crosscutting axis of gender, give the pregnant women’s body a series of meanings which organize her experience and at the same time, transcend it, dehumanizing, tugging or silencing its singularity.” In the social representation, Fernandez (1994) contends, motherhood is seen as the “paradigmatic” function of women and as that which gives them identity and meaning to their lives; see also Chap.​ 1 and other chapters in Part I in this volume.

Some authors (see López 2006; Zamberlin 2005; Biagini et al. 2008; Greco 2008) argue that women from disadvantaged social groups, with few or no options of participation in the public sphere, “choose” to follow the “road of motherhood” – culturally imposed from generation to generation – since it guarantees them a certain social recognition they would not achieve through other means.

However, as Greco herself (2008: 89) points out, the issue of pregnancy, whether planned or unplanned, inevitably leads to the complex issue of the desire to be a mother which cannot be analyzed solely from the sociocultural point of view, seeing it as a gender mandate. It is important to also consider the sociopsychological aspects involved in it. From this point of view, it is important to have in mind that desire is always built in virtue of, and at expense of, a part of unconscious knowledge, that is, to say, unavailable, which is what prevents these women from accounting for their attitudes and behaviors (especially those visualized as contradictory or “illogical”).

The HIV infection and the possibility of avoiding its transmission from mother to child have made a matter which is already difficult to deal with and to understand, even more complex. Research carried out in different contexts indicates that a diagnosis of HIV infection during pregnancy is an experience that causes deep uncertainties and a specific psychological burden (Bennetts et al. 1999; Kwalombota 2002; Nelms 2005; Torres de Carvalho and Piccinini 2006; Gonçalvez and Piccinini 2007; Sanders 2008; García 2009). While some authors emphasize the psychic suffering which these women undergo (Kwalombota 2002), others stress the ways in which the HIV diagnosis increases the medicalization of pregnancy, labor, and puerperium. Thus, for example, Gonçalvez and Piccinini (2007) maintain that apart from the fear of transmitting the virus to the baby and of the usual anxiety pregnancy elicits, women must submit themselves to a highly medicalized process in which most of the decisions are out of their control, a situation which has an impact at a subjective level. García (2009: 257), in turn, points out that the body “becomes -both for the medical intervention and for women themselves- to some extent split, separated from their own histories and feelings. It becomes a means that, as mothers-to-be, they must make available for studies and therapeutic practises in order to protect the child they are expecting.”

Regarding motherhood, a meta-analysis conducted by Sandelowski and Barroso (2003)³ concluded that it entailed work directed toward the illness itself and the social consequences of having HIV infection in the service of two primary goals: (a) the protection of children from HIV infection and HIV-related stigma and (b) the preservation of a positive maternal identity. According to the authors, motherhood both intensified and mitigated the negative physical and social effects of HIV infection. HIV-positive mothers engaged in a distinctive kind of maternal practise to resist forces that disrupted their relationships with and ability to care for their children, as well as their identities as mothers.

Similarly, a qualitative study conducted by Hebling and Hardy (2007), aimed at describing the feelings of a dozen HIV-positive women regarding motherhood, indicated that it was seen as an essential attribute of women and a reason for living. The study also revealed that some women made provisions with their family for the care of their children and that thinking about the possibility of their children becoming orphans made women feel impotent and guilty. Such painful feelings were minimized through mechanisms of defense like compensation, denial, rationalization, and projection.

The contradictions associated to motherhood in women with HIV infection also arise in the study carried out by Long (2009) in South Africa. The psychologist concludes that HIV infection promotes social representations and more specifically prejudices and stigma which associate it with a negative situation while the pregnancy is meant as a positive event that contributes to the complete fulfillment of a woman. Other research carried out in Vietnam maintains that motherhood grants women a certain status, while being childless is stigmatized. At the same time HIV-positive mothers reported feeling like unfit parents, a reflection of negative broader social opinions on HIV and its association with “social evils” (Oosterhoff et al. 2008; see also Chap.​ 14 in this volume).

This chapter discusses findings produced within the framework of a collaborative study between CEDES and CENEP (Center for the Study of State and Society)⁴ and CENEP (Center for Population Studies),⁵ supported by WHO. The research has a double purpose: (a) to identify, from the woman’s and health service providers’ point of view, the obstacles to the provision of integral health care to women of reproductive age who live with HIV/Aids and (b) to promote greater interaction between the several health services which provide care to this population (infectology, obstetrics, gynecology, and family planning) in two selected hospitals in Buenos Aires city⁶ and to document and monitor this experience.

The qualitative analysis presented here is based on 11 semi-structured interviews with women taking their babies to be tested for HIV to CNRS⁷ during January of 2010. The interviews were performed by the authors and took place in a private room after the blood test to the baby for an accurate diagnosis was performed. As customary, an informed consent was applied. Upon finishing the interviews, counseling was provided to those women who required it, and informative material was provided to all of them. The interviews were recorded (with the women’s prior authorization) and then they were transcribed and coded for their analysis.

The central themes of the interview guideline were the following: basic sociodemographic characteristics; time and circumstances when they were notified about their HIV infection; experience in relation to diagnosis, reconstruction of the steps taken since then, and perception of difficulties and facilitators in the care provided by the health services; partner’s role; pregnancy experience; and reproductive intentions.

In the following sections, the main findings resulting from this qualitative material are shown. Most of the women interviewed had a low education level: only two had graduated from high school. Their ages ranged between 20 and 41 years old, being 29 the average age. Their profile was similar to that of a sample of women we interviewed in 2009 – as a baseline study – who attended the CNRS to perform their viral load tests or to test their babies. Among these last (N  =  44), which made up 26% of the women interviewed (N  =  169), 29 was the average age. Most of them had not gone beyond the elementary education level (N  =  21), a lower number had not finished their high school studies (N  =  15), and only a minority (N  =  8) had graduated from high school or higher level.