A SMILE and a dance often accompany the birth of a newborn - but in the age of HIV-Aids, a cry of sadness often characterises the reality of motherhood.

A SMILE and a dance often accompany the birth of a newborn - but in the age of HIV-Aids, a cry of sadness often characterises the reality of motherhood.

This is according to the experiences shared by HIV-positive mothers in a well-researched book entitled Contradicting Maternity.

It explores the realities of motherhood in the context of HIV-Aids in South Africa.

Drawing on interviews with HIV-positive women attending antenatal care at a Johannesburg hospital, the book gives a rare account of the fears and hopes that such women go through from pregnancy to motherhood.

"The title is about all the contradictions that go with these multiple identities of learning that you're HIV-positive, which is associated with such negative consequences in a lot of people's minds, and learning that you're going to become a mother as well . the identity that's much more idealised, particularly by friends, family, people one knows," says the book's author Carol Long, a clinical psychologist and associate professor at the University of the Witwatersand.

"It's really about the contradicting experiences and emotions, but also the contradicting social meanings of both HIV and motherhood," she says.

In the searching interviews that Long conducted with the women, she detected an over-riding factor: A feeling of guilt brought on by their HIV infection.

"For example, there was one woman who was very worried that her baby might be HIV-positive, and even after she got tests back saying that her baby was HIV-negative, she still felt that guilt and that her baby might be harmed in some way."

For some, the guilt was self-condemning and judgmental.

"There were women who wished they weren't pregnant in the first place.

"They were also .very clear that they didn't want to become pregnant again - just in case their babies did become HIV-positive.

"They were very disapproving of women who knew that they were HIV-positive and still became pregnant."

But there were also some women who did know they were HIV-positive and they wanted to continue living, instead of dying, and so, they made a choice to become mothers.

"There was one woman in particular who said that she could still become pregnant. This was something that was very important for her. The words she used was she wants 'people to know that you can get some of the things that you want'," says Long.

Coupled with the guilt that they might pass on HIV infection to their babies during delivery, the women expressed fears that they might infect their babies through breast-feeding.

Research released last week by the Department of Health shows that 29,3percent of pregnant women in South Africa have HIV. It was conducted among 34000 women attending public sector antenatal clinics.

Long says the women's experiences illustrate the importance of further roll-out of mother-to-child HIV transmission interventions. - Health-e News