Exploring maternal health experiences of contraceptive use and anti-natal care for young women who marry early in Namaacha, Mozambique.

Abstract

This study explores the Sexual Reproductive Health and Rights (SRHR) experiences of women who marry early in Namaacha District of Mozambique. Young women who marry early are often forced into marriages and experience a life void of choices, about their SRHR. This study is anchored through a review of literature that examined the impact of early marriage practice, its trends, and determinants to influence SRHR decision-making both globally and locally; and is informed by a critical theoretical framework of Gender and Power proposed by Connell (1987). The research specifically explored how women talk about their experiences of maternal health (i.e., use of modern contraceptives and attendance of antenatal (ANC) care services during pregnancies); decision making processes regarding the use of contraceptive methods; and barriers/facilitators for effective use of modern contraceptives and antenatal care services. A life grid methodology from the qualitative interpretivist tradition was used to collect narrative data of ten adult women residing in Namaacha District in Mozambique. The women were selected using a purposive/judgmental and snowball sampling methods and selection was based on self reported criteria that they married early and had their first pregnancy before the age of eighteen. Two open ended interview guides were utilised to collect data and the interpretative phenomenological analytical method guided the data analysis process. The findings in this study revealed a positive prognosis regarding women’s use of modern contraceptives (MC) as well as attendance of ANC during pregnancy in Namaacha district. Despite reports of low and inconsistent use of MC as well as later attendance of ANC during pregnancy, participants reported having support from their community and respective husbands to utilise maternal health services. The majority of participants described how the information about the benefits of family planning methods that they have accessed, whether at the health centers, media or in community gatherings, motivate them to seek and use modern contraceptives. Participants mentioned using at least one or more modern contraceptive method during marriage and they could name some of the modern contraceptive methods currently available. Participants did not report attending four or more times ANC appointments during normal pregnancies as recommended by the literature on ANC model, however, they did report attending at least once during some of their pregnancies. The current struggle includes motivating women to start attending these services earlier in their pregnancies. From the participants’ stories, awareness of the personal and external barriers and facilitators to accessing information to empower themselves is critical. For them, early marriage is still deeply rooted in the community and culture, which in many ways affects their decision to seek and use contraceptives and ANC during pregnancy. The participants described living in privation of basic necessities and in an environment where their decision-making power around general issues and private ones were very low, particularly at early stages of their marriage. Thus, this study found that early marriage had negatively impacted women’s well-being and further possibilities of growth. Overall, participants described being satisfied with the marriage despite the challenges of it. They understand the negative impacts of early marriage on their lives but work within such patriarchal systems to change them.