Pregnancy planning in Botswana: what dimensions matter to Batswana women?

Sara Randall, University College London
Christine Kgathi, University of Botswana
Neo Moshashane, University of Botswana
Boineelo Bula, University of Botswana
Chelsea Morroni, University College London

In the Botswanan context of relatively low fertility combined with good access to education and health services and high HIV prevalence, facilitating pregnancy planning is an important stage in improving reproductive health services. We use qualitative data from a study undertaken in Gaborone (2015) to investigate local perceptions and experience of different dimensions of pregnancy planning. Our results suggest that Botswana is far from experiencing effective pregnancy planning. In individual accounts of reproductive lives few women planned their first pregnancy, thus generating both physical and psychological repercussions throughout their reproductive lives. Women confront a constellation of constraints in different dimensions of life, including economic and employment uncertainty, high HIV prevalence, perceived unreliability of men, and the practical difficulties of managing and caring for children in frequently chaotic contexts, whilst simultaneously experiencing strong social pressure to become mothers. Individual level reproductive planning responding to physical needs and reproductive aspirations is uncommon.