title: "I get hungry all the time": experiences of poverty and pregnancy in an urban healthcare setting in South Africa.
abstract: BACKGROUND
  For pregnancy to result in a healthy mother and infant, women require adequate nutrition and to be able to access antenatal care, both of which require finances. While most women working in the formal sector in South Africa obtain some form of maternity leave, unemployed women receive no such support. Additional interventions in the form of expanded social assistance to vulnerable pregnant women are needed. To help inform such an approach, we undertook a series of qualitative interviews with low-income pregnant women in Johannesburg.
  
  
  METHODS
  Qualitative, in-depth interviews were held with 22 pregnant women at a public sector antenatal clinic in Johannesburg in 2011 to gather data on their greatest needs and priorities during pregnancy, their access to financial resources to meet these needs, and the overall experience of poverty while pregnant.
  
  
  RESULTS
  A total of 22 women were interviewed, 5 of whom were primagravid. One woman was in the first trimester of pregnancy, while nine were almost full-term. All but one of the pregnancies were unplanned. Most participants (15/22) were unemployed, two were employed and on paid maternity leave, and the remaining five doing casual, part-time work. In most cases, pregnancy reduced participants' earning potential and heightened reliance on their partners. Women not living with the father of their children generally received erratic financial support from them. The highest monthly expenses mentioned were food, accommodation and transport costs, and shortfalls in all three were reportedly common. Some participants described insufficient food in the household, and expressed concern about whether they were meeting the additional dietary requirements of pregnancy. Preparing for the arrival of a new baby was also a considerable source of anxiety, and was prioritized even above meeting women's own basic needs.
  
  
  CONCLUSIONS
  Though pregnancy is a normal life occurrence, it has the potential to further marginalise women and children living in already vulnerable households. Extending the Child Support Grant to include the period of pregnancy would not only serve to acknowledge and address the particular challenges faced by poor women, but also go some way to securing the health of newborn children and future generations.
authors: Centre for Health Policy/MRC Health Policy Research Group, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. fscorgie@wrhi.ac.za.|Wits Reproductive Health & HIV Institute (WRHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. fscorgie@wrhi.ac.za.
authors: Fiona
authors: F
authors: Scorgie
authors: Centre for Health Policy/MRC Health Policy Research Group, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Duane.Blaauw@wits.ac.za.
authors: Duane
authors: D
authors: Blaauw
authors: Department of Sociology, University of Johannesburg, Johannesburg, South Africa. tessagd@yahoo.com.
authors: Tessa
authors: T
authors: Dooms
authors: Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersand, Johannesburg, South Africa. Ashraf.Coovadia@wits.ac.za.
authors: Ashraf
authors: A
authors: Coovadia
authors: Wits Reproductive Health & HIV Institute (WRHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. vblack@wrhi.ac.za.
authors: Vivian
authors: V
authors: Black
authors: Centre for Health Policy/MRC Health Policy Research Group, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Matthew.Chersich@wits.ac.za.|Wits Reproductive Health & HIV Institute (WRHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Matthew.Chersich@wits.ac.za.
authors: Matthew
authors: M
authors: Chersich
mesh_terms: D000293:Adolescent; D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics*; D012959:Socioeconomic Factors; D013019:South Africa; D014504:Urban Health / Q000191:economics*