Information::Gynecological Programs

Life Goes On Booklet.pdf

HIV+ Women and Pregnancy

By Shari Margolese

With the advances in HIV care and treatment, many HIV+ women are living longer, healthier lives. As they think about the future, some of these women are deciding to have the babies they always wanted.

The good news is that the advances in HIV treatment have also brought down the rate of mother-to-child HIV transmission significantly. If the mother takes appropriate medical precautions, the rate of transmission can be reduced from 25 percent to below 2 percent. In addition, studies have shown that being pregnant will not make HIV progress faster in the mother.

Before You Get Pregnant

Find an obstetrician (OB) who is familiar with HIV care. He or she can explain your options for getting pregnant with as little risk to your partner as possible.
Get screened and treated for sexually transmitted diseases.
Give up smoking, drinking and drugs. All of these can have a negative impact on your health and the health of your baby.
Start taking pregnancy vitamins that contain folic acid and calcium while you are trying to become pregnant. This can reduce the rates of some birth defects.
If friends and family are unsupportive or critical of your decision to have a child, put together a support network of people who are caring, non-judgmental and well educated about HIV and pregnancy. Your network can consist of medical providers, counselors and other HIV+ women who are considering pregnancy or have had children.

HIV Drugs and Pregnancy

HIV+ women may want to avoid some of the more invasive prenatal tests, such as amniocentesis, chorionic villus sampling, and percutaneous umbilical blood sampling.

There are two types of delivery: Cesarean section (C-section) and vaginal delivery. Elective or planned C-sections are done before labor begins and before the mother's "water" (the membranes that surround the baby) breaks. This reduces the baby's contact with the mother's blood.

For a woman on HIV therapy with a low viral load (less than 1,000), a C-section is not likely to further reduce her already low risk of transmitting HIV. But for a woman with a viral load over 1,000 or one who is not already receiving treatment at the time of delivery, a C-section may reduce the chances of transmission. Speak to your doctor about the pros and cons of each method of delivery.

After the Baby is Born

Since a baby can be infected with HIV through breast milk, it is important not to breast feed if you have other options. However, occasional breast-feeding appears to increase risk over continuous breast-feeding. You can still have a strong bond with your child even if you bottle feed.

Once the baby is born, he or she will receive three or four HIV tests before getting the final results after several months. During this time, the baby may need to take HIV medication and anti-pneumonia medication. This doesn't mean the baby is sick; it is just a precaution to decrease the chances of transmission and illness.

In Conclusion

Deciding to have a baby is a big step for any woman, but for an HIV+ woman it is even more complicated. Talk to your doctor and OB for "preconception" health care and counseling before you start trying to get pregnant. If you plan ahead, there are many things you can do to protect your health and the health of your new baby.

Reprinted and modified with the permission of The Well Project (www.thewellproject.com)
For more information call Voices of Positive Women and ask for the HIV and Pregnancy Booklet.