I am about to give birth to my fourth child since I contracted HIV 14 years ago. I'm obviously no stranger to this process. I've always been extremely healthy and so my first three children were delivered naturally. My husband (who is HIV negative) and I moved to a new state within the last year where I am receiving great care. However, I was shocked when my OB told me at my last appointment that she would be inducing the labor. I am not happy about this at all and expressed that to her. She told me it was the "recommendation". This is news to me. I carried my other babies full-term with no problems. Can you explain to me why she is telling me this? Do I have options? I really want to tell her NO, but I hate being lectured by doctors. Please give me some insight so I can make an informed decision. Thank you!

Hello,

You should discuss this issue with your HIV specialist. Elective caesarian section is often recommended to reduce the risk of HIV transmission to the infant during childbirth. More recent studies have suggested it is only necessary if the mother's HIV plasma viral load is detectable. Having given birth to HIV-negative infants in the past is not a guarantee that your next delivery will also have the same result, particularly if you are not on a fully suppressive antiretroviral regimen.

Good luck.

Dr. Bob