In the dark old days of the late 1980s and early 1990s, when little HIV treatment was available, having HIV dashed all hopes of motherhood. But today, with the right care, a woman with HIV can expect to lead a long and healthy life. So, if your dream is to become a mother, the likelihood that you'll have an HIV-negative child is greater than it's ever been before. In fact, there's a baby boom among HIV-positive women. What do you need to know about pregnancy and HIV? Here are some answers to frequently asked questions.
"The biggest challenge in being pregnant and HIV positive is the fear and not knowing, because I didn't know whether my son would be positive or not. At first, I was very uneducated about HIV and pregnancy, because I never intended on getting pregnant ... I cried every day, and prayed every day."
-- Jessica Mardis, diagnosed in 1995, mother to an HIV-negative son
- Retrovir (AZT)
The most critical thing is for you to have an undetectable viral load. If your viral load is undetectable, and if you take anti-HIV medication before and during pregnancy and delivery, your baby only has a 1 to 2 percent risk of being infected. If you do not take HIV treatment, the baby has a 20 to 30 percent chance of being HIV infected.
Will anti-HIV medications harm me or my baby?
The majority of HIV medications have been shown not to harm babies. Only Sustiva, which is one of the drugs in the one-pill-once-a-day regimen of Atripla, Viracept and the combination of Videx and Zerit should not be taken by any woman thinking of becoming pregnant. Talk to your doctor about which other drugs may be harmful during your pregnancy. If you are already taking anti-HIV medications, the worst thing you can do is stop taking them without consulting your doctor first.
C-Section or Vaginal Birth?
You can plan for a normal vaginal birth if you have an undetectable viral load. If your viral load is above 1,000, you should plan for a C-section. A C-section would dramatically reduce your chance of transmitting HIV to your baby.
- Videx + Zerit
HIV does not progress any faster in HIV-positive women who get pregnant. It's important, however, that you get your HIV and any other disease, such as diabetes, under control before you get pregnant.
Will my baby have to take HIV medications?
Yes, you will have to give your baby HIV medications for approximately six weeks.
Can I Breastfeed?
Breast milk can transmit HIV, so it's recommended that women with HIV do not breastfeed and instead use infant formula.
Is Pregnancy different for HIV-positive women?
Research shows little difference between pregnancy in HIV-positive women and negative women. Women taking HIV medications may be more likely to give birth prematurely or have babies that weigh less than average.
I don't want to get pregnant. Can I take contraceptives?
Various HIV medications interact with oral contraceptives, making them less effective, so you'll need to also use other contraception to avoid pregnancy if you are taking HIV meds.
Is it harder for HIV-positive women to get pregnant?
Women with HIV may have a harder time getting pregnant. If you've been trying to get pregnant for a while, you may want to see a fertility doctor experienced with HIV-positive women.
My partner is HIV negative and I'm not. Can we still start a family?
There are many ways to have a baby when you are in a mixed-status relationship. Although there is no method that is 100 percent risk-free, there are many low-risk options, from the at home method of using a turkey baster to paying top dollar at a fertility clinic. The key is for the HIV-positive partner to have an undetectable viral load.
How do I find an obstetrician who is knowledgeable about HIV-positive women?
The best person to ask for a referral is your health care provider, if he or she is an HIV specialist. Otherwise, call the largest HIV organization near you and see if they can refer you to someone. It's crucial to your health and the health of your baby that you find someone with lots of experience helping a pregnant HIV-positive woman.
"The best way for me to learn how to cope with my diagnosis was by learning everything I could about HIV. The more educated I became, the less scary the virus was. I also found it extremely important to have people in my life that supported me and that I could talk with openly. Finding out you are HIV positive is an extremely scary thing, but life can and does go on. Since my diagnosis I have given birth to an amazing little boy, gone to college and found love. I have HIV, but it is not in charge of my life."
-- Kelly Hill, diagnosed in 2000
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