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HIV/AIDS Blog Central

Parenthood: Expecting the Unexpected

By Brooke Davidoff

July 13, 2010

People want to know what it's like to be pregnant and have HIV. I really don't know. Not to be a smartass, but I've never had one without the other. I'm not sure if my mood changes, tiredness and nausea are pregnancy related or HIV medication related.

When I learned I was positive in January 2010, my first OBGYN informed me that I could not have natural childbirth, and I could not breastfeed. She also informed me that I was her first-ever HIV-positive patient. That was pretty un-reassuring for my husband and I. She referred us to an HIV OBGYN, and gave us the option to stay with her and see the HIV doctor a few times for educational reasons, or to just move our visits over to the HIV doctor.

After one more visit with my pre-HIV doctor the choice was easy. She had a cold, but seemed to avoid me like the plague. The visit was beyond weird, and we decided not to go back. She went over my numbers, which my new HIV primary doctor had done the day before, and she had very little baby information to go over. Being first-time parents, and new to HIV as well, we decided we needed a doctor who was comfortable with me. Someone who had the answers to questions we knew would come up.

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I realize every doctor needs a first patient to learn from. I also realize I'm too new to both of these topics to be a doctor's first anything.

From the first time I walked in, the HIV OBGYN was amazing. I was educated and comforted all at the same time. It was nice to know I was not the ONLY one who has this disease. She works in a teaching hospital so in her educating me, she's also got residents in the room learning at all times. I'm not only comfortable with that, I'm signed up for a research study on pregnant HIV women.

It's her job to treat HIV women and their babies, so questions I never even thought of are answered. She doesn't look at me as a disease, and I realize I'm just another patient to her, but she manages to make me feel important. For that, I can honestly say I love her.

I lost five pounds in a two-week period after starting the HIV medications. I was then put on two anti-nausea medications.

I began researching HIV and baby stuff, knowing I really didn't know much about either.

Months later, with my mind set on a c-section, I was told by my new OBGYN that if my viral load was undetectable, there was no reason for a c-section and natural was the way to go. Depending on a woman's viral load within weeks of delivery, she can have natural childbirth.

There I was, left with less than two months of pregnancy, and we had not been to ONE Lamaze class. I hadn't even looked into natural childbirth, since I was so excited to not have to do it. I thought my only perk of HIV was to skip the labor part of this baby.

All the programs I found on classes for parents-to-be were six weeks long -- where new parents are taught to breastfeed and all sorts of other new parent information. Had we been planning to go to one of these six-week-long parent classes we would have missed two weeks due to my father's death in May. We were out of town for two weeks, and when we got back home parenting classes were far from the list of things to do in either of our minds.

From what I have learned in my short time to research this, without proper prenatal and postnatal care of mother and baby, the infection rate for babies is about 1 in 4.

Recommendations for pregnancy and birth:

  • Treating the HIV+ mother with a Retrovir (AZT, zidovudine)-containing regimen during pregnancy. Guidelines state the treatment of the pregnant woman may start as early as 14 weeks into the pregnancy.
  • Giving the mother a dose of intravenous (IV) Retrovir during delivery.
  • Treating the newborn with oral Retrovir for six weeks after birth.

C-section delivery recommended:

  • The viral load is unknown or is greater than 1,000 copies/ml at 36 weeks of pregnancy
  • There has been no HIV medications taken during the pregnancy
  • There has been no prenatal care prior to 36 weeks of pregnancy
  • A c-section should be scheduled prior to the rupture of membranes ("water breaking")

Vaginal delivery can be done if:

  • There has been prenatal care throughout pregnancy
  • The viral load is less than 1,000 copies/ml at 36 weeks of pregnancy
  • HIV medications have been taken during pregnancy

The average pregnant woman gains between 15 and 35 pounds. I went the first seven months, and lost five pounds. I am going into my ninth month pregnant and have only gained seven. I don't exercise or work out.

I am currently undetectable. My due date is July 29th. My husband and I went on a tour of the birth floor at the hospital a few weeks ago, and we got to see the rooms where women deliver, and the rooms you go to hours after where you recover. From all the stories I have heard from co workers, and friends, I really have no desire to have natural childbirth. I have been horrified of it forever.

I talked my doctor into a c-section. Hopefully my next post will not be about how my son decided to come early, and I had to have natural childbirth. But as it goes today, I'm going to be a mother to a baby boy July 15th. I will come into the hospital hours before he's removed and will be given an IV of AZT for four hours. All my HIV and nausea medications are provided by the hospital. The baby will be on HIV medication for six weeks. And then after more blood work, we go from there with his care and mine.

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See Also
What Did You Expect While You Were Expecting?
HIV/AIDS Resource Center for Women
More Personal Accounts of Becoming Pregnant With HIV

 

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Voice of ONE


Brooke Davidoff

Brooke Davidoff

Brooke was diagnosed HIV positive in January 2010 -- two months married and 11 weeks pregnant with her first baby -- and has already begun to educate others about HIV. She lives in Seattle, and her poetry has been featured on TheBody.com. Her son was born on July 15, 2010.


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