Toronto Program Focuses on Pregnant HIV-Positive Women

Jay MacGillivray, a midwife who specializes in working with HIV-positive women, and Dr. Mark Yudin, an obstetrician, have developed the Positive Pregnancy Programme at St. Michael's Hospital in Toronto, Canada. The program attends to HIV-positive women's medical needs and supports the patients through the pregnancy, by combining maternal health care with social services, counseling, and companionship. It is now in its seventh year.

In its early years, the program served about three to five women per year, but in 2012, it helped 44 women. According to MacGillivray, none of the mothers who participated has given birth to a child with HIV. MacGillivray explained that her motivation to start the clinic came from her experiences as a midwife, where she saw healthcare professionals treating pregnant women with contempt or fear. She herself had been warned by another nurse not to touch a patient because the woman was HIV positive.

MacGillivray and Yudin view the clinic as an expanded model of care as they work with pregnant women on any type of problem, including immigration status, trouble in a relationship, or difficulties finding housing. The clinic operates one day a week and treats women with HIV as well as those who do not have HIV. Patients see the midwife and doctor during regular checkups as well as a nurse and social worker.

The program is attracting international attention, and the team receives requests to speak at conferences around the world. At present, Trent Newmeyer, a Brock University professor, is evaluating the program through a series of interviews with its clients to determine how well the model might work in other locations.