Pregnancy - desire to have children

Regardless of whether you are a man or a woman, and despite your HIV, you can still have a healthy baby under proper supervision from a doctor. If you take certain precautions, it is practically impossible for your baby to get HIV from you. Also since your life expectancy with HIV is more or less normal, HIV doesn’t need to stand in the way of your desire to have children. The only difference is that as a positive woman you cannot breastfeed your baby and your baby will have to take HIV medications for a month. Even though there is almost no chance that your baby will be born with HIV, many new parents (and parents-to-be) are very worried until they get the final results. You also need to think about how the people around you will react: do they realise that you have HIV? And when will you tell your child? Every positive mum or dad will find her or his own way of dealing with these issues. You can get important guidance from your HIV doctor or internist and your HIV nurse. And it is also a good idea to get in touch with other people with HIV who are – or want to become – mothers or fathers.

Becoming a positive father
You can consult with people at the hospital as to whether you can make your partner pregnant through normal, unprotected sexual contact or whether it would be better to do that through artificial insemination. That depends on whether or not your partner also has HIV and whether or not your viral load is undetectable. In the case of artificial insemination, your sperm will be ‘washed’ at the Amsterdam Medical Center (AMC): this involves separating your sperm cells (which do not contain any virus) from the rest of your semen. Next, the sperm cells will be checked to make sure that no virus has managed to remain among them. In this situation, there are two types of artificial insemination. With IVF (in vitro or ‘test-tube’ fertilisation), one or more egg cells are fertilised outside of the body with carefully inspected sperm cells. The resulting embryos are then placed back in the womb. With IUI (intrauterine insemination), the sperm cells are put into the womb by means of a syringe on the day that ovulation is expected. If your partner does not have HIV, her pregnancy will otherwise be a normal one.

Becoming a positive mother
It’s not exactly a simple procedure, but the good news is: in the AMC in Amsterdam alone, the pregnancies of hundreds women with HIV have been supervised in recent years and not a single baby was born HIV positive. Which measures can you take?

  • Discuss your desire to have children with your HIV doctor or HIV nurse before you start anything. That way you can check to make sure your HIV medicines will not damage the foetus, which is to say that you can safely become pregnant.
  • You will be referred to a gynaecologist who specialises in HIV.
  • If your partner does not have HIV, you may be advised to try self-insemination in order to prevent him from getting HIV. In that case, your partner will put his sperm into a small sterile container and then you can put it inside your body vaginally using a syringe without a needle (in some cases you might also use a little rubber tube). If you use HIV medicines and your viral load has been undetectable for at least half a year, some HIV doctors may advise you to get pregnant through normal sexual contact. It is becoming more and more clear that your chances of passing on your HIV are very slight if your viral load has been undetectable for at least half a year and if neither you nor your partner has any sexually transmitted infections (STIs).
  • If you have not started using HIV medications for the sake of your own health, you will be advised to start using HIV medicines in week 20 of the pregnancy in order to protect your baby. You can stop using them again once you have had your baby.
  • You will give birth in hospital. You will be advised not to breastfeed your baby, since it is possible that you can pass on your HIV through breastfeeding. Just to be sure, you will give your baby HIV medications in the first month in the form of (sweet) liquids that you squirt into its mouth a couple of times a day.
  • Immediately after birth, your baby will be tested for HIV (the viral load will be tested), and one to three months later it will be tested again. If the baby still tests negative at that point, you can assume that it does not have HIV. Just to be sure, however, your son or daughter will be tested for HIV once more after a year and a half.

FAMILY.matters is a game (and a booklet) developed by the Hiv Vereniging for families in which at least one member has HIV. Families with HIV can order FAMILY.matters free of charge from the Servicepunt of the Hiv Vereniging (020 689 2577- mon, thu, thurs, fri 14.00 - 22.00).

Treat Her Like a Lady
In the free booklet Treat Her Like a Lady, 15 women talk freely about their lives with HIV. There are also interviews with their HIV doctors and HIV nurses. The booklet contains lots of information about positive pregnancies. You can get a copy of Treat Her Like a Lady from your HIV nurse or through the Servicepunt of the Hiv Vereniging (020 689 2577 - mon, thu, thurs, fri 14.00 - 22.00).

Read more what positive women and an HIV nurse have to say.





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