Having a Baby When You Have HIV: Is It Worth the Risk?

hen one or both partners are living with HIV, deciding to have children is hard and risky. Many of them worry about passing the virus to the baby, pregnancy risks for the mother, and the effects of antiviral medications on their child. These fears may prevent some people from becoming parents; however, thanks to modern medicine, people living with HIV can now have safe pregnancies and healthy children, just like others. The only important things are to follow the doctor’s orders carefully and be monitored before and during pregnancy.

In this article by Raadina Health, we help you make better decisions by explaining the common concerns, how the virus is transmitted, whether the couple should postpone pregnancy, and more.

Pregnancy with HIV: How Does Modern Medicine Help?

The good news is that modern medicine can now help people living with HIV have a safe and healthy pregnancy. Here is how:

• Before trying to conceive, the to-be-parents should take multiple blood and urine tests. If their HIV test is positive, they should start antiretroviral therapy (ART) to reduce the risk of transmitting the virus.
• With antiretroviral therapy, the mother’s viral load is reduced to undetectable levels. When the virus is at its minimum level, the risk of passing HIV from mother to baby is reduced to less than %1.
• Most antiretroviral medications used during pregnancy are safe for the mother and her baby. However, some drugs should be replaced, or their dose must be changed. That’s why the mother must stay under the doctor’s supervision throughout the pregnancy.
• The type of delivery is determined weeks before the pregnancy ends. In many cases, the mother can choose vaginal delivery, but if the viral load is high, the doctor recommends a C-section to reduce the risk of mother-to-child transmission.
• After birth, the baby receives preventive medicines, and several HIV tests are taken from him/her at specific times. The tests are usually done 12 to 24 hours, 2 to 6 weeks, 4 to 6 months, and 12 to 18 months after birth.



Common Concerns about Pregnancy with HIV

People living with HIV usually have similar concerns about pregnancy and delivery. Below are some of the most common fears they have, plus medical solutions for them.

I might pass the virus to my baby.

As explained earlier, if the mother’s viral load is controlled and becomes undetectable on blood tests, the risk of transmission to the baby is less than 1%.

Solution: Follow medical advice carefully and take the necessary tests when ordered.

My antiviral medications may hurt the baby.

Modern antiretroviral medicines are safe for use during pregnancy. So, the mother can take them both before and during pregnancy without worry.

Solution: The doctor adjusts the type and dose of the medication based on different stages of pregnancy.

HIV causes fertility issues.

HIV itself does not usually cause serious fertility problems in women. Other factors, such as additional infections, poor general health, or a weak immune system, may affect fertility.

Solution: These issues can be resolved with proper medications.

I might get other infections during pregnancy.

The antiviral medicines used during pregnancy suppress the virus and improve the immune system.

Solution: If you take the medications as ordered, the risk of getting other infections is low.

My HIV will get worse during pregnancy.

If you get proper treatment, pregnancy doesn’t make HIV worse. In fact, antiviral medicines keep the virus under control and reduce it to very low levels.

Solution: There is no evidence that pregnancy worsens HIV, but the mother should be checked regularly to make sure the disease is not progressing.

People might judge us for our decision.

People living with HIV are constantly worried about being judged by society or their relatives. Solution: They should get support from their partners and families, attend counseling sessions, and find proper support groups. These methods can greatly reduce their stress and increase their confidence.

Pregnancy and HIV: Who Is Eligible and Who Is Not?

Not all people living with HIV can get pregnant and have healthy children. However, those with the following conditions are considered good candidates:

• People who take their medications regularly
• Those with low viral load that cannot be detected in a blood test.
• Those who have enough time and commitment to visit doctors and repeat tests.
• People with good overall health.
• Those who are mentally prepared to deal with the stress and challenges of pregnancy.
• People who don’t use drugs or alcohol, get enough rest, and have a healthy diet.
• Those who have good access to medical care.

When Should You Postpone Pregnancy?

If the mother has a high viral load or has recently started antiretroviral treatment, it is better to postpone pregnancy for a few months. Chronic conditions such as heart, kidney, and liver diseases can also increase the risk of pregnancy for the mother. In such cases, the disease should first be treated or controlled, then the couple tries to conceive. The couple should also postpone pregnancy if they don’t have access to good medical care, don’t have enough time to visit doctors, or are not mentally ready at this moment.

Emotional Support in Pregnancy for HIV-Positive People

For people living with HIV, pregnancy and fertility issues are not the only problems. Many of them worry about social judgment or being rejected by their families, friends, and colleagues. That’s why the family and close friends should support them and help them reduce their stress and anxiety. Doctors usually recommend attending private or group counseling sessions to reduce concerns during this time. Learning and practicing stress management techniques can also help them go through pregnancy in a healthier way.

 The Last Note

Pregnancy can be a challenging experience for people living with HIV; however, if they take medications to control viral load, get regular checkups, maintain a healthy lifestyle, and choose the right delivery method, they can have a safe pregnancy and give birth to a healthy baby. In fact, the risk of passing the virus to the baby in such couples is less than %1.

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FAQs

1) Can people living with HIV have children of their own?

Yes. If they undergo the necessary treatments and control the viral load, they can get pregnant and have healthy children.

2) Do antiretroviral medicines affect the baby?

The antiretroviral drugs that you use during pregnancy are totally safe for the baby. Remember that only your doctor can change the type and dose of your medication. So, do not adjust the drugs without your specialist’s permission.

3) How likely is mother-to-child transmission?

If you follow all medical recommendations step by step, the risk of passing the virus to your baby is less than %1.

4) Can women with HIV have a natural vaginal delivery?

The type of delivery depends on the mother’s viral load. If the viral load is high, a C-section is usually recommended.

5) Can you breastfeed if you have HIV?

In most cases, the doctors suggest formula milk instead of breastfeeding to reduce the risk of transmission.