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What To Expect Before You're Expecting

What To Expect Before You're Expecting

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There’s no reason you can’t bring home your own healthy bundle of joy

With better medication and keener understanding of the virus, people with HIV who want to be parents are finding ways to make it happen safely. With proper care, you can reduce the risk of transmitting HIV to your baby to less than 2%. Here is a road map for moms and dads to-be.

How Do You Want to Grow Your Family?
- If you’re a woman who wants to get pregnant, there are options for you. But remember, if you’re a man, woman, or couple (even a same-sex couple) with HIV, adoption is always an option. Though agencies used to deny requests from HIVers, the Americans With Disabilities Act now prohibits adoption agencies from discriminating against couples or individuals with HIV or AIDS.

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Before Getting Pregnant
- Find and consult with an obstetrician who specializes in HIV care and pre-conception counseling. General obstetricians may not have the knowledge to properly care for an HIV-positive person who is trying to conceive. Likewise, HIV specialists may not have much experience in gynecology or childbirth.

- HIV-positive men may consider the option of sperm scrubbing. Since HIV occupies the seminal fluid and not the sperm itself, the process essentially separates the sperm from the seminal fluid. The sperm is then deposited in the woman’s body during a peak period of fertility.

- Women or couples may also opt to use a sperm donor, either through a sperm bank or by asking someone they know.

- Couples in which both people have HIV may be tempted to get pregnant the old-fashioned way: through unprotected sex. However, these couples also share the risk of reinfection or superinfection (where you get a second strain of HIV), even if both members have a low or undetectable viral load. In either case, you may be reinfected with a more drug-resistant form of the virus.

- A 2004 Spanish study found that serodiscordant couples (couples with one HIV-positive person) who had unprotected sex only during high-fertility days, were closely monitored by a doctor, and in which the positive partner took highly active antiretroviral treatment without fail and had consistently low viral loads were able to have a baby without transmitting HIV to the child. Talk to your obstetrician about what this means for you.

- Don’t forget the issue of money. In addition to HIV treatment, pregnancy and delivery are expensive, but HIVers may be able to use Medicaid to help cover costs, depending on your state.

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During Pregnancy:

- Women should take extra folic acid supplements, in addition to any folic acid that may be in prenatal vitamin packs.

- Avoid taking too much vitamin A. Though some doctors recommend high doses of vitamin A for HIV-positive women, it could actually cause birth complications if more than the standard 5,000 milligrams are taken per day.

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While in Labor
- If a woman is on HAART, there is not much need for a cesarean birth. Once doctors discovered that HAART reduced the mother-to-child transmission rate by 70%, the need for cesarean births for HIV-positive mothers diminished.

- An IV drip of AZT is administered to the woman as a way to pre-load the baby with the drug to prevent transmission during labor.  


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After The Birth
- Breast-feeding is not recommended for HIV-positive women. If an HIV-positive woman does breast-feed, she puts her child at a 14% risk for transmission. Reliable formula, using clean water, is much better for your newborn.

- After the baby is born, he or she will be tested several times to ensure there was no HIV transmission. An HIV pediatrician may also prescribe a medication plan to cut the infant’s risk of HIV infection by 50%.

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Michelle Garcia

Editor