By William R. Short, MD, MPH
Many women living with HIV wonder if they can have healthy pregnancies. Happily, the answer is yes: With good medical care, women with HIV can have healthy, HIV-negative babies and be strong and healthy parents.
The first step is for women who are HIV-positive to have a candid talk with their HIV provider about whether they want to have children, now or in the future, and the options available to them if they do. Some women with HIV may not feel comfortable talking about such a personal decision, but it is an important talk to have. Some HIV providers might not bring it up, and some might not have the necessary expertise. In such cases, they might refer the patient to an OB-GYN specialist with specific expertise working with women with HIV.
When an HIV-positive woman is ready to have a child, it is important for her to talk with her HIV provider to make sure she is healthy during this time. For an HIV-positive woman, this includes appropriate and consistent treatment for HIV before she gets pregnant.
Current treatment for HIV enables HIV-positive women to have a healthy pregnancy and a healthy baby. In the past, prior to effective HIV drugs, one in four HIV-positive women transmitted their infection to their baby. With today’s very effective HIV medications taken before and during pregnancy, the risk of the baby getting HIV is less than 2 percent. If the mother’s viral load is very low and she has no other medical reasons for a Cesarean delivery, an HIV-positive woman can deliver vaginally.
After the baby is delivered, it is important for HIV-positive women to avoid breastfeeding as mothers can pass HIV to their babies through breast-feeding. Instead, women should give their babies formula or ask their doctor about getting human breast milk for the baby from a milk bank.
Having HIV does not mean not having children. Women with HIV can have healthy babies by optimizing their health through medical care for their HIV guided by a supportive health care provider.
Read more about preventing HIV transmission from mother to child during pregnancy, labor and delivery, or breastfeeding on this CDC webpage. AIDS.gov also offers information on its Having Children page.