STARTING A FAMILY
HIV doesn’t prevent you from becoming a mother. You can have children if and when you are ready.
It’s important to know that if you are on effective treatment, you can live a long and healthy life without passing the virus to partners* or children. By having an ‘undetectable’ viral load – which means the amount of virus in your blood is so low that it is considered ‘undetectable’ – you can conceive naturally without passing the virus on during sex*. If your HIV viral load is detectable or you are gay, there are other options to become a mother.
*While effective viral suppression with antiretroviral therapy has been proven to substantially reduce the risk of sexual transmission, a residual risk cannot be excluded. CDC (Centers for Disease Control and Prevention) states that there is effectively no risk of sexual transmission of HIV in individuals with an undetectable viral load.
To help you plan for your next appointment and helpful questions to ask, go to What To Ask for tips and downloadable questions.
- Can I have a healthy child?
- Can I conceive naturally and safely?
- What happens when my child is born?
- Where can I turn for support?
CAN I HAVE A HEALTHY CHILD?
Thanks to advances in HIV treatments, you can have healthy pregnancies and healthy babies, with the support of your healthcare team.
In fact, the advice available for women living with HIV is generally the same as for women who are HIV-negative. There are only a few extra steps to be aware of to help reduce the risk of transferring HIV to your partner and child. For more information see How can I prepare?
HOW CAN I PREPARE?
If you are pregnant or trying to get pregnant, there are things you can do to protect your health and the health of your unborn child:
- Talk to your healthcare team about HIV treatments – if you are not already on HIV treatment, you should talk to your healthcare team about starting treatment as soon as possible
- Take your HIV medication as prescribed – it is very important to adhere to your HIV medication to help ensure your HIV viral load is undetectable. This will reduce the risk of HIV being passed on to your child
- Quit smoking – this reduces the risk of complications during pregnancy and birth and increase the likelihood of having a healthy child. Visit the smoking page for advice on how to quit smoking
- Stop drinking alcohol – as this can increase the risk of long-term harm to your child
- Follow a healthy diet – it is important to eat a variety of different foods every day to get the right balance of nutrients that you and your child need. See our diet and HIV page for more information on what a balanced diet looks like
- Take folic acid supplements – as this may reduce the risk of your child being born with any defects.Talk to your healthcare team about where you access folic acid tablets, they are usually available at pharmacies
CAN I CONCEIVE NATURALLY AND SAFELY?
Yes, your HIV status does not prevent you from getting pregnant. You may conceive naturally and significantly reduce the risk of passing on HIV to your partner, if you follow your HIV treatment as advised by your healthcare team, have had an undetectable HIV viral load for more than six months, and neither you or your partner have any sexually transmitted infections*.
Your partner may also be offered HIV pre-exposure prophylaxis (PrEP) as a preventative step when you are trying to conceive.
If you become pregnant unexpectedly, you should consult your healthcare team straight away. They can then advise you on the steps you can take to ensure you and your baby stay healthy throughout the pregnancy.
*If you are living with HIV and considering becoming a mother, you should speak to your doctor.
CAN I HAVE A NATURAL BIRTH?
Your options for giving birth are dependent on your HIV viral load during pregnancy and your personal circumstances. You should talk to your healthcare team about your options and delivery preferences, and they can also advise on other considerations for the birth.
STARTING A FAMILY AS A TRANSGENDER WOMAN
As a transgender woman, you have choices when deciding to have children:
- If you’re still making sperm, you can use your own sperm to get your partner pregnant
- You can donate your sperm to someone who can carry the baby for you
- Or, if you are not currently considering starting a family, you can save your sperm at a sperm bank for later if and when you’re ready to have a baby. If you take hormones, you may need to stop for 3–6 months to make enough sperm
If none of these options are right for you, you can also look into adoption or fostering a child.
If you are an HIV positive transgender woman looking to start a family, you can significantly reduce the risk of passing HIV onto your partner if you follow your HIV treatment as advised by your healthcare team, have had an undetectable HIV viral load for more than six months, and neither you nor your partner have any sexually transmitted infections*.
*If you are living with HIV and considering starting a family, you should speak to your doctor.
WHAT HAPPENS WHEN MY CHILD IS BORN?
- Your child will take a course of HIV treatment as an extra measure to prevent HIV transmission. The duration and type of HIV treatment prescribed will depend on whether your HIV viral load was detectable or undetectable during the pregnancy and birth
- Your child will be tested several times for HIV, with the first test just a few hours after birth and the final test at 18 months to conclusively determine your child’s status
- The likelihood of transmitting HIV to your child is reduced to less than 2% if you take all of the necessary precautions, which involves you taking your HIV medication as prescribed, you do not breastfeed your child and your child being on HIV medication for a short period of time. When the necessary precautions are not followed, transmission rates range from 25% to 35%
- If your child is diagnosed as HIV positive, they will be referred onto a specialist clinic for children with HIV, to ensure the right care and support is given
- Breastfeeding is not recommended for women living with HIV, as it carries a risk of passing the virus to your child. It is instead advised that you use formula to feed your child. Talk to your healthcare team for more information and advice
WHERE CAN I TURN FOR SUPPORT?
Having a child is a rewarding and exciting experience, but there can be challenges along the way. For all mums, receiving support from your partner, family, friends and healthcare team can make all the difference during difficult times.
Talking to other mums living with HIV can also be helpful, as they can provide practical advice and talk about their own experiences of starting a family. Watch Angelina’s story of motherhood and hear her top tips on how to manage parenthood.
You can also ask your healthcare team for information about local support groups.