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Girl Talk
Healthy bundles of joy
What HIV-positive women can do to prepare for a successful pregnancy
by Laura Vicol
-positive women have to grapple with many decisions
HIVand life challenges when embarking on the wonderful
journey of childbearing. Obtaining specialized HIV care and
support during pregnancy is very important for the health of the
mother and can ensure the birth of a healthy, uninfected baby.
Women starting their care early, receiving intensive
pregnancy-related health counselling and HIV therapy, have
enjoyed safe pregnancies and healthy, uninfected babies.
If you’re HIV-positive and considering childbearing, prepare
for the pregnancy well in advance of becoming pregnant. For
example, before getting pregnant, start taking prenatal vitamins.
Review your antiretroviral regimen with your healthcare providers
to ensure your medications are safe during pregnancy.
Get a nutritional assessment. Address your ongoing primary
healthcare issues.
Once you’re pregnant, take a prenatal multivitamin
containing at least 0.6 mg of folic acid. Most prenatal
vitamins have an average of 0.6 – 1 mg of folic acid along
with other important vitamins and minerals. Eat a balanced
diet, rich in a variety of nutrients—this is good for your own
health and for the development of a healthy baby. Eat a
variety of fresh, wholesome foods that are high in iron,
folate, proteins, and vitamins.
Healthy eating doesn’t mean you need expensive or special
foods. The most important aspect during your pregnancy is to
make healthy choices in the foods you buy and prepare. For
some women, this may only mean integrating more fruits and
vegetables into your diet or getting used to eating breakfast
regularly. Work closely with a registered dietitian who is experienced
in HIV care and pregnancy.
Research data indicates that the risk of HIV transmission
from mother to child increases with injection drug use (such as
heroin), use of other substances like cocaine, cigarette smoking,
and unprotected sexual intercourse with multiple partners.
There are also unique considerations related to the use of
antiretroviral medication before and during pregnancy. The
choice of HIV medication is always made based on the unique
needs of each HIV-positive woman. Avoid certain medications,
such as efavirenz (Sustiva) during the first trimester of your
pregnancy and when you’re trying to get pregnant; clinical data
indicates an increased risk for birth defects related to these
medications. Also avoid other medications such as nevirapine
(Viramune), didanosine (Videx) and stavudine (Zerit), or take
them with great care, because these medications can have potential
unwanted side effects and toxicities in pregnant women.
Pregnancy represents a major change in your self-image,
priorities, behaviour patterns, relationships with others, problem
solving, and coping skills. Compounded with the multiple
challenges you face as a person with HIV underscores the need
for support, housing, adequate nutrition, and stable general
health in order to achieve the best possible outcomes. 5
Laura Vicol is a family nurse practitioner at the
Oak Tree Clinic at BC Women’s Hospital and
Health Centre.
Oak Tree Clinic
Oak Tree Clinic, located at BC Women’s Hospital and Health
Center in Vancouver, provides HIV-related medical care to
women and children, as well as pre-pregnancy planning and
pregnancy care to HIV-positive women. In BC, all pregnant HIVpositive
women are referred to Oak Tree, which serves as a
provincial referral centre for obstetrical care in HIV. Over 400
pregnant HIV-positive women have received care and have delivered
uninfected infants at the clinic since 1996.
Staff also provides medical advice to primary care providers,
specialists, and midwives in communities throughout the
province. Oak Tree’s multidisciplinary team provides ongoing
support in specialized HIV care, obstetrical, gynecological,
dental, pharmaceutical, and primary care. The clinic also has a
registered dietitian, social worker, and addiction counsellor.
14 living5 MayqJune 2010