It is safe to become parents, if you have HIV status. Yet, due to prejudices and limited access to resources, many do not dare. Anton Basenko, living with HIV for 16 years, dared. His baby was born this spring. How did he and his wife prepare for labor? What should PLWH (people living with HIV) and doctors take into account? This articles gives answers.

Family planning

“Don’t be afraid to become parents. Throughout the last 10-20 years a lot was done in Ukraine to make PLWH fulfill their reproductive rights,” assures young father with HIV status, project manager at Alliance for Public Health Anton Basenko.

Today Anton got free from work to spend more time with his baby. He says that delivery was an unforgettable experience. He participated fully, except those 15 minutes that were needed for a C-section. Anton was ready to participate in the labor. Yet he was not allowed to the surgery room, since it was an emergency delivery. “I planned to be present, but last minute they turned me and told to wait outside. Nevertheless, I saw my baby during the first minutes of his life,” recalls Anton.

Anton and his wife did not attend special courses for future parents, but the couple had actively studied specialized literature and experience of their friends and colleagues also living with HIV. “Don’t be shy to ask questions. The more questions you ask, let even sensitive, the less surprises you will have afterward,” Anton says. For those who do not know where to get information, Anton advises to pay attention to three sources: All-Ukrainian Hotline on issues related to HIV/AIDS/TB, All-Ukrainian Network of PLWH and Alliance for Public Health. Specialists on the hotline will help to find answers to essential questions about childbirth planning for PLWH, needed therapy and elimination of all potential risks. Moreover, specialists at AIDS Centers have been working with PLWH for years, so they can respond to questions that are difficult for ordinary doctors to answer.

Choosing a birth location

The next issue that might be worrisome for future parents is where to give birth. Anton and his wife chose a doctor in a state hospital based on references. PLWH have the right to give birth not only at a specific but at any maternity hospital. “It is stereotypical to think that there is no choice, so one has to deliver at one exact place. There is a choice, and you can’t be denied it,” assures Anton.

Another stereotype that Anton breaks is that it is better to give birth at private hospitals. They say PLWH will receive better care there. Yet Anton has considerations.  “When we talk about comfort, equipment, and cleanliness, then no doubt. But we go to labor not for a nice medical gown, right? For instance, at private clinics, they might not have antiretroviral therapy (ART) for children. However, this is more important than any comfort. That’s why you should check such things in advance,” young father says. Also, when choosing a maternity hospital, one should take into consideration whether it is going to be a C-section or not. If a woman has been taking ART for a while and viral load is not detected, she may give birth in a natural way. Though when it comes to a C-section, then it might be better to go to a state maternity hospital. Especially when you have a certain endorsed specialist on your mind. “You will spend 3-4 days in the maternity, with a C-section included. It is not that long, thus you could forgive some comfort matters, but think more of having essential medication and doctors’ expertise,” Anton suggests.

Doctors’ competence

Doctors often treat PLWH as “special people with a special status”. Moreover, they make it clear to their patients, thus building an invisible wall between each other. Sometimes it turns into sending pregnant women with HIV to special separate hospital rooms. 

“It was fine with the attitude in the maternity hospital where we gave birth, but I noticed that, in general, medical staff has a burnout,” Anton comments. Probably, due to burnout and overload, physicians may lose vigilance, especially when it comes to emergency delivery. “They might forget to ask how long a pregnant woman has been taking ART, and, consequently, prescribe an infant with a needed medication not for a week, but for 28 days, and not only one, but three drugs,” Anton gives examples. Such mistakes and inattentiveness may damage a newborn’s health severely. Therefore, one should consciously choose a doctor, trust him/her, but be well-informed oneself. “Patients that have a basic understanding of all these matters, can clearly see and feel when there is falsehood, stigma and doctor’s incompetence. They won’t see that doctor again. So, if you, as a doctor, are interested in expanding your practice and engaging new clients, you should read specific medical literature and new medical protocols, bring intolerance and continuously develop yourself,” Anton suggests.

According to the operational data of the Center for Public Health of the Ministry of Health of Ukraine, 244 thousand Ukrainians are living with HIV. 70% of them are people of reproductive age. They can give birth to absolutely healthy children, yet are often scared and doubtful. Especially when it comes to assisted reproductive technology. However, HIV status changes nearly nothing in the patient’s care nowadays. No doubt that future parents should study accessible information sources by themselves and seek advice. Doctors, in their turn, should confirm their expertise, address exact questions to their patients and be well-informed. Most importantly – they should perform their tasks professionally regardless of a patient’s status.

Фото: © 2016 Brendan Hoffman/Global Fund Advocates Network/