All women have the right to make their own choices around reproduction, regardless of their HIV status. A woman living with HIV should expect and receive the same level of support from doctors and healthcare workers as women who do not have HIV. Women should also expect to be closely involved in any decisions made about pregnancy and childbirth. However, women living with HIV sometimes face judgement so accessing support can be an important part of this process.

Can women living with HIV have healthy babies?

Cis women living with HIV can have healthy pregnancies, and babies who are healthy and HIV negative. Trans women who are living with HIV can get their partner pregnant without passing on HIV. Effective HIV treatment, an undetectable viral load, careful planning about delivery, and avoiding breastfeeding all ensure there is a very low risk of a woman with HIV passing it on to her baby. Talking to other women living with HIV who have been through the same experience can help a woman living with HIV to make informed decisions about her pregnancy, birth, and looking after her baby’s health, such as having strategies in place for adhering to treatment and for not breastfeeding.

HIV-positive women have the choice to disclose their HIV status to their children as well as anyone in their children’s lives (schools, babysitters, friends, etc.)

For HIV-positive women who are taking hormonal contraception, it is important to note that several HIV drugs interfere with the way some hormonal contraceptives work, and the contraceptive may not be as effective as usual. If a woman is able, it could be a good idea to consult with a doctor about what contraceptive will work best. 

More information about planning a healthy pregnancy

Breastfeeding carries a risk of passing on HIV on to the baby. For women who can breastfeed, the risk of transmission varies, depending on:

  • her state of health
  • whether she is on HIV treatment
  • her HIV viral load
  • how long she breastfeeds for
  • whether the baby receives any food or water in addition to breast milk (research has shown that 'mixed' feeding makes the transmission of HIV more likely.)

Is breastfeeding recommended for women living with HIV?

In Canada, where women can formula feed safely, women living with HIV are advised only to feed their baby with formula milk from birth. This is different than advice given in other parts of the world, where breastfeeding is recommended for women with HIV. This is partly because safe, clean water, bottle sterilizing equipment, and appropriate formula milk may not be available.

Things to consider

The decision about whether or not to breastfeed can be a difficult and complicated one. Cultural and familial pressure to breastfeed, as well as the desire to bond with the baby can be overwhelming for some women. Deciding not to breastfeed can also raise anxieties around unintended disclosure for women when trying to keep their HIV status private. Families, healthcare workers, friends, and even strangers often feel they can ask why women are not breastfeeding their child putting HIV-positive mothers in a difficult situation.

Getting support

Seeking support from other HIV-positive mothers can be a great resource for new moms who are navigating this process. HIV service organizations can also be a source of support for women looking for tips on how to explain to people in their lives why they’re not breastfeeding.

In Ontario, The Teresa Group provides free formula for one year to HIV-positive mothers who live anywhere in the province.

More information on infant feeding for HIV-positive women can be found here

Effective HIV treatment, an undetectable viral load, careful planning about delivery, and avoiding breastfeeding all ensure there is a very low risk of a woman with HIV passing it on to her baby.

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