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Positive Outcomes: HIV and Me
Choosing Motherhood
Christina’s story
Being a mother is amazing, a great experience and a privilege. It’s changed my life and I wouldn’t change it back for the world. Ironically, I didn’t think I would have children, even before I was diagnosed with HIV. I was diagnosed in 1990. I already knew about HIV, and when I experienced classic seroconversion illness, I figured I better get tested. I just had this feeling about it. I didn’t fit the stereotypes, so I had to convince a doctor to test me, and I wasn’t surprised when it came back positive (the doctor was).
With diagnosis, my life took a different direction than what I had figured it would. For one thing, I imagined it meant I wouldn’t get married. I didn’t have a relationship for seven years after I was diagnosed. Then I met a man, and told him my HIV status. He pretended it didn’t matter, but when he didn’t call me for about a month, I knew it did. I met my husband Allan after that, in 1998.
About two weeks into the relationship, I told him. He was fine with it. He knew about safe sex, and it wasn’t an issue. Being the eldest of six children, I didn’t feel I had to have children, and in fact the first HIV doctor I saw said to me that I might as well be sterilized. He’s since changed that opinion, but that was relatively early days. I told Allan I didn’t want to have children, and he was fine with that too.
But things changed when my mother died. Something in me realized that maybe I would like to think about having children. I assumed I was going to die before Allan, and I started thinking about wanting someone to be with him after I died. Allan and I imagined what it might be like to have children. Were we willing to try? Were we willing to take the risk that the child might have HIV? Because I would be an older first time mom (I was 38 at the time), were we willing to take the risk that the child might have birth defects?
We went to see my HIV doctor, who sent us for a consultation with Dr. Deborah Money at Oak Tree Clinic. I had already made up my mind about some things. I told her that I didn’t want to hassle with monitoring my menstrual cycle beyond trying to get pregnant at what I figured was the middle of my cycle. I didn’t want to take any fertility drugs, or interfere much. And I only wanted to try for 4-6 months, because I didn’t want to get caught in the fertility roller coaster. If it happened, it happened, and if not, then that was okay too. Dr. Money was very nice, but laughed and said, “Most women who are 38 try to get pregnant for six months to a year and then come see me. It’s been nice to meet you.”
I didn’t want Allan to take any risks of getting infected. We always practice safe sex. We tried that first month- I used the “turkey baster method” on day 14 [inserting Allan's sperm with an oral syringe.]. A few weeks later we were going to a party and I realized my period was a bit late. I thought I’d better take a test, because if I were pregnant, I wouldn’t have a drink at the party. When we saw that it was positive, we couldn’t believe it. I really think it was meant to be.
When I was first diagnosed, I had started on AZT right away, and except for 2000-2002, I’ve always been on meds. I’ve always been healthy. I was on a triple combination through my pregnancy. I had a great pregnancy- no nausea, no complications like gestational diabetes. My viral load was tested monthly, and I had four ultrasounds during the pregnancy. I decided to have an elective c-section. I knew that even with the medications, my baby’s chance of infection was only about 1%, but I thought if a c-section could make it less, that’s the route I wanted to go. It turned out my baby was breech, so it would have ended up a c-section anyway.
The delivery was wonderful. There were a lot of people in the room- a doctor for me, a doctor for the baby, a student doctor, a nurse for each of those people, and a few extra nurses. Everyone was great there was no strangeness or discomfort about my having HIV. Allan and I were amazed when we met our baby – a boy! We named him Jacob.
Jacob was absolutely perfect. He had good Apgar test scores [standard tests to check a baby's health at birth] and his first HIV test, which was taken at birth, came back negative the next day. That first 24 hours of his life was so focused on meeting him and getting to know him that I didn’t think too much about the first test. The test at one week made me a bit more nervous. I started thinking “What if?” and knowing that if it did come back positive, it was because of me. I had a feeling it wouldn’t, but I wanted to hear it out loud. That one-week test came back negative too, and I thought, “Thank God.” He was also tested at one month, and it was negative too, so they told us then that he was negative. Nevertheless, he was tested again at 6 months, a year, and 18 months just to be sure. And he is negative. I would have liked to breastfeed, but I didn’t want to take the risk of transmission, and it was nice for Allan to have the chance to feed him (nice for me to sleep a little more too!). All of my family and close friends know I am positive, so I didn’t get any flack there, but if a stranger asked why I wasn’t breastfeeding, I told them I sometimes took medication for migraines, and it would not be good for Jacob.
The only negative experience I’ve had around birth and feeding choices came in a prenatal class. The instructor was adamant that a natural, medication free vaginal birth and breastfeeding were the only options for “good” mothers. I wrote a letter to the hospital about that. I felt confident in my own choices, but what if a woman didn’t?
For women who are thinking about having a baby, there is stuff to consider. I think the big one is do you have support from family or friends? Is your partner supportive? Do you have the financial means to pay for daycare (which is incredibly expensive in Vancouver)? Medically, I think any woman with HIV who is thinking about having a child has great access to care and can go ahead with confidence. There is great care at Oak Tree Clinic. One day I will tell Jacob about my HIV status. At three and a half, he already knows that I need to take medicine. I figure when he’s around six or seven, I’ll introduce the basic concept of HIV, but I’ll also tell him that it’s something we keep in our family. It’s a private thing, because I don’t want people to discriminate against him. As he gets older, I’ll tell him how I got it.
When I think about the future, I know Allan and Jacob will have each other if anything should happen to me. I am Catholic, and my spiritual faith helps me. I don’t worry about death, and I know Allan and Jacob will remember me and we will meet again. I am very healthy now, and there’s no reason to think I will die prematurely. I look forward to watching Jacob get older. We decided to try to have second child, and agreed we would try for six months. It didn’t happen, so I believe this is the family we are meant to be. Being a parent has strengthened me and I wouldn’t change it for the world.
To read more of Christina’s story, see The Positive Side (January 2008).