HIV Positive Women, Pregnancy and Motherhood
ICW submission to the UK All Party Parliamentary Group on Population
Development and Reproductive Health hearings on maternal morbidity.
Despite HIV positive women having the right to make informed voluntary decisions about having children or not and the right to healthy motherhood, in practice it is hard to achieve our reproductive rights and hence ensure full reproductive health. Testimonies shared by ICW members, all of whom are HIV positive women from around the world, show that those who choose not to have (more) children struggle to access appropriate contraceptives and related services. Negotiating their use with sexual partners can also be difficult. A decision not to have children is, amongst other reasons, influenced by negative social reactions to HIV positive women having children. In fact when HIV positive women want to get pregnant or are pregnant they often face a lack of services and information about how to safely conceive, have a healthy pregnancy and look after a baby. This situation is exacerbated by severe discrimination by health care workers, communities, the media, politicians and even HIV activists, against HIV positive women who wish to be or become pregnant.
The emphasis on HIV testing in antenatal clinics serves to reinforce the belief that women bring the virus into the family, at a time when they are struggling with the trauma of their status and the impact on both their unborn and their older children. The failure of testing services to consider the discrimination and gender inequalities HIV positive women face on disclosure of their status lead many not to disclose. Not disclosing, or the stigma and discrimination if they do, then prevents women from accessing appropriate care, treatment and support, or testing services, for themselves and their children. Badly-designed services and indiscreet health workers that do not protect confidentiality and badly-designed policies, such as those criminalising HIV transmission, put not only HIV positive women’s reproductive rights at risk, but also endanger their rights to the benefits of scientific progress, health, liberty and life.
Some good examples of support for HIV positive mothers, training for health workers etc do exist. To ensure they are the norm requires commitment from policymakers, health managers, NGOs, community leaders and activists. Together we need to ensure that HIV positive women are provided with non-judgemental, confidential support, services and advice on contraceptives, conceiving, child bearing and rearing, that will enable them to make informed decisions about whether to have children (or not) and how to rear them. We also call for meaningful involvement of HIV positive women in the design of policies and programmes in order to ensure they are relevant to our lives.