“Can I still have a child?”

That was one of the first questions I asked after being diagnosed with HIV. It’s a question I am sure doctors hear often.

This was 2004. I wanted to have a baby since I was 24. I was diagnosed at 27. As luck would have it, I was in a major U.S. city with a women’s HIV Clinic.

I can still remember how relieved I was to hear ,Yes, absolutely. Just focus on getting yourself and your partner undetectable first. Little did I know that the goal of having a child would take over a decade to realize.

My partner was far from undetectable. He had checked into the hospital two weeks earlier with pneumonia. Within a few days, he was placed in a medically induced coma. I spent two awful weeks wondering if he would live. I can honestly say, they were the hardest weeks of my life.

During that time, I was told he was HIV positive and I should get tested. Luckily, he recovered. We were thankful he was alive.

The next year and a half was a mess. We moved across the country.

I went on antiretroviral medication a couple of months later, and after some trial and error, I got on ones I could tolerate. I was undetectable in a year. The body took longer to respond. His immune system had taken a beating.

He had wanted a child after being diagnosed. However, once the euphoria of surviving wore off, he changed his mind. It was largely due to a lack of knowledge about HIV and pregnancy in our new location.

The HIV care there was focused on men. There was not a real women’s clinic. The information they gave us contradicted to what I had heard originally. We were told there was still a small chance our baby could be positive, even with my undetectable viral load. Something like 1%.

One of the worst memories I have of that place was being sent to a male psychiatrist. When I told him about my desire to have a child, he did his best to convince me it was immoral to have one. That he would not take the risk even if it was a 0.1% chance.

For a while, I was convinced it was wrong for me to want a child. I became depressed. I badly wanted to be a mother and the conflicting messages were confusing. I remember thinking that the chance of birth defects for a normal pregnancy was 3-4%. Why was it considered moral for every other mother to take that chance and immoral for me to take a much smaller one?

I know now that I faced stigma and paranoid fear.

In larger cities they already shared the truth with undetectable women. The truth that they could not transmit HIV as long as they remained undetectable. The estimate of 1% risk of perinatal transmission included all women on antiretroviral medication, those with detectable viral loads as well.

My partner and I broke up after 7 years together. He had been frightened of having a child. But I was not ready to give up. I moved back to the other coast. Once there, I had better doctors with up to date knowledge. Overtime, I learned to ask the right questions of my doctors and get information specific to undetectable women.

Several years had passes since my diagnosis. POZ magazine started publishing articles on how women living with HIV could have children safely. Yet doctors still gave me the 1% statistic. Only when I asked if any undetectable person had ever transmitted HIV to their child did I receive the answer NO. Finally, I had some support.

I had no partner. I was positive. I was scared that no one would want me, that I would not be able to find anyone to share a life with and have a family with. At first, I only dated men from HIV positive dating websites. Several years later, I was no closer to having a child.

I was 36 and felt like my biological clock was ticking. I was not waiting anymore. So, I started artificial insemination. Not the fancy kind assisted by a doctor, but frozen sperm sent through the mail from a fertility clinic.

Filling out the forms online I quickly realized my status would make me ineligible to this kind of help. So, I lied. I knew I was no different from any other woman who wanted a child. My HIV status was not a valid reason to deny access to fertility assistance.

Then I found my current partner. We both wanted a child. I was honest with him about my past. He was HIV negative, so I suggested that he meet my doctors. This was before U=U. We used condoms. The doctors told us - that because I was undetectable and had been for years, we could try and get pregnant the old-fashioned way.

I could tell it was hard for my partner to get over the fear he had. Years of fear-based HIV education has a profound effect. We worked through it and a month after we started trying, I was pregnant.

We faced some challenges with insurance. I had recently moved to Canada and only had health insurance in the U.S. The clinic in Canada agreed to see me for my pregnancy and I planned to travel back to the U.S. for the birth.

The women’s HIV clinic in Canada was great. They had seen many women living with HIV through pregnancy and were very supportive. During the early part of the pregnancy, I had morning sickness, which was probably made worse by my HIV meds. I worried about taking such powerful medications while pregnant.

I had recently moved. So, to find more support I joined a pregnancy group. About 10 pregnant women would meet up regularly and chat. It was nice to have other pregnant woman I could talk to. I did not tell them I was HIV positive.

I was worried I would be judged, that they would assume I used injection drugs or had sex in exchange for money. Or that they would be afraid of me and worry that I would infect their babies. Or that they would think I was wrong to want a baby. That I did not deserve to have one as a person living with HIV.

I did end up telling one of them after the birth. I still don’t know if the distance I felt after was the due to knowledge of me having HIV or for other reasons. I suppose I can never know that.

Anyway, a month and a half before my due date I was diagnosed with preeclampsia and had to move back to the States immediately.

I had a gynaecologist in the States who specialized in pregnancy with HIV. I had talked with her about wanting to have a vaginal childbirth. She assured me that being HIV positive did not have to affect the way I chose to give birth.

After about a week in the States, I was checked into the hospital to keep an eye on my high blood pressure. Overall, I was well cared for. With one exception. I was at a teaching hospital, so the doctors were on rotation. When one of the doctors went over my birth plan, she told me that where she was from, they only allowed HIV positive women to have C-sections. That it was a risk to my baby to have vaginal childbirth. She was from the South.

I knew this was not true. My OB-GYN had told me so and I had done my own research. I felt so angry at this woman. All the rage I felt at uninformed professionals who had made me question my desire to have a child came back. Forcing women living with HIV to have unnecessary surgery was a standard in the past. It was the last thing I needed to have to defend my birth plan. Months later, I told my OB-GYN about this encounter and she made sure that the doctor received up to date information about HIV and childbirth.

I was induced at 37 weeks. Early induction is standard for women with preeclampsia. During the induction, I had IV medication for preeclampsia, induction, and HIV. It was a lot.

The birth was a complicated one, though it had nothing to do with my HIV status. The medication for the preeclampsia counteracted the induction medication. After two days of labour, I ended up needing a C-section.

I was sad to have to change my birth plan, but it happened for the right reasons. My baby needed it.

I gave birth to a healthy baby girl.