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What happens if I don't take my HIV medication?
Like most new moms, you're likely to be very tired, so it's easy to forget to take your medication. But for any HIV-positive woman, stopping treatment can have long-term effects on health. Stopping HIV medication increases the risk of infections, cancer, and drug resistance.
Although it might be hard, it's important to take HIV medication exactly as prescribed. Missing a dose or taking it at the wrong time means that your infection could get worse, leaving you with fewer treatment options in the future.
It's also normal to get the baby blues in the first few days after giving birth, so don't be surprised if you feel emotional or weepy. But if those feelings don't pass, or if you feel overwhelmed by sadness, anxiety or despair, talk to your healthcare provider.
Being HIV positive may put you at greater risk of getting postpartum depression (PPD). PPD is a serious illness that can affect how you care for your baby and yourself. PPD can also make it harder to remember to take your medication or attend appointments with your provider.
What care will I receive after I give birth?
You should get lots of support from your healthcare team after you have your baby.
Your obstetrician (ob-gyn) and HIV doctor will manage your health and medication. They may also refer you to specialists in mental health or substance abuse, if necessary.
Your healthcare provider may also connect you with a social worker or hospital program to help you get services such as:
- peer counseling (advice and support from another mom who's HIV positive)
- housing, food, and transportation support
- legal advice
Your baby also needs planned and coordinated pediatric care with a specialist to help ensure he doesn't get HIV.
How soon after birth do I need to use contraception?
It may seem too soon to think about birth control if you've just had a baby, but you may be fertile again sooner than you think – even before you've had a period. Use contraception as soon as you start having sex again after the birth of your baby.
Most women resume sex 6 to 8 weeks after delivery. If you think you may become sexually active sooner than that, talk to your provider about contraception before leaving the hospital.
Even if you hope to have more children in the future, leaving a gap of 18 months or more before becoming pregnant again is generally recommended for all women. This gives your body time to recover from the previous pregnancy and prepare for the next one.
Planning a pregnancy also means that your care and medication can be adjusted before you conceive. This gives your baby the best chance of being healthy.
What type of contraception works best?
Condoms protect you from sexually transmitted infections and from passing HIV on to your partner, but they can be unreliable as a form of contraception. The safest approach is to use condoms in addition to another long-acting birth control method, such as an intrauterine device (IUD) or implant. The pill or an injection may also be good options for some women.
What's the long-term outlook for my health?
There's currently no cure for HIV. However, antiretroviral therapy (ART) can control the virus and delay the onset of AIDS.
If you and your partner plan to have another child, you'll give your family and future baby the best possible start if you can:
- Stick to your HIV medications meticulously to suppress the virus and stop it from developing drug resistance.
- Follow safe sex practices and use appropriate contraception until you're completely prepared to have a pregnancy that's as healthy as possible.
- Get good nutrition and regular exercise.
Talk to your provider about family planning and preconception care at your routine health visits.
Remember that having unprotected sex risks transmitting HIV to your partner. Protect your partner by using assisted conception through insemination of his sperm at the time of ovulation.
If he's also HIV positive, it's safest to use donated sperm, though other options may be available. To find out what's best for you, talk to a healthcare provider experienced in family planning for HIV-positive couples.
Visit the Society for Maternal-Fetal Medicine's website for more information and to find an MFM specialist near you.