Delivery
Like most mothers, you may wish to deliver your child vaginally. This is possible if the medication works well and if all other conditions are ideal. You should talk to your doctor about this.
If the conditions are not optimal, for example because the amount of HIV in your blood is too high, your child can be protected from infection by a C-section. In that case, a vaginal delivery should not be performed because blood and vaginal fluids enter the child’s mouth over a longer period of time and with great pressure during contractions. This is different with a delivery by C-section: The child is not exposed to contractions, it is removed from the abdomen within a few minutes and dabbed clean immediately – therefore it will hardly be exposed to HIV.
Your HIV specialist will advise you on which type of delivery is best for you and your child, and which hospital has a medical team that is experienced in HIV.
Scheduled Cesarean section
A scheduled C-section enables all necessary measures to be carefully prepared in order to avoid complications. The C-section is not carried out in the week of the due date but scheduled for the 37th week of pregnancy at the earliest. Once the exact date has been scheduled, the hospital can get a medical team for the delivery that is experienced in HIV infection and can offer you the best possible support.
In the ideal case, only the lower part of the body is numbed during the C-section: in that case, you can be awake during the delivery and experience it without any pain, and your child is not exposed to the anaesthetic drugs. After delivery, you can still hold and caress your child on the operating table. In exceptional cases, the C-section can also be carried out under general anaesthesia.
A C-section lasts only 25 to 40 minutes in total and is a routine surgery. In Germany, around one third of all babies are delivered this way nowadays. The doctors at the hospital will answer your questions about C-sections.
If someone asks you…
… why you delivered your baby by C-section, you can say: “The child’s position in the womb wasn’t ideal and the doctors decided on a C-section as a precaution.”
Vaginal delivery
A vaginal delivery is possible under optimal conditions. In that case, the risk of HIV transmission to the child is as low as with a C-section.
Unfortunately, not all hospitals offer vaginal deliveries for pregnant women with HIV. They cannot be scheduled and can take a long time during which a specialised medical team must be on duty. It is however possible to schedule a C-section, which can be carried out in almost any hospital.