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Why Ma stopped asking me about having kids: Family planning and HIV

As this is the first post of the year, let me take this opportunity to send best wishes for 2020. May God fulfill all your heart’s desires. Even if you’re unsure about what the year holds, may you continue believing that God WILL fulfill his purpose for your life.

My first post for this year is about family planning and HIV. The topic was inspired by a conversation I had with Ma over the December holidays. Growing up, I have never been one that imagined myself having children. I did see myself getting married. In fact, I always said I would get married at 25. But there was never a desire to be a mother. There are several factors that influenced this. It was in the way I was introduced into womanhood, when I had my first period. I shared this on my Facebook page recently (Nozibele Mayaba). When Ma had “the” talk with me, she said I shouldn’t sleep with boys. She said I would get pregnant and that was a sin. When I had decided that I would start having sex, it wasn’t such a big deal because I knew Ma would never find out. But there was no way she would miss a baby, if I ever had to pregnant.


The second influence was the fact that I grew up in large family. Ma only had my brother and I. But when we were growing up, she decided to take in her distant cousin’s daughter. When my uncle passed away, leaving 3 boys, she decided to take 2 of the boys to come live with us. When my cousin passed away, about 4 years ago, she took in her 3 daughters. It was always a full house. With this, came responsibility. And from a financial perspective, I was one of the people that had to make sure that everyone was taken care of. At times, it was too much for me. And, to some extent, that is why I was never keen to have children of my own.


When I started dating Skhu, she was very encouraging for us to start our own family. She said as soon as we got married, we must start a family as soon as possible. When we did get married, it was a conversation I had with her every other week when I called her. One time she called me on a Thursday afternoon. “Nozi, I have great news for you. I just came back from our weekly women’s prayer meeting. I asked the other ladies to pray with me. I prayed God will bless you with Quadruplets. You would only need to give birth once and that would be it”, she said. I never took her seriously because this was absurd.


Since I disclosed my status to her, I have seen some changes in our conversations. She’s no longer as encouraging with the children’s topic. Playing with my niece, I recently joked around about how it’ll be so much fun if Iminathi had to have a playing partner. She kept quiet. She made a comment about how Iminathi was a handful. I jokingly asked how she would manage if I had to bring another Iminathi. She kept quiet. It didn’t hit me until I came back to Johannesburg that Ma probably thinks I won’t be able to have children anymore. Or if she thinks I can, she’s concerned my children would be HIV positive.


I wondered how many people thought like Ma. How many people were aware that my HIV status does not limit me from having as many children as I want. This post is dedicated to explaining the many options we have in having children; babies born HIV negative, from HIV positive parent(s).


HIV positive and HIV negative partners

In a situation where one partner is positive, the first step is to make sure that the HIV negative partner is taking pre-exposure prophylaxis (PrEP). Pre-exposure prophylaxis (PrEP) is a course of HIV drugs taken by HIV-negative people to prevent infection. Taking PrEP correctly will virtually eliminate your risk of getting HIV. The second step is to make sure that the HIV infected partner is taking ARVs. At this stage their virus should be undetectable. Undetectable doesn’t mean they’re cured. It means they are unable to transmit the virus to another person.


Only when the above has taken place, to get pregnant, the couple may choose between these options:


Sex without a condom

With the help of a clinician, the couple may have sex without a condom. They only have sex when the woman is ovulating. This is a period where you’re most likely to get pregnant. When fertilization has happened, the couple is advised to go back to using a condom. There are slim chances for the HIV negative partner because they’re protected by PrEP and undetectable virus.


Home Fertilization

This process involves the man ejaculating into a clean cup or condom. After sex, using a syringe (without a needle), you suck up the sperm and insert the syringe deep inside the vagina. Once the syringe is deep inside the vagina, you squeeze out and deposit the semen.


In vitro fertilisation

This is a costly procedure. It involves using an egg donated by another woman, who has been cleared of all diseases. When her eggs have been matured, they are taken out of her ovary and mixed with your partner’s sperm. Once there is an embryo, it is put in your womb. Even though the egg used is from a woman who’s HIV negative, it is still important for you to take ARV’s to prevent the virus from passing to the child during pregnancy or childbirth.


“Washed” procedure

If only the man is HIV-positive, the sperm undergoes a procedure where it is “washed” to separate the seminal fluid which contains most of the cells carrying the virus, from the sperm. The sperm is retested for the presence of any remaining virus and if found to be HIV-negative, the woman can be inseminated.


After pregnancy

- For 4 to 6 weeks after birth, babies born to women with HIV receive an HIV medicine called zidovudine (brand name: Retrovir). The HIV medicine protects the babies from infection with any HIV that passed from mother to child during childbirth.

- HIV testing for babies born to women with HIV is recommended at 14 to 21 days of life, at 1 to 2 months, and again at 4 to 6 months. The HIV test looks for HIV in the blood.

- The results of at least two tests must be negative to be certain that a baby does not have HIV. The first negative result must be from a test done when a baby is 1 month or older, and the second result must be from a test done when a baby is 4 months or older. The results of two HIV tests must be positive to know for certain that a baby has HIV.

- If testing shows that a baby has HIV, the baby is switched from zidovudine to a combination of HIV medicines. HIV medicines help children who have HIV live healthier lives.


I trust that this information has been able to assist you.


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Regards

Nozibele Qamngana Mayaba

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