CHLP Releases First Legal and Medical Guide on HIV and Pregnancy (2009)
On December 1, 2009, World AIDS Day, the Center for HIV Law and Policy is releasing a groundbreaking report and guide on the medical and legal issues surrounding HIV and pregnancy in the United States. The guide, HIV and Pregnancy: Medical and Legal Considerations for Women and Their Advocates, makes it clear that persistent beliefs among medical, social service, and justice system professionals that women with HIV should avoid childbearing are unsupported by medical science or the law. The guide is the first of its kind, and charts the intersecting medical, ethical, and legal issues that can arise for HIV-positive women who are or may become pregnant.
"For the last several years, we have talked with women living with HIV, and lawyers representing them, looking for help and guidance when health care providers, child welfare workers, or judges treat HIV as a bar to good decision making, including the decision to have a child," said Margo Kaplan, the Center's Director of Planning and Research, and one of the authors of the guide. "This area of HIV seems to be influenced by multiple assumptions: that women with HIV shouldn't get pregnant, that when they do they have no right to weigh and choose different treatment options, and that if their newborn is HIV-positive then they must have done something wrong. HIV and Pregnancy was written to respond to these assumptions, and the many requests for assistance we received, with an accurate medical and legal guide," Kaplan added.
According to the report, informed patients with a supportive health care environment have better health outcomes and healthier offspring—yet women living with HIV frequently encounter patronizing attitudes and negative judgments, particularly when considering pregnancy. Although transmission of HIV from women to their newborns was a significant problem in the first decade of the AIDS epidemic, more recent medical advances, and the discovery that administering antiretroviral medications can dramatically reduce the risk of mother-to-child transmission, has nearly eliminated perinatal transmission in the United States. Judgmental assumptions about the skills and safety of women living with HIV who are pregnant or looking to become pregnant interferes with the ability—and the right—these and all women have to make treatment decisions about their own pregnancy and health, and the right all parents have to make informed decisions about the health care of their children.
Lynn Paltrow, Executive Director of National Advocates for Pregnant Women, called HIV and Pregnancy, "a powerful affirmation that women do not lose their civil or human rights because they are pregnant, and that pregnant women who have HIV infection or other health problems are human beings entitled to dignity, privacy, and informed consent. It is a powerful addition to our collective understanding that punitive and coercive policies are not helpful responses to public health issues."
Paltrow, who heads a national organization dedicated to defending the rights of pregnant and parenting women, stated that, "As an attorney and activist who has represented numerous pregnant women and their families as well as leading medical and public health organizations, I can attest to the fact that HIV and Pregnancy is an extremely valuable resource. It can be used to inform and empower pregnant women and anyone committed to ensuring reproductive justice and evidence-based maternity care."
Claire Simon, Coordinator for the Young Women of Color HIV/AIDS Coalition, agreed, stressing the need to recognize and support the right HIV-positive women have to make informed decisions about their reproductive health: "HIV and Pregnancy is a great tool for women and advocates to better understand the complexities of mother to child HIV transmission. It provides accurate and sound information that will further much needed discussions with service providers, policy and law makers as well as women infected and affected by HIV. I commend the Center for HIV Law and Policy for developing this tool to help women understand their rights, risks and responsibilities as we continue to strive for greater access and treatment options for women."
HIV and Pregnancy underscores not only the legal basis, but the public health advantage, of treating women as active partners in their own and their newborns' treatment, and recognizing their right to appropriate counseling and medical care that accommodates their reproductive options. The guide provides a frank, balanced discussion of the medical issues and options women will encounter at all stages or their pregnancy, and how to deal with legal issues that also may arise when their right to make choices are challenged.
The guide can be accessed and downloaded here.