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HIV-INFECTED PREGNANT WOMEN
AND
ABORTION
MISS
BY
JULAPORN SRINHA
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Introduction
 HIV-infected pregnant women
 Abortion
Mother to child transmission
Decision to continue or terminate pregnancy in
HIV-infected pregnant women
The effect after the women decided to
continue or terminate pregnancy
The appropriate way for these problem in
Thailand
Conclusion
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Introduction
increase HIV/AIDS in women
increase HIV-infected pregnant women
increase orphan
The women have HIV infected by
sexual contact with infected person
sharing needles/syringes
blood transmission
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Eg. From one hospital in Bangkok,1996
40 HIV infected mothers 95% got the disease from
her husband
Eg.Stringer et al,1999
480 Thai physicians: unwilling to perform
Pelvic examination(19.2%)
Vaginal delivery(30.7%)
Cesarean section(39.5%)
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Abortion
One way that HIV-infected were
chosen
Expulsion of the fetus from
the womb during the first 28
weeks of pregnancy
Induced abortion
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Thai Penal Code Section 305 :Abortion is illegal
except in 2 cases
The first: the health of the mother
The second :rape
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Opinion in some group in abortion
Prajayyothin,1996:
727 student 15 to 24 yrs,Bangkok >80% don’t to
prefer to abortion method
Kamkorn,1997:
704 female vocational student in Bangkok .87.2%
> 80% do not agree with abortion
Otherwise it might be reasonable for some critical
medical condition such as high risk pregnancy or
sexual transmitted disease (HIV positive)and so on
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Mother to child Transmission
One-third
It is also not clear why some babies
of HIV-positive women are infected
and other are not
Developed countries: 15%-20%
Developing countries: 25%-35%
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Period of Transmission
Antenatal(during pregnancy)
Perinatal (delivery)
Postnatal (breastfeeding)
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Preventing mother to child transmission of HIV
Antiretroviral therapy
ACTG 076:
AZT ,1996
100 women : 25.5%
($1,701,333)
save
$1,596,831
8.3%
($104,502)
Efficacy of treatment
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Cesarean section and Antiretroviral treatment
414 women received AZT ,Ricci,2000
10.6% give birth to have infected babies during
vaginal delivery
1.7% during cesarean section
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Breastfeeding
Not to breastfeed through breastfeeding
Use powder milk
But breastfeeding should be recommended HIV
infected women in areas where infectious disease
and malnutrition are the main cause of infant deaths
and where infant mortality is high
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Decision to continue or terminate
pregnancy
source
No. of
HIV+
women
No.
decided
terminate
% decide
terminate
Selwyn et al,1989
Sunderland et al ,1992
Chaiprasitti,1994
Kongsakorn ,1995
Auttagovit,1995
Teanchai,1996
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32
9
20
154
150
14
6
4
4
38
57
50%
18.8%
44.4%
20%
24.7%
38%
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Factor that involved in decision
Data physician
Husband’s perception
Economic status
Religion
Education
Status of disease
Power within their families
Age of pregnancy
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The effect after the decision
Mainly,women who decided to keep the baby faced
longer to more serious problems than the one who
terminated their pregnancies
Economic
religion
sickness
orphans
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The appropriate way for these problem
Preventing infected in women
Education in HIV/AIDS
Advocate for women in HIV screening test
Antiretrovirus ,cesarean section
powder milk
orphans
Supporting group
Service system
counselor
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For this problem in Thailand
in 1999: 1433,593,500 bahts
72.83% use in servicing ,treatment,and counselling
Conclusion
The HIV-infected women decided to continue
or terminate pregnancy is the complex process
The pregnant women’s right to choose to abortion
when she have HIV infection
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This question is too difficult to answer
Every one can answer when the world blows out.
In some situation ,you cannot decide them to be
right or wrong.
It depend on her decision because of she is first
person to receive the result of effect.
Everybody would like to agree with her decision
and support her health both body and mental
health.
We would like to support them in stead to judge
them because you are not referee but you are
the person in supporting group.
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