During pregnancy and in the perinatal period, confusion, guilt, anxiety, fear of transmission to the unborn child may arise and require sensitive handling, negotiation, offers of referrals, support, and advocacy. The nurse may link the woman, and her partner/family, to appropriate counselling, peer support, and culturally specific care and provide education to help overcome practical or psychological problems around the time of diagnosis. The nurse can also act as the key worker in advocating for the woman and family when dealing with external agencies or health facilities.
In principle, the nurse should support the mother to:
- make informed choices about pregnancy care.
- make informed choices around the mode of birth and mode of feeding.
- ensure health information is dealt with sensitively and compassionately whilst maintaining confidentiality. This may include withholding information from other family members or contacts.
- support ongoing engagement with primary HIV care providers to help achieve HIV viral suppression (that her HIV VL is undetectable).
- receive the best information on care for herself and her baby through pregnancy and beyond.
- ensure optimal adherence to her prescribed ART.
- ensure attendance at appointments, avoid loss to follow-up after the birth.
Following these principles, the nurse may identify that the woman needs help to navigate the health system, as she may have competing priorities.