Delvigne A, Gustin M L, Englert Y, Laruelle C, Vekemans M
Service de Gynécologie-Obstétrique, Hôpital Universitaire Saint-Pierre, Bruxelles, Belgique.
J Gynecol Obstet Biol Reprod (Paris). 1990;19(6):751-8.
Such demands raise difficulties, as the physician has to consider (and has to be the defender of) the coming child. A thorough psychological investigation must be conducted, as the couple's motives and those of each partner considered separately are not necessarily in agreement. Most important for the couple are the persistence of common projects and the strengthening of the bonds. The husband wants to survive through a child, to give an ultimate present and to increase the chance of keeping his partner. The wife shows her faithfulness and diminishes her partner's guilt feelings. She is, anyway, in a difficult situation if trying not to become pregnant, especially if she had already expressed a wish for maternity in normal circumstances. Unconscious mechanisms can intervene, such as fantasmatic adultery (through IAD) which reequilibrates the couple: the husband who brought the HIV has to be forgiven, or punished. Also, and most importantly, one has to analyze the prospects for the child, who is at risk of loosing his father, and also his mother: a later transmission of the virus to her cannot be excluded. The child will be confronted by illness and death of his father, and by heavy family secrets. The attitude of the medical team remains problematic: no clearcut attitude prevails.
