The US Public Health Service's 2001 recommendations on the use of drugs in pregnant, HIV-infected women seem to be so open-minded: "The decision to use any anti-retroviral drug during pregnancy should be made by the woman after discussing the known and unknown benefits and risks to her and her fetus with her healthcare provider." In reality, what happens to HIV-positive mothers who exercise their right to informed choice is much more complicated. Doctors don't generally reveal all the negatives outcomes of treatment as advised, and patients who don't agree with the standard of care can get slapped with "intent to harm" their children. When social service agencies are called in, treatment options become a matter of legal negotiating rather than personal choice. In extreme cases, children have been taken from their parents.

Christine Maggiore founded Mothers Opposing Mandatory Medicine (MOMM) to help women avoid such an ugly scenario. She has a confidential toll-free phone service; she connects questioning parents-to-be with healthy HIV-positive mothers who have chosen not to medicate; and she sends out packets of information that include the full version of the following boiled-down pieces of her advice:

1. If you are HIV-positive and want to have children, share the information only with trusted family members, friends, and a doctor who you know will support your decision to avoid HIV/AIDS drugs and interventions.

2. Don't apply for public benefits and don't accept them if they become available to you. Local, state, and federal agencies can impose the accepted standard of care and create custody battles when recommendations are not followed.

3. Make sure the doctor or midwife delivering your child is sympathetic with your choices and will not perform postnatal HIV testing without your consent. New York and Connecticut have mandatory newborn testing laws; in other states, having a supportive doctor or delivering in a birthing center or at home can take you out of the routine HIV-testing loop.

4. If you are currently seeing a doctor or other practitioner who does not sympathize with your medical choices, don't invite serious problems by disagreeing with him or her. Instead, tell the doctor you understand the recommendations, and phone the office later to say that you have found a specialist better suited to your needs.

5. Be aware of what your current or ex-partner accepts as true about HIV and AIDS. Keep in mind that disagreements over health choices between partners, particularly exes, can lead to intervention by public health agencies and custody problems.

6. Use hospital emergency rooms only for emergencies. HIV tests are frequently given to ER patients without their consent.

To receive the complete MOMM guidelines, "Six Steps HIV-Positive Mothers Can Take to Exercise Informed Choice and Avoid Legal Problems," call toll-free 1-877-804-4MOM.