Across the world, childbearing among HIV-positive women is a socially controversial issue. This paper derives from a larger research project that investigated reproductive decisions among HIV-positive women in Quang Ninh, a northern province of Vietnam. The paper focuses on 13 women who had an abortion after being diagnosed as HIV-positive, exploring their reflections, concerns and dilemmas. The results show that the HIV-positive pregnant women sought to balance their desires for a child with their worries of being unable to fulfill their responsibilities as mothers. Even while strongly desiring to become mothers, women in this study opted to terminate their pregnancies out of fear that they could not care adequately for the child they expected. These results indicate that when providing reproductive health counselling and support for HIV-positive women and their families, it is essential to take into account the socio-cultural factors that shape women's reproductive options.