Can I transmit HIV to my unborn baby?
The bad news:
Yes, you can. During pregnancy, HIV can pass through the placenta and infect the fetus.
During labor and delivery, the baby may be exposed to the virus from a woman’s blood and other fluids.
When a woman goes into labor, the amniotic sac breaks (her water breaks). Once this occurs, the risk of transmitting HIV to the baby increases. Most babies get infected during the birth process.
You can also infect your baby with HIV by breastfeeding.
The good news:
If you are HIV positive, getting treatment before and during pregnancy usually can prevent infection in your baby.
If you take HIV medicines throughout pregnancy, labor and birth, and give your baby HIV medicines for 4 to 6 weeks after birth, the risk of passing HIV to your baby can be 1 in 100 (1 percent) or less.
What happens if I only discover late in my pregnancy that I am HIV positive?
You will be offered ARVs immediately upon diagnosis to take for the rest of the duration of your pregnancy.
As soon as your baby is born, your baby will also be put on ARVs and tested for HIV. You and the baby will remain on ARVs indefinitely if the baby also tests positive.
Babies that test negative from a mother that tested positive, are usually given ARVs for a period of 6 weeks after birth to prevent HIV if the mother is not breastfeeding. For mothers that breastfeed, the baby remains on ARVs till breastfeeding stops.
If you were unaware that you are HIV positive:
Please note that there is a high risk of your baby being born with HIV if you only start taking ARVs late in your pregnancy. The HIV virus can pass from the mother to the baby via the placenta.
In HIV-positive women, it is best to be on ARVs before you plan to get pregnant – definitely before 12 weeks of pregnancy. The placenta is fully developed by 16 weeks of pregnancy and transmission of the virus can happen from the mother to the baby.
Can I give birth normally?
If you have been taking ARVs throughout your pregnancy and your viral load is low – you can give birth naturally.
Viral load (the amount of virus that needs to be monitored during your pregnancy. The work of ARVs is to lower the viral load in the body.
An increasing viral load indicates either that the infection is getting worse or that the virus has developed resistance to the drugs used for therapy and is no longer effective. A decreasing viral load indicates improvement, treatment effectiveness, and suppression of HIV infection.
If your viral load stays under 200 copies per millilitre, you’re considered virally suppressed and unable to pass HIV on.
If your viral load is high – for example, 1000 copies per milliliter of blood, it is advisable to have a cesarean section to lessen the risk of transmission.
Does a cesarean section carry more risk for a mother that is HIV positive?
Yes – if your viral load is high and your CD4 COUNT is low, it may carry more risk. Your risk of infection is higher and the incision will heal slower. You will be given antibiotics to reduce the risk of infection.
- Monitoring of baby’s weight.
- Checks on feeding practices.
The baby will receive an HIV test at birth, 10 weeks, 6 months, 18 months, and 6 weeks after breastfeeding has stopped.