Pregnancy and HIV
March 1, 2017
Table of Contents
- The Good News
- Before You Get Pregnant
- The Pregnancy Guidelines
- HIV Drugs and Pregnancy
- Tests, Procedures and Delivery
- After the Baby Is Born
- In Conclusion
Due to advances in HIV care and treatment, many women living with HIV (HIV+) are living longer, healthier lives. As women living with HIV think about their futures, some are deciding to have the babies they always wanted.
The good news is that advances in HIV treatment have also greatly lowered the chances that a mother will pass HIV on to her baby (also known as perinatal HIV transmission, or vertical transmission; also sometimes called "mother-to-child" transmission). The World Health Organization reports HIV that can be perinatally transmitted as much as 45 percent of the time when mothers are not taking HIV drugs. However, with HIV treatment, the chances of perinatal transmission can be less than five in 100 births. According to the US Centers for Disease Control and Prevention (CDC), if the mother takes HIV drugs and is virally suppressed (viral load is undetectable), the chances of transmission can be less than one in 100. It is also important to note that studies have shown that being pregnant will not make HIV progress faster in the mother.
One way we learn about how HIV drugs affect pregnancy is through the Antiretroviral Pregnancy Registry. Pregnant women living with HIV are encouraged to register (through their health care providers) with the Antiretroviral Pregnancy Registry at www.APRegistry.com. This registry tracks all women in the US who are pregnant and taking HIV drugs to see if these medications are harmful to the developing baby.
It is important to plan carefully before getting pregnant:
- Discuss your plans with your HIV health care provider to make sure you are on the right treatment plan for your own health and to reduce the risk of perinatal transmission (more about this in the next sections).
- Find an obstetrician (OB) or midwife who is familiar with HIV care. She or he can explain your options for getting pregnant with as little risk to your partner as possible. For more information on getting pregnant and options for safer conception, see our fact sheet on Getting Pregnant and HIV.
- Ask your HIV health care provider and your OB or midwife to talk with each other and coordinate your care before and during your pregnancy.
- Get screened for sexually transmitted infections or diseases (STIs or STDs), hepatitis B and C, and tuberculosis.
- Do your best to give up smoking, drinking, and drugs -- all of these can be bad for your health and the health of your baby. Researchers recently found that smoking dramatically increases the risk of pregnancy loss -- miscarriage and stillbirth -- in women living with HIV.
- Start taking pregnancy vitamins ("prenatal" vitamins) that contain folic acid while you are trying to become pregnant. This can reduce the rates of some birth defects.
- If friends and family do not support your decision to have a child, put together a support network of people who are caring, non-judgmental, and well educated about HIV and pregnancy. Your network can include medical providers, counselors, and other women living with HIV who are considering pregnancy or who have had children.
If you are living with HIV or partnered with someone who is, and you want more information on having a child, please see our fact sheet on Getting Pregnant and HIV.
Several groups of experts on pregnancy in women living with HIV have developed guidelines that provide information about appropriate care and treatment for women living with HIV who are, or may become, pregnant.
As a first step, the pregnancy guidelines issued by the US Department of Health and Human Services (DHHS) recommend a thorough check up, including a number of blood tests, to find out about your health and the status of your HIV infection. A resistance test (see our fact sheet on resistance for info about this test) should be included if you:
- Are starting HIV drugs
- Are taking HIV drugs and have a detectable viral load (500-1,000 copies or more)
The results of a resistance test can help you and your health care provider choose the best drugs to take.
Recent studies have shown that starting HIV treatment as early as possible, even when someone feels well and has a high CD4 count (a strong immune system), is the best way to stay healthy while living with HIV. Also, starting HIV treatment and having an undetectable viral load before getting pregnant is healthier not only for the mother, but also for the baby. As a result, the World Health Organization (WHO) recommends that all pregnant and breastfeeding women living with HIV, regardless of their CD4 count, begin HIV treatment as soon as possible and continue it lifelong. This is important for the health of the woman as well as for her baby, since HIV drugs can reduce the risk of perinatal transmission.
HIV drugs need to be taken just as they are prescribed to have the best chance of working (see our fact sheet on adherence for more info). Also, if a woman living with HIV takes HIV drugs and gets her viral load very low, she reduces the chances of transmitting HIV to her sexual partners.
More From This Resource Center
Newly Diagnosed? Words of Encouragement from HIV-Positive Women
What Every HIV-Positive Woman Should Know About GYN Care and Prevention
|What Did You Expect While You Were Expecting?|
|HIV/AIDS Resource Center for Women|
|More on HIV & Pregnancy|
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