HIV, Pregnancy & Birth
Whether you are thinking about getting pregnant or are already pregnant, there are a number of issues to consider for those living with HIV or for those whose partner has HIV.
Current treatments and support are highly effective at preventing mother to child transmission of HIV and there are also effective methods in helping HIV negative women not get infected from an HIV positive partner during conception.
In Sheffield, we have excellent specialist maternity services that can provide information, advice and support.
Planning a pregnancy
If you are HIV positive and are planning a pregnancy, you can request advice about conception and discuss options for your HIV treatment with the consultant who manages your HIV.
For women who have a male partner who is HIV negative, the risks of infection during conception through unprotected intercourse can be prevented if the woman uses a self-insemination kit – for more information on self-insemination procedures, see www.aidsmap.com. Your consultant or other healthcare worker should be able to support you in finding information / resources to carry out this simple procedure.
For women who are HIV negative and are planning a pregnancy with an HIV positive man, there are alternative methods of conception that do not involve unprotected penetrative sex.
These can include:
- Sperm washing – The HIV virus is present in the fluid that men ejaculate not in actual sperm. Click here for more information about sperm washing
- Artificial insemination – From an anonymous donor or from someone known who is HIV negative (e.g. a friend or partner’s family member etc.)
Most HIV positive women have straight forward pregnancies and, with good HIV treatment, the risk of transmitting the virus to the baby is very low.
Pregnant women with HIV are advised to have anti-retroviral medication during the pregnancy. This is to reduce the chance of the baby acquiring the virus. Women who are not on treatment before they become pregnant may have it stopped after the baby is born.
Some women may worry that taking anti-retroviral whilst pregnant may cause harm to their babies. Although there can never be a guarantee (about anything in life), we know that thousands of women have taken HIV medication during pregnancy which has resulted in many babies being born HIV negative who might otherwise have been infected.
Women who are HIV negative but have a partner who is HIV positive are seen by the specialist midwife and advised to have a series of tests during the pregnancy based on their individual circumstances. Use of condoms is recommended during pregnancy and during breast feeding to reduce the chance of the woman acquiring HIV and passing it to her baby.
Babies are sometimes delivered by Caesarian section, however this is not always necessary if the mother has a very low viral load by the time of the birth.
Caesarian births may be recommended if the mother:
- Has a viral load greater than 50 copies / ml
- Is taking monotherapy as an alternative to HAART treatments
- Is co-infected with Hepatitis C virus
Your choice regarding the type of birth will be agreed with you around 36 weeks gestation.
Bottle feeding is recommended for babies whose mothers have HIV as the virus can be passed on in breast milk. The baby will have anti-retroviral medication for 4 weeks after being born and will have tests for the virus to confirm that they are free of the infection.
Although HIV free donated milk could be given to babies of HIV positive mothers, there is currently no NHS provision for this.