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HIV Treatment During Pregnancy and Birth

You can have a healthy pregnancy and baby. Get good prenatal care as soon as you know you are pregnant to learn all you can about transmission, treatment, the birth and newborn care, including feeding.

HIV Transmission During Pregnancy

During pregnancy, a combination of HIV drugs is advised to reduce the chances of mother to child transmission (also know as vertical or perinatal HIV transmission). If you choose to take treatment, the chance your baby will be infected is about 1% (1 in 100). If you don’t, the chance your baby could be infected is about 25% (1 in 4). We don’t know the life-long effects of these treatments on kids who were exposed during pregnancy, but Oak Tree Clinic can give you the most up-to-date research.

Despite taking HIV medication, the infection rate during pregnancy can be increased through:

  • unprotected sex during pregnancy (even if you are already HIV+ )
  • drug use, particularly cocaine, crack, or heroin. Complete withdrawal can be dangerous during pregnancy, so if you are using, contact a drug and alcohol counsellor for advice.

Treatment and Screening

Usually women start treatment after their first three months (first trimester). If you are already on treatment, you may be told to stay on it to manage your viral load. Get care as soon as you know you are pregnant, and don’t stop taking your meds without talking to your doctor.

Regular blood tests to check your viral load and how you’re responding to HIV medication help the doctor guide your care, particularly as you approach your due date. You may have ultrasound screening, but amniocentesis won’t be used because it might expose the baby to your blood, which is a risk for HIV transmission.

The Birth of Your Baby

Vaginal birth is recommended, but if your viral load is too high, a caesarian will be advised. There has been debate on whether caesarian births are less risky for vertical transmission, but with a full course of HIV medication, vaginal birth is preferred. A caesarian is abdominal surgery, which is harder to recover from than vaginal birth.

During delivery, you will receive medication intravenously, and the baby will be given medication in syrup form immediately starting at birth and continuing for six weeks.

Babies are tested for HIV at birth, one day old, one week old, and several times after that. The test used detects HIV itself, not just the antibodies (your baby will have your antibodies, but not necessarily have HIV). If at least two test results are positive after one month of age, the baby has HIV. If at least two test results are negative after one month of age, the baby doesn’t have HIV. Your baby will be tested up until 18 months, to make sure she has cleared the HIV antibodies.

Breastfeeding Not Recommended

HIV can be transmitted through breast milk, so breastfeeding is not recommended. There have been programs offering free infant formula to HIV+ moms in BC; check with us or Oak Tree for current information.

It’s important to talk about treatment during pregnancy as early on as possible so you can make treatment decisions that work for you and your baby. Contact us if you want more advice.

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