HIV And Protecting Your Unborn Baby
Give your baby the best chance to be born HIV negative
Expectant moms living with HIV can transmit HIV to their babies in pregnancy or during labour and birth. The World Health Organisation (WHO) says that without intervention, there is a 15 to 45% transmission rate of passing HIV on to your baby. However, with the right advice and treatment, your baby can be born HIV negative.
HIV Status
HIV shows no outward symptoms. The only way to know if you are HIV positive, is to take a test. If you don’t yet know your HIV status, it’s important to have a test done as soon as possible. One should be completed in the first trimester and a second test done in the third trimester at 27 to 28 weeks. If you are HIV negative, you can protect yourself and your baby from infection. If you are HIV positive, you can work with your healthcare provider to reduce the risk of transmission to your baby.
Taking ARTs
The most effective way to prevent transmission from mother to baby, is for an HIV positive expectant mom to take antiretroviral therapy (ART). ART is medication that helps to protect the immune system and keep HIV under control. It is not a cure for HIV, but an important treatment that will help you to stay healthy while living with HIV.
Taking ARTs daily will reduce the amount of HIV in your blood. Your healthcare provider will refer to this as a ‘viral load’. If your viral load reduces when you start taking ARTs, the treatment is working. The medication can help the load to drop so low that it becomes undetectable, called an undetectable viral load. This means that you cannot transmit HIV to your partner through sexual contact. An undetectable viral load can also help to prevent transmission between mother and baby. Read our article Living Well With HIV for more information on managing your pregnancy with HIV.
Other Ways To Keep Baby Safe
Disclose your status to your healthcare professional
In South Africa, your HIV status is confidential and anything you share with a healthcare professional is kept in the strictest confidence. Your GP or gynaecologist will keep your status confidential and may not share your status with anyone without first obtaining your permission.
If you disclose your HIV status to your midwife or healthcare provider, confidentiality is guaranteed. Your midwife is trained to provide you with the best advice for your pregnancy and for your baby’s growth and development. If you are honest about your HIV status, your midwife can tailor their advice specifically for your health condition and to help you protect your baby.
Practice safe sex
If you and your partner are both HIV positive, with detectable viral loads, you can become reinfected (transmit or contract a different virus strain) if you have sex without a condom. Condoms can also prevent other sexually transmitted infections (STIs) which may have serious consequences for your health and your baby’s health and development. If your partner doesn’t know his or her status, encourage them to get tested. If you have sex with a new partner and don’t know his or her status, insist on using a condom to protect your baby.
Speak to your doctor about safe childbirth options
A C-section is recommended to reduce the risk of mother-to-child transmission during labour and delivery for mothers with a high or unknown viral load close to the birth. If your viral load is undetectable or suppressed (the virus’s function and ability to replicate is suppressed), you may be able to choose a normal vaginal delivery (NVD).
If you take ARTs throughout your pregnancy as prescribed, you can reduce the risk of transmission to your baby to 1% or less. In addition to this, you will need to give your baby HIV post-exposure prophylaxis (PEP) as prescribed by your healthcare provider. This is a course of medication for your baby to reduce the risk of him or her becoming infected with HIV. Your healthcare provider will determine how long your baby will need to take the medication, usually between four and six weeks.
Contact your midwife or healthcare provider for support, advice and counselling.
Resources: https://www.who.int/; https://www.westerncape.gov.za/; https://www.hiv.gov/;https://www.avert.org/; https://www.aidsmap.com/; https://www.cdc.gov/; https://www.acog.org/; https://i-base.info/; https://www.hiv.gov/
