Living Well With HIV In Pregnancy
Guidance and support for HIV positive expectant moms
Access to quality healthcare and taking antiretroviral therapy (ARTs) throughout your pregnancy provides your baby with the best chance of being born HIV negative. Before ARTs, medication which treats HIV, and other preventative measures were available, mother-to-child HIV transmission rates were up to 43% in African countries. Today, transmission rates have declined significantly, largely due to the introduction of Prevention of Mother-to-Child Transmission (PMTCT) programmes.
Healthy Pregnancy Guidelines
To learn more on how to reduce the risk of passing HIV to your baby in pregnancy, see our article Protecting Your Unborn Baby. Let’s take a closer look at the other aspects important for a healthy pregnancy.
See your healthcare provider for regular prenatal check-ups. These are important for all pregnant moms. At these visits, your healthcare provider will check that you are healthy and that your baby is growing well. Standard pregnancy screening tests like a urine test to check your glucose (sugar) levels and protein will be done. A urine test can also detect an infection in your urinary tract (kidney, bladder and urethra, the tube that carries urine from the body), called a UTI. Your blood pressure will also be checked at every prenatal visit. This is to monitor you for preeclampsia, a serious pregnancy complication, characterised by protein in the urine and high blood pressure (hypertension). Although healthcare providers do not believe that HIV increases your risk for the condition, it is carefully monitored as more research is required. Your healthcare provider will also monitor your weight and check that you are gaining weight steadily.
Follow healthy pregnancy guidelines. These are important for every expectant mom. Follow the guidelines for eating a healthy diet, getting exercise and adequate rest. If you aren’t currently taking a prenatal multivitamin, ask your healthcare provider to prescribe one.
Take your ARTs. Take this medication exactly as your healthcare provider has prescribed. Don’t stop taking it and don’t skip doses. Depending on when you started taking ARTs, you may experience side-effects like nausea and vomiting. These are also symptoms of morning sickness and it can be difficult to know which is the cause if you are still in your first trimester. Tell your healthcare provider if you don’t feel well. He or she may be able to prescribe anti-nausea medication that is safe to take in pregnancy.
Monitor viral load and CD4 counts. Your viral load and CD4 count will be checked throughout your pregnancy. Viral load refers to the amount of HIV in your blood. CD4 or T cells are white blood cells that fight infection. A CD4 test measures the amount of T cells in your blood and will give your healthcare provider information on the health of your immune system. If your viral load is high or detectable and your CD4 count is low, there is a higher risk of you passing HIV to your baby. With HIV treatment, your CD4 cell count should increase and your viral load should decrease, even becoming undetectable. A low CD4 cell count can also put you at higher risk for other illnesses as your immune system weakens.
Speak to your healthcare provider. They provide supportive care to help you to make informed choices during your pregnancy and give advice on how you can take care of yourself and your baby.
After your baby’s birth, you will need to make the decision of whether to breastfeed your baby, or use formula. Moms living with HIV are no longer discouraged from breastfeeding, but rather empowered to make an informed choice. To learn more, see our article, Feeding Your Baby, in this month’s e-newsletter.
Contact your midwife or healthcare provider for support, advice and counselling.
Resources: https://www.aidsmap.com/; https://www.samrc.ac.za/; https://www.ncbi.nlm.nih.gov/p; https://hivpa.org/; https://www.acog.org/; https://www.marchofdimes.org/; https://i-base.info/;
https://medlineplus.gov/; https://my.clevelandclinic.org/
