This information is about HIV, pregnancy and childbirth.
You can also find more general information at our HIV section.
Finding out you are HIV-positive during
Pregnancy
All pregnant women are now offered a test for HIV as a routine
part of antenatal care. This is because finding out if you do have
HIV when you are pregnant means that you can receive treatment that
will significantly reduce the chance of passing the infection on to
your baby and making sure you stay really well during the
pregnancy. If you do not want this test or have any concerns you
can discuss this with the medical staff. The test is never
done without asking you first.
If you are found to be HIV positive you will be advised to start
some tablets at least for the time you are pregnant (and maybe long
term if you need it to keep yourself well). This will help keep you
well during your pregnancy and will also mean that there is a very
small chance of your baby becoming infected with HIV.
Issues for an HIV-positive woman who wants to become
pregnant with an HIV-negative man
There is a risk that unprotected sexual intercourse with an
HIV-positive woman will lead to infection of a HIV-negative male
partner. However, if this is the case and the woman wishes to
become pregnant it is possible to prevent the male partner becoming
infected if the woman uses a self-insemination kit. This simple
procedure involves the woman inseminating herself (basically
squirting the semen into her vagina), at the time she is ovulating
(producing an egg), with her partner's sperm which has been
collected in a sterile pot.
Most hospitals or women's health organisations can offer advice
and appropriate equipment. It is a good idea to discuss your plans
with the healthcare team that look after your HIV. This is
especially important if you are on HIV medication or have other
health problems. Your HIV team may want to optimise it to make sure
if you become pregnant the baby wont be harmed.
Issues for an HIV-negative woman wishing to become
pregnant with an HIV-positive man
If the father is HIV-positive but the mother is not, the baby
will not be directly infected from the father's sperm. But if the
woman becomes infected during conception there is significant risk
of transmission to the baby.
There are some actions that you can take in these
circumstances.
- Normal conception: Some couples may elect to get
pregnant by having intercourse like any other couple. This is only
recommended when the male is on treatment AND their HIV is fully
controlled AND they have been checked for other infection AND that
he is producing good quality sperm. The female partner may also
take anti-HIV drugs during this time to further reduce the risk of
becoming infected with HIV. Couples wishing to conceive in this
manner MUST talk to their HIV doctors and nurses before they
consider this and get support to make sure they do this
safely.
-
- Sperm washing: One option for couples where
the male is HIV-positive and the woman HIV-negative may be sperm
washing. A semen sample can be `washed' and used for insemination.
A woman wishing to get pregnant by this method will be monitored to
determine when she is due to ovulate, and then her partner will be
asked to provide a sperm sample which is washed before testing it
for HIV. So far there have been no cases of HIV transmission to the
female partner with this method. However, unfortunately, few
centres in the UK offer this service and NHS funding remains
limited. It is important to note that sperm washing is looked upon
as a risk-reduction process and not a fertility treatment.
- Artificial insemination: Another option for a
woman who is HIV-negative and whose partner is HIV-positive might
be artificial insemination with another man's semen either from an
anonymous donor, or someone known (such as a member of her
partner's family). This is an option that many women use if their
partner is infertile or risks passing on other
infections.
Issues for HIV-positive couples
Until recently it was thought that pregnancy could have a
negative effect on a HIV positive woman's health as the immune
system might be further suppressed by pregnancy. It now seems that
pregnancy is only likely to have an impact on a woman's physical
health if she is already unwell, or has very low CD4 counts.
If you are both positive and taking combination
treatments it is important to discuss conception and contraception
plans with health professionals preferably before
conception.
This is particularly important if either of you has resistance
to any HIV drugs as there is a chance a resistant strain of the
virus could be passed between partners. Also there may need to be
changes to your medication to make sure if you become pregnant the
baby won't be harmed by the drugs.
Reducing Infection Risk for the Baby
- A team effort between you and all the people who are there to
look after your pregnancy, your baby and you HIV and taking the
tablets that are advised mean there is a very small chance of your
baby becoming infected with HIV. We currently can get the risk as
low as 0.1% (which is the same as saying 1 mother in every 1000
with have a baby born with HIV).
-
- After birth: All babies born to mothers who
are HIV positive will receive a four week course of medication. It
is important not to breastfeed your baby and you will be given help
to formula feed your baby.
- Your baby will need an HIV test when it is 6 weeks old and then
need further tests usually at 3 months and 18 months.
- If your baby is found to have HIV (which is very rare) they can
have medication to keep them healthy and they should enjoy a normal
happy life able to all the things any child enjoys.
Help, information and support
You will find more detailed information at the links below:
- NAM is a community based HIV information
provider. It has 3 factsheets under the heading
reproductive health on: mother to baby
transmission, pregnancy and contraception and sperm washing. More
at: http://www.aidsmap.com/cms1044467.aspx
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- AVERT is an international HIV and AIDS
charity, based in the UK, working to avert HIV and AIDS worldwide,
through education, treatment and care. More information on
pregnancy and HIV at: http://www.avert.org/pregnancy.htm