Pregnancy and HIV
Women living with HIV can get pregnant and have babies. HIV treatment has been used safely in pregnancy for over 20 years and has had a hugely beneficial effect on the health of women living with HIV and their children.
If you have any questions or would like support around any of these issues, contact our Community Support team at 01 873 3799 or email firstname.lastname@example.org
I am a woman living with HIV, can I have a baby without passing on HIV?
Yes. Women living with HIV can give birth without passing on HIV to their baby. HIV treatment has been used safely in pregnancy for over 20 years and is key to preventing HIV from being passed on.
If you are thinking about or planning to have a baby, it’s a good idea to talk to your HIV doctor about how you can prepare for a healthy pregnancy.
In Ireland if you find out you have HIV when you are pregnant you will be referred to a HIV clinic and started on HIV treatment as soon as possible after the first trimester (first 12 weeks of pregnancy). You will be monitored throughout your pregnancy.
HIV testing is offered and recommended to all women attending antenatal services in Ireland. Whether you are aware of your HIV status before getting pregnant or if you are diagnosed with HIV at antenatal screening or any other time during your pregnancy, you will be linked in with a specialist team of clinicians to plan your and your baby’s delivery and care.
How can HIV be passed on to my baby?
HIV transmission is possible during pregnancy, labour and delivery, or through breastfeeding. This is referred to as vertical transmission.
Vertical transmission can occur:
- During pregnancy – HIV can be transmitted through blood crossing the placenta to the fetus/baby.
- During delivery – HIV can be transmitted through cervical secretions or blood during labour and childbirth.
- During breastfeeding – HIV can be transmitted to the baby through breast milk or blood during breastfeeding.
How can I prevent passing HIV on to my baby?
Your viral load (the amount of HIV in your blood) is the biggest factor in terms of the vertical transmission of HIV. HIV treatment can prevent your baby from getting HIV. The aim of HIV treatment (antiretroviral therapy/ART) is to get your viral load to an undetectable level. In pregnancy, being on effective HIV treatment and having an undetectable viral load means that the baby is exposed to less virus while in the womb, during birth and delivery, and when breastfeeding. Also, some HIV drugs cross the placenta and enter the baby’s body which can help prevent HIV from establishing itself.
Effective HIV treatment and optimum care have reduced vertical transmission rates to less than 1%.
Is it safe to take HIV medication during pregnancy?
Yes. HIV treatment has been used safely in pregnancy for over 20 years resulting in many babies being born without HIV.
If you are planning to get pregnant, are already on HIV treatment and have an undetectable viral load, it is unlikely that your treatment will be changed. In some cases, you may need to change part of your treatment combination. You can discuss this with your HIV doctor.
If you find out you have HIV when you are pregnant you will be started on HIV treatment as soon as possible after the first trimester. The aim of the treatment will be to get your viral load to an undetectable level by week 36 of your pregnancy.
Can I have a vaginal delivery?
If you have an undetectable viral load at week 36 of pregnancy, the options for delivery are the same as anyone who does not have HIV. If there are no other medical considerations, then you can have a vaginal delivery.
If you have a detectable viral load your doctor will recommend an elective/planned caesarean section. A caesarean section (also known as a C-section) is an operation to deliver a baby that involves making a cut in a woman’s abdomen. A caesarean section reduces the risk of passing on HIV as it prevents the baby coming into contact with blood and other fluids during a vaginal delivery.
Regardless of the viral load though, a woman with HIV may have a caesarean section for other medical reasons.
What happens to my baby when born? Will my baby need to take HIV drugs?
After being born, your baby will have to take a short course (up to a month long) of HIV medication (in liquid form).
When will I know that my baby is HIV negative?
HIV tests will be done several times in the early years of your baby’s life:
- just after birth
- at six weeks
- at 12 weeks
- at 18 months (final HIV antibody test).
If these tests are negative and you have never breastfed, you will know for sure that your baby does not have HIV.
Can I breastfeed my baby?
In Ireland (and in other high resourced countries) it is advised not to breastfeed your baby.
U=U (undetectable = untransmittable) does not apply to breastfeeding. There is a small chance of HIV being passed on if you breastfeed, even if you have an undetectable viral load.
The best way to ensure that HIV is not passed on through breastfeeding is to formula feed as there is no chance of HIV being passed on.
Should I continue taking ART after my baby is born?
Yes. HIV treatment is lifelong and is recommended for everyone living with HIV. Consistent adherence to your HIV treatment is key to maintaining your health and wellbeing.
I’m a HIV positive man, can I father a baby?
Yes. Men living with HIV can become fathers. HIV cannot be passed directly from a father to the baby.
Can I pass HIV on to my partner if we want to have a baby?
If you have an undetectable viral load for at least six months and continue to take your HIV treatment, HIV cannot be passed on during sex.
Other HIV prevention options such as timed conception (if as a couple you still prefer to use condoms even if undetectable) and PrEP (Pre-Exposure Prophylaxis) can be discussed with your HIV doctor.
Can a woman with HIV undergo IVF (In Vitro Fertilization)?
IVF is a complex series of procedures, conducted in a lab, to help a woman conceive or prevent genetic problems during conception. In Ireland, guidelines currently require a designated lab to conduct these procedures for women living with HIV. Unfortunately, there is no lab dedicated to this service for women living with HIV in Ireland, so they must avail of IVF in another country. IVF clinics in Ireland can provide further information.
Antenatal HIV Testing in Ireland (Health Protection Surveillance Centre)
Preventing Perinatal Transmission (The Rainbow Clinic, Crumlin Children’s Hospital)
Getting pregnant when you have HIV (aidsmap.com)
HIV and Pregnancy: Education for Healthcare Professionals (Queen’s University Belfast)
Disclaimer: The information provided here is not a replacement for medical advice, diagnosis or treatment. Those with concerns or require further information should contact their HIV clinic, a GP or sexual health service.