Were you diagnosed with HIV while pregnant?
Are you having a baby after diagnosis?
Are you living with HIV and planning to start a family?
You are not alone. Over 1,200 women living with HIV give birth in the UK every year. Although pregnancy is usually a joyful occasion, we know it can be a challenging time, especially when you are living with HIV.
Our Positively Women project can provide you with emotional and practical support to help you start a healthy, happy family, including information around reducing the risk of passing on HIV as well as answer questions you may have about HIV treatment and pregnancy. We also support men living with HIV planning to start families as well as sero-different (HIV negative) partners (women and men) of people living with HIV.
Our Mentor Mothers are women who have been through the pregnancy journey whilst living with HIV themselves. They are trained to provide emotional and practical support around all aspects of the pregnancy journey, including talking about HIV to others, treatment, delivery options, and aftercare. A mentor mother can be like a friend by your side to support you, give you information, or simply talk through all your concerns during and after pregnancy. If you would like to have the support of a Mentor Mother, please contact Helen on 020 7713 0444 or email firstname.lastname@example.org.
Our workshops are facilitated by women living with HIV and cover key topics including:
Will I have a positive baby?
Women living with HIV can have healthy babies as long as they collaborate with their doctors and midwife and take HIV medications as prescribed. The main risk factor in HIV transmission is your viral load. If this is ‘undetectable’ (which means that there is very little virus in your blood: below 50 copies/mL) then it is extremely unlikely that you will l transmit HIV to your baby. The risk increases if your viral load is detectable, particularly at the time of the baby’s delivery, but the risk of transmitting HIV can still be very low with appropriate treatment and medical care
Can I have a vaginal Birth?
Yes, as long as there are no other complications that would otherwise prevent a vaginal delivery.
Reasons that may prevent this could be:
If you don’t have an undetectable viral load at the time of the birth your health care team may recommend for you to have a caesarean section as this would offer more protection from HIV in your blood to the baby.
If you have concerns or questions about what kind of birth would be right for you could talk to one of our advisors, a mentor mother, who is a woman with HIV who has had a baby and is trained to give support an advice. Please call Helen on 020 7713 0444 or email email@example.com
Can I have a vaginal birth after a caesarean?
This would depend on the reason for having a previous caesarean (C-section). If the only reason was that you had a C-section due to having HIV, this has now changed and women with HIV can choose to have a natural birth.
In the UK most NHS trusts will consider a Vaginal Birth After Caesarean (VBAC) after one C-section.
If you have had two C-sections, then they might prefer for you not to deliver by a vaginal birth. You can insist, but the risks increase with every birth. If you have any other types of surgery on your uterus they might advise against a VBAC. Every surgery increases the risk of possible uterine rupture.
One of most problematic causes of a failed VBAC is uterine rupture, which is when the scar on your uterus from your previous C-section re-opens during labour, putting you and your baby at serious risk. Fortunately it’s extremely rare: only one in 100 women who attempts a VBAC experiences uterine rupture.
If you have concerns or questions about what kind of birth would be right for you, you may want to talk to one of our advisers, a mentor mother, who is a woman with HIV who has had a baby and has been trained to give support an advice. Please call Helen on 020 7713 0444 or email firstname.lastname@example.org
Will I have a specialist midwife?
A few hospitals will have a specialist HIV midwife. In most hospitals you will be seen by a special midwife who specialises in care for patients who may have some health conditions, including HIV.
If you have concerns or questions about pregnancy and HIV, you may want to talk to one of our advisors, a mentor mother, who is a woman with HIV who has had a baby and has been trained to give support an advice. Please call Helen on 020 7713 0444 or email email@example.com
Will my baby be on medication?
If you have been on treatment and your viral load is undetectable at the time of the birth your baby will be given zidovudine monotherapy.
This means he or she will take this single anti-HIV drug, usually twice a day, for four weeks, starting within four hours of being born.
If you have not been on HIV treatment at all during your pregnancy, and your baby is less than three days old (72 hours), your baby should be started on HIV treatment immediately. Again, the recommended treatment in this situation is a three-drug combination, taken for four weeks.
Not all anti-HIV drugs available are considered suitable for use in babies. Which anti-HIV drugs are used in a three-drug combination can also depend on any treatment you have been on (because your baby will have been exposed to those drugs in the womb). Doctors will use the best available evidence to help them choose the right combination for your baby.
Giving medications to your new born and waiting for tests can be stressful. I you have concerns or questions about your baby you may want to talk to one of our advisors, a mentor mother, who is a woman with HIV who has had a baby and has been trained to give support an advice. Please call Helen on 020 7713 0444 or email firstname.lastname@example.org
Can I breastfeed?
To prevent the transmission of HIV to the baby, current UK guidelines recommend the complete avoidance of breastfeeding for infants born to mothers living with HIV, regardless of whether the mum is healthy, her viral load, or if she is taking HIV treatment.
This is because there is an extremely small possibility that HIV may be passed through breast milk, even if the mother is on HIV medication has an undetectable viral load.
The guidelines in the UK are different from the global guidelines by the World Health Organisation who recommend exclusive breast feed. This is because the risk is extremely low, and there are higher risks associated with not having clean water and costs of formula milk. Mixing formula milk and breastfeeding is especially discouraged. The formula milk may irritate the mouth and digestive system of the baby and make it more vulnerable to HIV in breast milk. Therefore women are especially discourage from mixing the two kinds of feeds. Women need to make a choice either to exclusively bottle feed, or only breast feed, according to their circumstances.
You can read more about UK breastfeeding guidelines from the British HIV Association (BHIVA) here.
Breastfeeding is a sensitive issue as some women may really want to do it as they know that breast milk is good for babies and also may they enjoy the bonding and closeness to the baby that goes with it. Also if you are not breastfeeding it may be difficult to answer questions from family and friends without mentioning HIV, and you may be worried about people finding out about your HIV status.
If you are worried about breastfeeding and related issues, you may benefit to talk to one of our advisers. You could talk to a mentor mother, who is a woman with HIV who has had a baby and has been trained to give support an advice. Please call Helen on 020 7713 0444 or email email@example.com
This booklet from i-Base answers many of the frequently asked questions about HIV and pregnancy. It is also designed to help you have a healthy, happy journey through pregnancy to baby and beyond.