A planned pregnancy can minimise stress, leaving you time to discuss issues with your partner and your doctor to optimise your health and to switch HIV drugs if necessary. It gives you the opportunity to commence health strategies before pregnancy e.g. taking folic acid. It also gives you a chance to sort out any maternity leave entitlements and to make financial arrangements.
Planning to get pregnant
Many women with HIV are choosing to have children. Although you have HIV, it’s possible for you to have a healthy pregnancy and it is likely your baby will be born healthy and HIV negative.
Without antiretroviral treatment or other interventions, about one in four women with HIV transmit HIV to their infants. With effective interventions, the risk of transmission is very low.
There are four recommended steps to reduce the risk of passing on HIV to your baby:
- Take HIV antiretroviral treatments during pregnancy
- Don’t breastfeed
- Consider a caesarean delivery
- Treat your baby with HIV medications (usually for 4 to 6 weeks)
Generally speaking, the lower your viral load the less likely you are to transmit HIV to your baby. The aim of HIV treatment in pregnancy is to achieve an undetectable viral load. If this is not achieved, a Caesarean delivery will be offered and will usually be performed before you go into labour
Notes on treatments:
- You must avoid becoming pregnant if you or your partner are taking the Hep C treatment Ribavirin or Rebetron, or if you have taken it during the previous six months.
- All women are advised to take folic acid when planning to conceive and early during pregnancy. If you are taking a drug called Cotrimoxazole (Septrin or Bactrim) because of an opportunistic infection or as prophylaxis, you may need to take an increased dose of folic acid.
Pregnancy check list
- Get screened for any genital infections and, if necessary, get treated. If you are sexually active, repeat the STI screening at 28 weeks.
- Learn about your treatment options and make a plan, including different options related to how well your viral load is controlled during your pregnancy.
- Learn about your delivery options and get a referral to a doctor with experience in HIV and pregnancy.
- Make a delivery plan with options related to how well your viral load is controlled during pregnancy.