How Does HIV Infect an Unborn Baby?Transmission of HIV from mother to unborn child occurs in one of three ways.
- Sharing a Blood Supply - HIV can pass from mother to unborn baby while growing inside the womb. Mom's HIV-positive blood also circulates in the unborn child, exposing the fetus to HIV in the process.
- Infection During Delivery - During delivery, the newborn baby is exposed to large amounts of the mom's infected bodily fluids. Transmission can occur if the exposure is prolonged. For this reason, most HIV-positive mom's deliver their baby by C-section; minimizing exposure to HIV-infected bodily fluids. C-section also provides the physician with some control of any exposure that does occur.
- During Breastfeeding - HIV can pass from mother to baby by way of breastfeeding. Mother's milk has very high concentrations of HIV, and without precautions, the risk of HIV infection during breastfeeding is around one in four. For that reason, women are instructed not to breastfeed if there are other options available to them; for example commercial formula.
Preventing the Transmission of HIV from Mother to Baby?Without proper precautions and care during pregnancy, during delivery, and after delivery, the risk of passing HIV to your baby is about 25 percent. But the good news is that the risk is dramatically less, about 2 or 3 percent, if these guidelines are followed.
- Using HIV Medications - We all know the benefits of taking our HIV medicines. Having a pregnant woman take a regimen containing Retrovir (AZT) during her pregnancy, during the delivery of her baby, and giving AZT to to the baby after delivery significantly decreases the risk of transmitting HIV to the baby.
- Delivering by Cesarean Section (C-section) - To decrease the risk of HIV transmission, exposure to HIV infected fluids must be kept to a minimum. A C-section is a quicker type of delivery with less exposure to infected fluids when compared to a vaginal delivery. Also, there is better control of the fluids and the baby's exposure to those fluids than there is with a vaginal delivery. While at one time it was recommended that women always deliver by C-Section, experts now suggest that in some cases, vaginal delivery may be a safe option.
- Avoid Breast Milk - Because HIV can be transmitted through breast milk, women who have HIV should not breast feed their babies if there are other suitable options available; specifically commercial baby formula. However, in many parts of the world, commercial formulas or clean water to reconstitute formula is not available, meaning breastfeeding is the only option.
Is Pregnancy Dangerous for the Mom to Be?There is no evidence that being pregnant makes a woman's HIV disease worse. Keep in mind that the HIV drug Sustiva (efavirenz) can't be taken during pregnancy due to the harmful effects it may have on the unborn child. Like all pregnant women, HIV-positive pregnant women must make healthy choices that include
- avoiding alcohol
- avoiding recreational drugs
- no smoking
- eating a well-balanced diet
- regular HIV care
Sustiva can cause birth defects if taken during pregnancy. Therefore, Sustiva should never be taken while you are pregnant. If you are pregnant or thinking about becoming pregnant and you're taking Sustiva, notify your HIV doctor and Obstetrician (doctor caring for your pregnancy) immediately.
Moms Must Take Care of Herself as well as Her Baby.Women, typically will do whatever it takes to assure the health of their unborn child, including taking HIV regimens without missing a dose. But some women will stop their meds after the baby is born. Like anyone living with HIV, adhering to HIV medications is an extremely important part of staying healthy. After delivery, moms who need HIV medicines should continue to take them. If a mother is not taking care of herself and is not staying healthy, she will be unable to care for her new baby.
It All Comes Down to This.The risk of passing HIV to your baby can be decreased to as little as two percent if a woman takes HIV meds at appropriate times in her pregnancy, delivers her baby by C-section, and does not breastfeed. HIV no longer prevents a couple from starting a family. HIV no longer means a woman can't become a mother. Again, with the proper medical care and by taking care of yourself, you can take control of your life and your future.
If you are thinking of becoming pregnant, talk to your HIV specialist and your Gynecologist in order to develop a plan for your pregnancy and for your healthy baby.