HIV and pregnancy – everything you need to know to keep baby safe

Being HIV positive and pregnant doesn’t necessarily mean your baby will get infected too. Here’s what you need to know.

Mother-to-child transmission is the greatest source of HIV infection in young children. 1 in 3 pregnant women are HIV positive and it has been estimated that 50 000 HIV positive babies are born in South Africa each year.

Can my unborn baby get infected with HIV if I have been diagnosed?

An HIV positive woman can transmit the HIV virus to her baby during pregnancy, labour, delivery and through breastfeeding. Maternal HIV expert, Dr Vivian Black says if the right procedures are followed, the chances of a baby becoming infected with HIV are actually very low. “Many people have the perception that an HIV positive mother will always give birth to an HIV positive child, but this is not the case, as the sperm and egg are not infected with HIV.”
Modern drugs have proven very effective in preventing HIV transmission during pregnancy, labour and delivery. Dr Black says thousands of women have taken ARVs during pregnancy without causing harm to their babies. The treatment has resulted in many babies, who might otherwise have been born infected, being born HIV negative.

Reduce your baby’s chances of contracting HIV:

  • Get adequate antenatal care, and start a course of ARVs.
  • Follow a healthy eating plan, treat any infections you may have and follow a gentle exercise routine.
  • Always opt for an elective C-section if possible.
  • Formula-feed your baby exclusively if you can afford it, sustain it and do it safely. If you can’t do this, it is best to exclusively breastfeed your baby.
  • Abstain from alcohol and cigarettes.

C-Section or natural birth?

There is a relatively high risk of HIV transmission during vaginal delivery due to the presence of the virus in the blood and mucus in the birth canal. However, recent research suggests that taking triple ARV therapy during pregnancy is as effective as having an elective C-section in preventing the transmission of HIV from mother to baby.
However, Dr Black says an elective C-section is best, but you can have a natural birth if your viral load is low. Elective Caesareans are not available in government hospitals unless you have an obstetric indication for one. Obstetric indications include several reasons like a previous C-section or the baby being too big to deliver vaginally, or if you are too small for a vaginal delivery.

ALSO SEE: 6 must-know C-section facts

Can I breastfeed if I’m HIV positive?

According to a recent study published in the online edition of American Journal of Clinical Nutrition, certain bioactive components found in mother’s milk are associated with a reduced risk of HIV transmission from an HIV-infected mother to her breast-fed baby.

Click here for tips on how to breastfeed your baby safely when you are HIV positive.

More about the expert:

Dr Vivian Black is  the Director of the Clinical Health Programme at the Wits Reproductive Health and HIV Institute. She has her master’s in Infectious Diseases and a background in Medical Microbiology. She has assisted the South African Department of Health with guideline development and over the past seven years she has contributed to developing PMTCT, Adult Treatment Care and Support and Sexually Transmitted Infection Management policies. Dr Black has over 40 publications in the field of maternal health and infectious diseases, is and active researcher and provides ongoing Health System Strengthening assistance.

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