This is when a pregnant woman with HIV can pass HIV to her baby if she doesn’t take treatment. It is also called vertical transmission. Steps to stop this happening are called ‘prevention of mother-to-child transmission of HIV’.
Prevention of mother-to-child transmission of HIV (PMTCT)
HIV can be passed on from an HIV-positive pregnant woman to her baby during pregnancy, childbirth or breastfeeding.
If you are pregnant and have HIV, taking antiretroviral treatment will stop HIV passing onto your baby.
Your baby will need at least three HIV tests in the first two years of their life to check that they are HIV-negative.
- The basics
- In detail
What is mother-to-child transmission of HIV?
How is HIV passed from mother to child during pregnancy?
HIV in the mother’s blood can pass into her baby’s body while she is pregnant. This is most likely to happen in the last few weeks of pregnancy, during labour, or delivery.
Is it possible not to pass HIV to my baby during my pregnancy?
Yes. It is important that you test for HIV when you are pregnant, to find out if you have HIV.
If the test result is positive, you should start treatment as soon as possible. Taking treatment properly can reduce the risk of your baby being born with HIV to less than 1% (virtually no risk).
Your baby will also be given treatment for four to six weeks after they are born to help prevent HIV.
How is HIV passed from mother to child during childbirth?
HIV from the mother’s blood and other fluids, such as the water in her amniotic sac, could pass into her baby.
Is it possible not to pass HIV to my baby during childbirth?
Yes. You can take HIV treatment which can lower the amount of HIV in your body to very low levels (undetectable).
This means that you can plan to have a vaginal delivery because the risk of passing on HIV to your baby during childbirth will be small.
If you are not undetectable, you may be offered a caesarean section, as this carries a smaller risk of passing HIV to your baby than a vaginal delivery.
How is HIV transmitted from mother to child during breastfeeding?
Breastmilk contains HIV so it can pass into a baby’s body if the mother breastfeeds.
Is it possible not to pass HIV to my baby during breastfeeding?
Yes. Guidelines vary depending on where you live and your circumstances.
If you always have access to formula and clean, boiled water it is advised that you do not breastfeed and give formula instead.
If you do not have access to formula and clean, boiled water all of the time you should breastfeed while both you and your baby are taking antiretroviral treatment.
If you do breastfeed, it is advised that you exclusively breastfeed (meaning the baby only has breastmilk) for at least six months. Mixing breastmilk and other foods before this time increases your baby’s risk of HIV. Your baby can be mix-fed after six months.
In many cultures breastfeeding is the norm or a woman’s preferred choice. If you want to breastfeed, talk to your healthcare provider about how you can do this safely.
How do you know if PMTCT worked?
Your baby should be tested for HIV at birth, and again 4–6 weeks later.
If the result comes back negative, your baby should be tested again at 18 months and/or when they have finished breastfeeding. This will determine your baby’s final HIV status.
If any of these tests come back positive, your baby will need to start treatment straight away.
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HIV prevention quiz
Why are some women with HIV told to breastfeed and others aren’t?
It can be hard to understand this. It depends on where a woman lives and if she can get clean water.
If she has access to clean water and formula feed, it is recommended that she formula feeds because then there is zero risk of passing on HIV to the baby.
If she doesn’t have access to clean water or formula feed, breastfeeding is best. This is because formula feed made with dirty, unsterilised water puts the baby at risk of other illnesses such as diarrhoea, which can be more dangerous for their health. Breastmilk is very nutritious and can offer the baby immune support in the first few months. And if the mother takes treatment, it will reduce the amount of HIV in her breastmilk.
What if a mother doesn’t have access to HIV treatment or safe formula feed?
Then it is advised that a mother breastfeeds for at least the first six months and only introduces other foods when she has reliable access to a safe alternative.
Supporting women who are pregnant and have HIV
Many women who are pregnant and have HIV may worry about their own health and the health of their baby. They might not know that HIV can be passed to their baby, or they might not know how to prevent it. Here are some things you can talk through with a woman who is pregnant and has HIV.
Try to learn the answers to the questions in the ‘Basics’ tab on this page to support her. Whether she has found out her HIV status during pregnancy or before pregnancy, a pregnant woman with HIV may have lots of questions and emotions.
Explain how HIV could be passed to her baby – discuss that it could happen during pregnancy, childbirth or breastfeeding.
Explain that she can take steps to prevent HIV passing to her baby. The risk of passing HIV to her baby is less than 1% (virtually no risk) if she follows the steps.
Talk through her feeding options to determine whether she should breastfeed or formula feed.
Encourage her to take her treatment well, which means taking it every day at the right time.
Explain that her baby will need to take HIV treatment for a few weeks when they are born. This doesn’t mean her baby has HIV – it is another step to prevent it.
Suggest that she could join a support group. It can help to speak with other women who are pregnant and have HIV, and women with HIV who have delivered healthy HIV-negative babies.