As we know, HIV can be passed on from an infected person to an uninfected person through body fluids such as semen, blood, and vaginal fluids. However, Mother-to-child transmission of HIV (perinatal or vertical transmission) is the transmission that occurs from an HIV-positive mother to her child-which can occur during pregnancy, labor (delivery), and breastfeeding. Perinatal transmission is the most common way children become infected with the virus.
Without the help of any form of treatment for either the expectant mother or the child, an ， HIV-positive woman has a 15% to 45% chance of transmitting the virus to her baby. That’s between a third and a half, which is fairly high. But with treatment, the chance can be as low as 2%!
How is HIV transmitted to a baby?
Vertical transmission occurs due to many factors. The most important of which is the amount of HIV in the blood – also known as viral load. Vertical transmission can occur if the baby comes in contact with mother’s blood or other body fluids.
During Pregnancy (in utero transmission): some newborn babies tested positive when they are only a few days old. The only explanation is that they became infected during pregnancy. This is most likely to occur if the placenta was damaged during pregnancy and the mother’s blood comes into the blood circulation of the foetus.
During childbirth: During vaginal births, babies have a high chance of coming in contact with the mothers' blood and other genital fluids. The virus is present in these body fluids and can be transmitted to the babies during childbirth. Especially for mothers with a high viral load.
Breastfeeding: HIV is present in breast milk and HIV can effectively be passed on from mother-to-child during breastfeeding. The virus in the milk most likely gets passed the infant’s stomach wall and into the bloodstream. It is always advisable for women with HIV NOT to breastfeed their babies. Instead, the use of baby formula is advisable to protect them from the virus.
How to Prevent Passing HIV to the Baby
With the right care and treatment, the chances of an HIV-positive mother delivering a healthy child free from the virus is about 98 percent-which is very high! But as it is the case with most STDs, early treatment is key. Hence, it is strongly recommended that women who are planning on becoming pregnant or who are already pregnant should be tested for HIV.
Protecting your baby during pregnancy
If you tested positive for HIV before you became pregnant, it is very likely you have a treatment regime in place already, provided your health care provider is aware, you should continue with your treatment. If not, you should talk to your healthcare professional about starting treatment at once.
If you found out during your pregnancy that you’re HIV positive, after talking with your healthcare professional, it is expected that you begin treatment and continue with it for the rest of your life.
The drugs used for HIV treatment are called antiretroviral drugs (ART). The treatment is usually made up of three or more ARTs taken together. Sometimes, they are combined into a single pill. Your doctor will be able to recommend which is best for you.
Protecting your baby during delivery
If you discover your HIV status and if positive, begin treatment early enough, the chances of transmitting the virus to your baby are extremely small at only 2%. For women living with the virus who are receiving HIV treatment, a vaginal birth remains an option if the viral load is undetectable.
However, in the case of a high viral load, your healthcare professional is likely to recommend a caesarean delivery. This is because vaginal birth is likely to bring the baby in contact with the mother’s blood and vaginal fluids.
Protecting your baby after pregnancy (breastfeeding)
HIV is present in breastmilk and can be passed on from an HIV-positive mother to her child during breastfeeding. According to a study, about 15% of babies born to HIV-positive mothers will be infected if fed breastmilk for 24 months or longer.
Health care providers strongly recommend HIV-positive women to use baby formula and not to breastfeed, especially if the cost of sterilizing equipment and infant formula is not a problem for you.
It is also advisable to give your baby a special type of HIV treatment for up to 6 weeks after delivery, usually in syrup form. Your healthcare professional is in a better place to recommend the appropriate type and dosage for your baby.
Where To Get Help
If you are pregnant, it is advised you attend your antenatal appointments regularly. You will be offered the traditional model for HIV testing known as the ‘opt-in’ method after voluntary counselling. It is becoming increasingly common for Prevent the Mother-to-child Transmission of HIV (PMTCT) services to offer Provider Initiated Testing and Counselling (PITC), where women have to decline to take the test after been given counselling about it.
An HIV-positive mother can pass the virus to her baby during pregnancy, at childbirth, and by breastfeeding. So, the Prevent the mother-to-child transmission of HIV approach requires the transmission of the virus to be blocked at each of these stages.
Pregnant women who are positive receive treatment for HIV to reduce the risk of transmission of the virus to their babies and to protect their own health. With the right care and treatment, HIV-positive women can become pregnant and deliver healthy babies completely free of the virus.