How to plan for Safe Pregnancy With HIV

HIV (human immunodeficiency virus) is a permanent, or chronic, viral infection. HIV kills white blood cells called CD4 cells. These cells help to control your body’s defense system (immune system) and fight off infection. If you do not have enough CD4 cells, you can develop infections, cancers, and other health problems.

With treatment, HIV may not progress quickly. It is possible for people with HIV to live for many years in good health and to have families. Now it is safer than ever for people with HIV to have children.

What actions can I take to have a safe pregnancy with HIV?

Before pregnancy

Talk with your health care provider, case managers, social workers, and other support systems about your plans to get pregnant. Your health care provider may recommend that you and your partner:

• Have a complete review of physical health and medical history, including labs, antiretroviral therapy (ART), and other medicines.
• Get tested and treated for other sexually transmitted infections (STIs).
• Take steps to decrease the amount of HIV (viral load) in your body to make it as low as possible (undetectable). To do this:
  • Take your ART medicines regularly.
  • Visit your health care provider for regular care and checkups.
• Use birth control (contraception) until you are ready to get pregnant.
• Only have unprotected sex when you know that you can get pregnant (fertile). Otherwise, use condoms. Ask your health care providers how to know when you are most fertile during the month.

If your partner does not have HIV, take steps to prevent the spread of the virus. This may include:

• Using artificial insemination to get pregnant. You may use your partner’s semen or a donor’s semen. This is the safest way to get pregnant as it protects your partner.
• Taking pre-exposure prophylaxis (PrEP) medicines. These help decrease your partner’s chances of getting HIV. Your partner should begin PrEP a month before you start trying to get pregnant and continue using it for a month after you become pregnant.
• Having regular testing for HIV. This helps you to know your viral load. It can also detect HIV early if it gets passed on to your partner.

Additionally, you should:

• Stop using alcohol, tobacco, and drugs.
• Take a multivitamin that contains at least 400 mcg of folic acid.
• Manage any ART side effects, such as anemia or high blood sugar.

During pregnancy

If you are already pregnant, talk with your health care provider as soon as possible. Discuss ways to make pregnancy safe for you and your baby. You will also need to:

• Find a health care provider who specializes in pregnancy (obstetrician) or a nurse-midwife.
• Tell your pregnancy provider that you have HIV.
• Take prenatal vitamins.
• Eat a balanced diet that includes plenty of fruits and vegetables, lean proteins, whole grains, and dairy.
• Go to regularly scheduled prenatal visits.
• Be sure that your HIV health care team and your pregnancy health care team work together to manage your care.

Where to find more information

If you or your partner has HIV, learn more about how to plan for pregnancy. Visit:

• The American College of Obstetricians and Gynecologists: www.acog.org  
• The Centers for Disease Control and Prevention: www.cdc.gov  

Summary

• It is possible for people with HIV to live for many years in good health and to have families.
• Make sure you involve your HIV providers, case managers, social workers, and other HIV support systems when planning to get pregnant.
• Visit your health care provider and take ART medicines regularly to decrease the amount of HIV (viral load) in your body before you get pregnant.
• Use birth control (contraception) until you are ready to get pregnant. Only have unprotected sex when you know that you can get pregnant (fertile). Use condoms at all other times.