Preventing mother-to-baby transmission of HIV - delivery

There are two recommended methods of delivery to reduce the risk of HIV transmission to your baby. You will need to discuss with your doctor the best option for you. This discussion is likely to include a consideration of your use of HIV treatment during pregnancy, your viral load, and your future plans to have children. The risk of you passing on HIV to your baby is reduced if it is delivered using a planned surgical delivery. This is called an ‘elective caesarean’ and is scheduled to take place in the 38th week of pregnancy, but will be performed sooner if labour begins early. Taking anti-HIV drugs during a caesarean delivery reduces the risk of you passing on HIV to your baby to very low levels. However, as with all surgery, a caesarean delivery carries some risk, and these should be fully discussed with you before you give your consent to the procedure.

You are strongly recommended to have a caesarean if you have a detectable viral load, or if the only anti-HIV drug you took during pregnancy was AZT (zidovudine, Retrovir).

If your viral load has been consistently undetectable (or very low) during pregnancy then you should be able to have a 'managed' vaginal birth. This means that your doctors and midwife will make sure that your labour doesn’t last too long and will take action to reduce the risk of you passing on HIV to your baby.

Should you have a child delivered by caesarean section, then this might have implications for future deliveries and you might want to discuss this with the team that looks after you during your pregnancy.