Tag: pregnancy

FAQs About HIV and Pregnancy



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Medically reviewed by Emily Barr, PhD, RN, CPNP-PC, CNM, ACRN, FACNM, FAAN

It might feel overwhelming if you’re living with
human immunodeficiency virus (HIV) and want to get pregnant. You might wonder if you could pass on the virus to your baby, or if you can keep taking your HIV medications while pregnant. These concerns are valid.

But many women
living with HIV can and do go on to deliver a healthy baby. Every year, 3,500 people living with HIV in the United States give birth.

We’re here to provide some answers that may ease your mind and help you have a conversation with your healthcare provider.

Can I get pregnant if I have HIV?

Yes, you can. But it’s ideal to talk with your HIV specialist before you get pregnant. This can help make sure you’re at your healthiest before getting pregnant, allow for any medication adjustments, and help keep you from transmitting HIV to your baby.

Of course, surprise pregnancies can happen, so if you find out you’re pregnant, let your healthcare provider know as soon as possible.

As long as you are on medications for HIV and your viral load remains undetectable, your chances of transmitting HIV to your baby can be less than 1%. An undetectable viral load means the amount of HIV virus in your blood is so low that a lab test can’t pick up the virus.

Being pregnant at age 35 or older (called advanced maternal age or geriatric pregnancy) comes with certain health risks compared to people under age 35 regardless of your HIV status, including:

The research is limited on those who are living with HIV and are pregnant over age 35, but it is possible that there may be higher risks.

Can I continue HIV medications while pregnant?

Yes, you can and, in fact, you should. It’s important to take HIV medications while pregnant to help protect both your health and the health of your baby. This can greatly reduce the chances of transmitting HIV to your baby.

Don’t skip doses and take your medications at the same time every day to keep your viral load as low as possible.

Many of the medications for HIV are thought to be safe to take when you’re pregnant. But, depending on what you take and how far along you are in your pregnancy, your healthcare provider might suggest you change up some of the HIV medications you’re currently taking if you do become pregnant. It’s important to talk to your healthcare provider to find out what the pros and cons of the possible medications are.

What are the risks to the baby if I’m living with HIV?

Most babies who get HIV, get the virus during delivery. If you’re having a vaginal birth, your healthcare provider may give you medications through an IV (intravenous) line that can lower the chances of transmitting the virus to your baby. If your viral load is high, you might have a cesarean section and get IV medication. This can help decrease the risk of transmission.

HIV can also pass through the placenta and infect the baby in utero. But, if you continue to take your HIV medications as directed throughout your pregnancy, labor and delivery, and give your baby HIV medications for two to six weeks after they’re born, your baby has less than a 1% chance of getting HIV.

Studies have shown that women who are living with HIV are up to two to three times more likely to have pregnancy complications than HIV-negative women. These complications can happen even if the HIV-positive women are taking antiretroviral therapy (ART). Possible complications include:

  • Miscarriage or stillbirth
  • Having a baby who is born with a low birth weight
  • Preterm, or very early, delivery

Can I breastfeed if I have HIV?

You can choose to feed your baby your milk through breastfeeding, chestfeeding or pumping with a greater than 99% chance of not transmitting HIV if you are on HIV medications and your viral load is undetectable. The pros and cons should be discussed with your key family members and your HIV specialist to make the best decision for you and your baby.

If you are on ART, the World Health Organization guidance for breastfeeding is the same as for people who are not living with HIV.

Can I take PrEP while pregnant or breastfeeding?

It is safe to take PrEP (pre-exposure prophylaxis) while you’re pregnant or breastfeeding to prevent HIV transmission. PrEP is safest when taken as a daily pill because PrEP injections aren’t approved in pregnancy.

PrEP is taken by people who don’t have HIV but are at high risk. You might want to take PrEP if you have a partner who is living with HIV, have or have had unprotected sex, or share or have shared needles during injected drug use.

If your partner has HIV, it’s also a good idea to test often because the risk of transmitting the virus to your baby is highest if you get the virus during pregnancy or while breastfeeding.

Will I be considered a high-risk pregnancy and need more doctor appointments?

Yes, your pregnancy will be considered high risk because living with HIV can put you at an increased chance of pregnancy complications, such as miscarriage, stillbirth and low birth weight. And you will have more appointments because you will need to see your HIV team as well as your OB team. Your healthcare team, including your HIV specialists and your OB or midwife, will want to monitor you more closely in order to plan for a healthy birth and avoid complications. They will check routine prenatal labs like your kidney and liver health, iron levels, blood sugar and also how well the HIV medications are working.

You also might be offered certain vaccinations such as influenza, Tdap, RSV, Covid-19, pneumococcal and hepatitis A and B if needed.

We’ve come a long way, and it’s not only possible but likely that your baby will be born without HIV. Talk with your healthcare team about how you can have the healthiest pregnancy possible while living with HIV.

This educational resource was created with support from Merck.

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Preguntas frecuentes sobre el VIH y el embarazo



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Emily Barr, PhD, RN, CPNP-PC, CNM, ACRN, FACNM, FAAN, hizo la revisión médica de este documento

Podría ser abrumador vivir con el
virus de inmunodeficiencia humana (VIH) y desear embarazarse. Podrías preguntarte si transmitirás el virus a tu bebé o si puedes seguir tomando tus medicamentos contra el VIH mientras estás embarazada. Estas preocupaciones son válidas.

Pero muchas mujeres que
viven con el VIH pueden hacerlo y tienen bebés saludables. Cada año, 3,500 personas que viven con el VIH en Estados Unidos tienen partos.

Aquí encontrarás algunas respuestas que pueden tranquilizarte y que serán útiles para que mantengas conversaciones con tu proveedor de atención médica.

¿Puedo embarazarme si tengo el VIH?

Sí, puedes hacerlo. Pero es ideal hablar con tu especialista del VIH antes de que te embaraces. Esto puede ser útil para que estés lo más saludable posible antes de que te embaraces, para permitir ajustes de los medicamentos y para evitar que transmitas el VIH a tu bebé.

Desde luego, pueden ocurrir embarazos sorpresa, así que si descubres que estás embarazada, avisa a tu proveedor de atención médica lo antes posible.

Mientras estés tomando medicamentos contra el VIH y tu carga viral esté a niveles indetectables, las probabilidades de que transmitas el VIH a tu bebé pueden ser menos que el 1%. Una carga viral indetectable indica que el nivel del virus del VIH en tu sangre es tan bajo que no se puede detectar.

Estar embarazada a los 35 años o más (también conocida como edad materna avanzada o embarazo geriátrico) viene con algunos riesgos médicos en comparación con personas que todavía no tienen 35 años, independientemente de tu condición de VIH, incluyendo:

  • Mayores tasas de abortos espontáneos
  • Mayor riesgo de trastornos genéticos
  • Complicaciones durante el embarazo, tales como presión arterial alta o diabetes

Las investigaciones son limitadas para personas que viven con el VIH y tienen embarazos después de los 35 años, pero es posible que hayan más riesgos.

¿Puedo seguir tomando medicamentos contra el VIH durante el embarazo?

Sí, puedes y, de hecho, deberías hacerlo. Es importante que tomes los medicamentos contra el VIH durante el embarazo porque eso será útil para proteger tu salud y la de tu bebé. Eso puede reducir de manera importante las probabilidades de transmitir el VIH a tu bebé.

No omitas dosis y toma tus medicamentos todos los días a la misma hora para que tu carga viral sea lo más baja posible.

Se considera que muchos medicamentos contra el VIH pueden tomarse en forma segura durante el embarazo. Pero, dependiendo de lo que tomes y en qué etapa estés de tu embarazo, tu proveedor de atención médica podría sugerir que cambies algunos de los medicamentos contra el VIH. Es importante que hables con tu proveedor de atención médica para identificar cuáles son las ventajas y desventajas de los posibles medicamentos.

¿Cuáles son los riesgos para el bebé si vivo con VIH?

La mayoría de bebés que se contagian de VIH, contraen el virus durante el parto. Si tienes un parto vaginal, tu proveedor de atención médica podría proporcionarte medicamentos mediante una línea IV (intravenosa) que puede reducir las probabilidades de que transmitas el virus a tu bebé. Si tu carga viral es alta, podrías verte obligada a tener una cesárea y a recibir medicamentos IV. Esto puede ser útil para reducir el riesgo de una transmisión.

El VIH puede pasar a través de la placenta e infectar al bebé en el útero. Pero, si sigues tomando tus medicamentos contra el VIH tal como se indicó durante tu embarazo, alumbramiento y parto, y proporcionas a tu bebé medicamentos contra el VIH durante dos a seis semanas después del nacimiento, tu bebé tendrá menos de 1% de probabilidades de contraer el VIH.

Estudios han demostrado que mujeres que viven con el VIH tienen dos a tres veces más probabilidades de tener complicaciones durante el embarazo que mujeres que no tienen el VIH. Estas complicaciones pueden ocurrir incluso si mujeres que tienen el VIH están sometiéndose a terapias antirretrovirales (TAR). Las posibles complicaciones incluyen:

  • Aborto espontáneo o parto de un feto muerto
  • Tener un bebé que nace con peso bajo al nacimiento
  • Parto pretérmino o prematuro

¿Puedo amamantar si tengo el VIH?

Puedes optar por alimentar a tu bebé con tu leche mediante lactancia materna o natural o extrayéndola con una bomba con una probabilidad de más del 99% de no transmitir el VIH a tu bebé si estás tomando medicamentos contra el VIH y tu carga viral no puede detectarse. Deberían discutirse las ventajas y desventajas con tus familiares importantes y tu especialista del VIH para que tomes la mejor decisión para ti y tu bebé.

Si te estás sometiendo a una TAR, la pauta de lactancia de la Organización mundial de la salud es la misma que para personas que no viven con el VIH.

¿Puedo tomar PPrE durante el embarazo o la lactancia?

Puedes tomar PPrE (profilaxis previa a la exposición) en forma segura durante el embarazo o la lactancia para prevenir la transmisión del VIH. Lo más seguro es tomar la PPrE como pastillas diarias porque las inyecciones PPrE no están aprobadas durante el embarazo.

La PPrE la toman personas que no tienen el VIH pero que tienen un alto riesgo. Podría ser conveniente que tomes la PPrE si tienes una pareja que vive con el VIH, si tiene o ha tenido sexo sin protección o si comparte o ha compartido jeringas para consumir drogas mediante inyecciones.

Si tu pareja tiene el VIH, también es conveniente que te sometas a pruebas frecuentemente porque el riesgo de transmitir el virus a tu bebé es mayor si contraes el virus durante el embarazo o la lactancia.

¿Se considerará que mi embarazo es de alto riesgo y deberé tener más consultas médicas?

Sí, se considerará que tu embarazo es de alto riesgo porque vivir con el VIH puede incrementar las posibilidades de complicaciones durante el embarazo, tales como abortos espontáneos, partos de fetos muertos y bebés de bajo peso. Y tendrás más consultas porque deberás visitar a tu equipo del VIH y a tu equipo obstétrico. Tu equipo de atención médica, incluyendo tus especialistas del VIH y tu ginecólogo o partera, desearán monitorearte más cuidadosamente para planificar un nacimiento saludable y para evitar complicaciones. Realizarán pruebas prenatales rutinarias de laboratorio de tus riñones, salud hepática, niveles de hierro, niveles de azúcar en la sangre y también de la efectividad de los medicamentos contra el VIH.

Es posible que también te ofrezcan algunas vacunas tales como la de la influenza, del Tdap, del VRS, del Covid-19, neumocócicas y de la hepatitis A y B, si fuese necesario.

Hemos progresado mucho y es probable y muy posible que tu bebé nazca sin el VIH. Habla con tu equipo de atención médica para ver cómo puedes procurar al máximo la salud de tu embarazo si vives con el VIH.

Este recurso educativo se preparó con el apoyo de Merck.

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FAQs on Gestational Diabetes – HealthyWomen



As many as 1 in 10 pregnancies will be affected by gestational diabetes. Factors like the age of the mother and rising obesity rates play a role in this increasingly common pregnancy complication.

HealthyWomen spoke to Maureen E. Farrell, M.D., FACOG, an OB-GYN and Navy veteran, about what a gestational diabetes diagnosis means for you and your pregnancy.

What is gestational diabetes?

Gestational diabetes is glucose intolerance that is diagnosed for the first time during pregnancy. It often resolves shortly after delivery.

What causes gestational diabetes?

Diabetes is caused when a person’s body can’t produce enough of the hormone insulin to manage blood sugar levels, and they get too high. Some women and people assigned female at birth (AFAB) develop diabetes during pregnancy because of hormonal changes. The placenta — the organ in the uterus that nourishes the growing fetus — creates hormones that are needed for a healthy pregnancy. Those same hormones can make it harder to produce enough insulin.

Usually, the body will still manage to control glucose and keep blood sugar at healthy levels throughout pregnancy. But for some people, insulin production can’t keep up.

That’s when gestational diabetes mellitus (GDM) develops.

What are the risk factors for developing gestational diabetes?

Many factors contribute to the development of gestational diabetes, including:

  • Having pre-diabetes prior to your pregnancy — pre-diabetes is when your blood sugar levels are higher than normal but not high enough to be considered diabetes
  • Previous pregnancies with gestational diabetes
  • Having close relatives who have any form of diabetes
  • Pregnancies of multiples
  • Age — people above the age of 25 are at greater risk
  • Previous delivery of a baby weighing more than 9 pounds
  • Race — Hispanic, Black, Native American and Asian-American/Pacific Islanders are diagnosed at higher rates than non-Hispanic white people
  • Pre-pregnancy weight — those living with overweight and obesity are more likely to develop GDM
  • Trauma and PTSD

Can people who have normal blood sugar levels before pregnancy develop gestational diabetes?

Yes. Women who have normal blood sugar levels before pregnancy can develop gestational diabetes.

How is gestational diabetes diagnosed?

Gestational diabetes is diagnosed using a fasting glucose tolerance test. This is most commonly given during the second trimester, between 25 and 28 weeks gestation. People with a previous history of GDM or other risk factors may be screened earlier.

What are the risks of gestational diabetes to the mother?

Babies born to mothers with gestational diabetes tend to be larger than average, which increases the likelihood of delivery complications, including the need for a C-section, excessive bleeding after delivery and damage to the birth canal.

Gestational diabetes also increases the risk of pre-eclampsia. Mild forms of pre-eclampsia can be managed with careful blood pressure monitoring and regular checks on the baby. Serious cases can cause liver and kidney damage to the mother.

What are the risks of gestational diabetes to the baby?

Babies born to mothers with poorly controlled gestational diabetes are often large, which is called macrosomia. This can make delivery dangerous for the baby because they can get stuck in the birth canal. The extra sugar they receive also causes the baby to produce too much insulin in the womb. This can lead to dangerously low blood sugar after delivery. And it increases the child’s risk for developing Type 2 diabetes later in life, as well as obesity and metabolic disorder in childhood.

Pre-eclampsia in the mother, which often goes along with gestational diabetes, can only be treated by delivering the baby, so the risk of preterm birth increases with gestational diabetes, as well.

Severe untreated gestational diabetes can lead to miscarriage or stillbirth.

How do you manage gestational diabetes?

Many pregnant people can keep their blood sugar in check with healthy eating habits and regular exercise. If those methods don’t work, you may need to take insulin. Checking your blood sugar throughout the day, including before and after eating, will let you know if your lifestyle and diet changes are working. Your OB-GYN and possibly a nutritionist will work with you to keep your blood sugar at levels that are safe for you and your baby.

How does gestational diabetes affect long-term health outcomes?

For most women, once the pregnancy hormones are out of the picture, your body will go back to regulating its own blood sugar normally — but not always. Anyone who has had gestational diabetes should be screened six weeks after delivering the baby to ensure their blood sugar levels have returned to normal. Mothers who are diagnosed with gestational diabetes are also at increased risk for other cardiovascular complications after pregnancy, including high blood pressure and heart disease.

One out of every 2 women who develop gestational diabetes will go on to develop Type 2 diabetes. But healthy eating and regular exercise can help lower your chances.

This educational resource was created with support from AstraZeneca.

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Family Planning with a Chronic Illness



Erica Lemons knew her path to motherhood wasn’t going to be easy. But she wasn’t going to let her chronic health condition stop her from getting pregnant.

“My doctor told me to talk to him before I got pregnant because of possible complications, so that’s the first thing I did,” she said.

Lemons quickly learned that trying to get pregnant with a chronic disease was going to be even more complicated than she thought. For starters, she had to stop taking the medicines she was on for her chronic illness and had to wait months before she could get pregnant.

“I was shocked — I didn’t realize how long I had to be off the medicines before I could even try,” she said. “My advice for anyone thinking about getting pregnant is to talk to your doctor sooner than later. You may have to wait longer than you think.”

Nearly 3 out of 10 women and people assigned female at birth in the U.S. are living with multiple chronic conditions. These conditions usually require medicine, which is why it’s important to talk about family planning with your healthcare provider (HCP), even if it’s just a possibility for the future. Your HCP may be prescribing more aggressive treatments that may not be the best option if you’re considering pregnancy in the future.

Unfortunately, not all HCPs are asking about pregnancy planning. This may be because of many factors, including a lack of time, knowledge and skills to start the conversation. In one review of pregnancy planning and women living with chronic conditions, the women said their health information needs were not being met. And they wanted to have better discussions with their HCPs.

What is shared decision-making?

Shared decision-making is when you decide on your treatment path after a thorough conversation with your HCP. This is especially important for people with chronic health conditions who are planning a family.

HCPs manage your health before, during and after pregnancy and provide guidance that may influence family planning. “Some diseases worsen during pregnancy and some improve, and knowing this would help you determine a good time to start trying to become pregnant,” said Connie Newman, M.D., adjunct professor of medicine at NYU Grossman School of Medicine and a member of HealthyWomen’s Women’s Health Advisory Council.

Chronic health conditions last more than a year and can include a wide range of diseases from multiple sclerosis (MS) to diabetes to high blood pressure. Both the condition and the medicine can affect pregnancy and your ability to get pregnant in the first place. Some medicines can cause serious problems during pregnancy, such as preterm birth and birth defects.

Read: Can Living in the U.S. Increase Your Risk of Preterm Birth? >>

“Patients should tell their HCP about their plans for pregnancy and ask the HCP whether the prescribed treatment is safe during pregnancy. If the answer is no, then the patient can ask about taking a different medication that is safe to use,” Newman said. “Patients should also ask whether the disease will worsen during pregnancy, and how their medications should be adjusted.” Changes may include the dose, how many times you take it and/or a different medicine altogether.

Questions to ask your healthcare provider about chronic disease and pregnancy

If you haven’t talked to your HCP about your plans, you may want to schedule a preconception counseling visit. During the appointment, your HCP will review your treatment plan and how pregnancy may affect your health overall.

Newman said it’s a good idea to write down questions you have about pregnancy and bring them with you to your appointment. These can include:

  • Will my disease get worse during pregnancy or improve? And when will this happen (first, second or third trimester)?
  • Will the medicine I’m taking be harmful during pregnancy, including very early pregnancy before I may even know I’m pregnant?
  • Can you describe the risks of the medicine?
  • Will I have to stop the medicine or switch to a different medicine when I’m pregnant? Should I do this when trying to get pregnant or after the pregnancy test is positive and I know for sure I’m pregnant?
  • Can I breastfeed while taking this medicine?

You can also talk with your HCP during your well visit if you haven’t already done so.

Weighing risks and benefits of treatment options

Weighing the risks and benefits of treatment are a crucial part of the shared decision-making process. “The HCP and the patient should discuss the risks and benefits to determine a plan for medication use during pregnancy,” Newman said.

Outside of talking with your HCP, Newman said women can read about potential effects of treatment options using reputable online sources, including the patient information part of the drug label or the drug labels written for prescribers.

Managing chronic conditions can also mean involving specialists and other HCPs in your family planning process. Lemons said her HCP connected her with a fertility specialist, for example, and other HCPs along the way. She said she appreciated all the frank conversations they had and that his support meant so much during a time when she felt so overwhelmed.

Lemons gave birth to a healthy baby boy in 2012. She said all the planning and waiting and anxiety wasn’t easy. But nothing is exactly easy when you’re pregnant and managing a chronic condition. “Just remember to be kind to yourself and your mental health,” she said. “Put yourself first.”

This educational resource was created with support from Viatris, a HealthyWomen Corporate Advisory Council member.

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