6 HIV and pregnancy

6.4 Mother's health and pregnancy

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A mother's own health (and her own treatment) is the most important consideration to ensure a healthy baby.

Overall, treatment for an HIV positive pregnant woman will be the same as for any HIV positive adult. Differences in treatment strategies are discussed later in this section.

It is important that the mother receives support from an experienced healthcare team during her pregnancy.

A mother's adherence to her own ARV treatment is critical. Many women have excellent adherence during their pregnancy. But after the baby is born it is easy for them to forget their own health.

Having a new baby can be stressful. In serious cases, women can have postnatal depression. So they will need lots of extra help from their family, friends and healthcare team. Support from a community group may be helpful.

Some discrimination still exists against HIV-positive people deciding to have children but although situations vary throughout the world things are generally better than they used to be.

HIV

Pregnancy does not make a woman’s own health related to HIV get any worse. It will not make HIV progress any faster.

CD4 count

Pregnancy may cause a drop in a woman’s CD4 count. This is usually about 50 cells/mm³ but it can vary a lot. This drop is only temporary. Her CD4 count will normally return to her pre-pregnancy level soon after the baby is born.

This is not a concern unless her CD4 falls below 200 cells/mm³. Below this level, she is at a higher risk from opportunistic infections. These infections could affect both the mother and the baby.

Opportunistic infections

In general, pregnant women need the same treatment to prevent opportunistic infections as women who are not pregnant.