Hesperian Health Guides

Pregnancy, Childbirth, and Breast-feeding


Pregnancy itself does not make HIV worse for a mother. But her pregnancy can be more complicated if she has HIV or AIDS. She may:

a health worker showing family planning methods to a man and woman

When babies born to mothers with HIV are very sick from birth, they probably have HIV. They should be taken as soon as possible to a health center or hospital to begin treatment with ARVs.

  • lose the baby during pregnancy (miscarriage).
  • get infections after pregnancy that are harder to cure.
  • give birth too soon or have a baby infected with HIV.

Despite these problems, many women with HIV still want to get pregnant and have a child.

If you want to get pregnant and you are not sure whether you or your partner are infected with HIV, you should both get tested. If getting tested is not possible, you can try to reduce your risk of becoming infected with HIV while trying to get pregnant if you:

  • have sexual intercourse without a condom only during your fertile time. At all other times, use a condom or practice safer sex.
  • never have sexual intercourse when there are signs of an STI.

If possible, all pregnant women should have a CD4 blood test to see how strong their immune system is. A pregnant woman with HIV should start ART for her own health. If you are pregnant and have HIV, it is especially important to take care of yourself—to eat well, prevent and treat other illnesses (like malaria), and to get treatment for HIV.


Most mother-to-child transmission of HIV happens during childbirth. Using ARVs before and after birth can help protect the mother and the baby. The transmission risk is greatest when waters have been broken for more than 4 hours before birth, with tearing of the birth canal, and where the baby has more contact with blood and vaginal fluids than usual during birth.

Infections after birth can be more dangerous if you have HIV. Get treated immediately.

This page was updated:21 May 2021