Choices for delivery and use of Caesarean section

Overview

The way your baby is born—whether you choose to have a vaginal birth or Caesarean section (C-section)—is an important consideration for HIV-positive women.

If you do have a Caesarean section, the operation must be carried out before the onset of labour and ruptured membranes. This is called “pre-labour” “elective” or “scheduled” C-section.

Several early studies showed that pre-labour C-section significantly reduced mother-to-child  transmission compared to vaginal birth. But these studies were before combination therapy and viral load testing were routinely used.

Recent data from the UK and Ireland indicate that mothers on combination therapy with an undetectable viral load can deliver vaginally and that pre-labour Caesarean delivery does not offer any additional benefit to the babies.

Caesarean section or C-section

Caesarean or C-section is a procedure to deliver a baby that involves making a cut through the abdominal wall to surgically remove the infant from the uterus.

It is important to understand that if your HIV is well managed and your viral load is below detection on combination therapy, then the risk of transmission with either mode of delivery is practically zero.

If you are receiving treatment and do choose to have a vaginal birth there is still a possibility that you may need to have an emergency C-section for obstetric reasons. This can also happen to any woman having a vaginal delivery whether she is HIV-positive or negative.

Medical teams will be a bit more cautious though with an HIV-positive woman than an HIV-negative woman with vaginal delivery.