I Have Hepatitis C and I’m Pregnant. Now What?
If you have hep C and are pregnant, you may be feeling a range of emotions, from thrilled to worried. You probably have a lot of questions. The most important thing to know is this: Most women with hep C can have healthy pregnancies and healthy babies.
What will the pregnancy do to the hepatitis?
If you learn that you are pregnant while taking hepatitis C treatment, talk to your doctor right away. Some of the hepatitis medications are not safe to use during pregnancy. Most of the medications are not dangerous, but they are not recommended because little is known about how safe they are in pregnancy.1,2
Pregnancy does not make hepatitis worse.3 Hepatitis blood tests may change during pregnancy - viral load may increase, liver function tests (LFTs) may decrease - but both tend to level out afterwards. Sometimes, though, viral load gets better after pregnancy. Your doctor may recommend that you test again after you have had your baby.1
What can I do to make the pregnancy healthier?
Tell your hepatitis doctor about the pregnancy, and tell your pregnancy care team about the hepatitis. They can work together to care for both the infection and the pregnancy. And as always in pregnancy, take steps to be as healthy as you can with your diet, exercise, and sleep.
Pregnant people are advised to avoid alcohol. Both hepatitis and alcohol affect the liver, so steering clear of alcohol is even more important for people with hep C.1
What about the baby?
Intrahepatic cholestasis of pregnancy (ICP) is a liver problem of late pregnancy. It is more common if you have hep C. ICP causes itching, especially of the palms of the hands, and increased LFTs. If it is severe, it may slightly increase the chance of preterm birth and stillbirth. To help prevent this, your care team may prescribe medication, and they will monitor you and your baby closely if you have ICP.1,3
In a meta-analysis of several research studies, the Society for Maternal-Fetal Medicine found that babies born to women with hepatitis C may be more likely experience adverse pregnancy outcomes, such as pre-term (early) delivery or low birth weight.1 According to the analysis, these babies may also be more likely to require intensive care after birth.1 However, more research to evaluate pregnancy outcomes in women with HCV is on-going, and your care team will watch for signs of potential problems in order to handle them early.
Hep C can be sometimes be shared from a woman to her baby. This does not happen often - only about 6% of the time. There isn’t a treatment to prevent this (yet), but your doctor or midwife can take care to make choices that lower the risk. For example, when monitoring the baby’s heartbeat in labor, using a device on the belly is recommended, rather than using a clip attached to the baby’s scalp. Having a C-section doesn’t change the chance that the baby will get hep C.1
Having HIV along with hep C increases the risk that the baby will get hep C. Treating HIV during pregnancy will decrease the chance that the baby will get hep C. Breastfeeding does not transmit hep C to babies. To be cautious, avoid breastfeeding if your nipples become cracked enough to bleed.3
Your baby’s doctor can check the baby for hep C. Many babies born with hep C will clear the infection without treatment. If not, even young children can take meds to treat and cure hep C.4 Most pregnant women with hep C, and their babies, do well. Work with your care team during and after pregnancy to take the best care of you and your baby.