HCV and Pregnancy
Everyone and their dog has opinions about what is “correct” or “proper” in terms of motherhood, pregnancy, and parenting. You would think that in all of the years we have been existing and reproducing as a species, we would have found a less hostile and more compassionate way of communicating about the difficulties that we can face during these shared life experiences.
Yet, there is still no easy way to bring up the question of what the risks and benefits are when it comes to choosing to become a mother while having an already known and present chronic illness like hepatitis C.
Stigmatization of hepatitis C pregnancies
The very question is the type of moral and ethical dilemma controversial enough to cause arguments among even the most polite company. For many women who have lived through the experience of hepatitis C and pregnancy this very notion has caused them to be on the receiving end of stigmatization by peers, medical professionals, and their communities at large.
However, I don't think there is much sense in denying that choosing to carry a pregnancy, become a parent, and raise a child while having a chronic illness will provide a unique set of challenges that could have been entirely avoided without said chronic illness.
I mean, there could be complications that arise during pregnancy and after birth that are directly related to having hepatitis C. Some might consider such complications avoidable, and by all logic, they are right in that regard.
However, in my opinion, that kind of notion is an oversimplified, unrealistic, uninformed, and stigmatized view of HCV during pregnancy and motherhood. In this article, I will do my best to explain why I believe that.
My pregnancy experiences
First of all, I think it is really important to disclose something about my lived experience that lends some personal insight on the matter. I have lived experience of pregnancy and motherhood during the period of time when I still had an active hepatitis C infection.
I was diagnosed with hepatitis C before getting married and giving birth to my two children. I openly disclosed this status to my care providers during both of my pregnancies, of which I chose the care of a midwife rather than my family doctor or an OBGYN.
My first pregnancy was a natural, unmedicated home birth that resulted in a healthy baby girl with perfect APGAR scores. I had no serious complications during my pregnancy, apart from severe all-day–lasting-nausea.
My daughter had testing completed at birth that confirmed that, despite my higher viral load during my pregnancy, she was hepatitis C negative. I did not pass on my illness via vertical transmission.
My son was a bit different. Due to complications relating to gestational diabetes, I was unable to justify the risk of a home birth, so my son was born in the hospital.
He was born at a high birth weight and had developed pneumonia from inhaling fluid while descending the birth canal. Despite less-than-perfect APGAR scores this time and a month-long hospital stay, he was also hepatitis C negative.
In hindsight, I realize now that the nurses in the NICU unit where my son was being monitored were largely uneducated on what hepatitis C was and what kinds of people live with hepatitis C. At that time, I accepted the discomfort as part of what it meant to live with a virus like HCV. That I just had to accept the stigma. That I didn't have a right to think it strange that they tested and re-tested my son for hep C way more times than necessary, “just to make sure.”
Advancements in treatments
During the time period when I became a mother, hepatitis C treatment was not the same as today. The standard at that time was still pegylated interferon alpha and ribavirin, with no promise of success and certainly no expected outcome close to SVR.
Today some things are different. We live in an age where the standard of treatment boasts such a high percentage it almost guarantees long-term success.
However, not everything is the same. If you are pregnant, trying to become pregnant, or are breastfeeding it is not recommended to take direct-acting antivirals during those time periods as the risks are largely unknown.
However, with the success rate of direct-acting antiviral therapies and the support of a good health professional, there is a much higher chance of successful and lasting health outcomes for both moms and babies who have lived or living experience of hepatitis C.
So what is my verdict? Did my having hepatitis C during my pregnancies cause more risks to myself and my child?
Sure, but not more than having any sort of chronic or long-term illness might cause during that time for another person. While I do believe one's health and the level of health impacts they are experiencing from a particular health issue (especially a chronic one) should be a factor considered when deciding to become a parent, things like emotional maturity, financial health, and personality should be more importantly considered.
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