Pregnancy and breastfeeding with hepatitis C

How is hepatitis C spread?

Hepatitis C can spread when blood from an infected person comes into contact with your blood. The virus cannot be spread through kissing, touching, sneezing, or by sharing food or surfaces.

Ways you can be infected with hepatitis C include:

• during birth
• from using drugs, for example with an infected needle
• from getting tattoos or piercings without sterile equipment
• from non-sterile medical procedures and exposure to blood

What are the symptoms of hepatitis C?

You may not show symptoms of hepatitis C soon after catching it, because it can take 1 to 3 months for the virus to cause symptoms. When symptoms do appear, they may include:

• fever
• aches and pains
• lethargy and sleep disturbances
• skin rashes and pruritis
• mood swings, depression or anxiety
• nausea and lack of appetite
• jaundice (yellowing of skin and eyes).

About 4 in every 5 people infected with hepatitis C develop chronic (long-lasting) infection. Complications can include liver failure or liver cancer.

Should I have a blood test for hepatitis C?

If you are concerned that you are infected with hepatitis C (for example, if your partner or someone you live with has it), you should have a blood test before you become pregnant. This is because it is best to treat hepatitis C when you are not pregnant.

If you are already pregnant, your doctor will offer you a hepatitis C test as part of routine screening. If your blood test for hepatitis C comes back positive, your doctor may ask you to do another blood test to confirm the results and check for other infections.

How can I prevent and treat hepatitis C?

There is no vaccine to prevent catching hepatitis C, so the best way to protect yourself is with safe sex, and by not being in contact with contaminated blood.

If you have a diagnosis of hepatitis C, treatment with antiviral medicine is effective. Your doctor will prescribe medicine that you will need to take daily or several times a day, over the course of a few months. These medicines can help cure you of hepatitis C.

You cannot take medicines to cure hepatitis C if you are pregnant or breastfeeding, as the medicines can affect your baby.

Ribavirin, an antiviral medicine, is not considered safe during pregnancy or breastfeeding. If you or your partner are currently taking ribavirin, you should use reliable contraception (birth control) and not try to become pregnant for at least 6 months after you finish taking it.

Will hepatitis C affect my pregnancy?

Having hepatitis C will most likely not impact your pregnancy, though there is a risk of passing the infection to your baby during birth.

If you need to have invasive tests (tests exposing your baby to your blood) during the pregnancy, your doctor can help you decide the best way to do this so you reduce the risk to your baby.

How do I prepare for labour and birth?

If you have hepatitis C, your doctor will try to reduce or avoid any optional medical procedures during the birth. This is to lower your baby's risk of exposure to your blood.

Your baby's risk of catching hepatitis C from you is not higher if they are born by caesarean section, compared with a vaginal (‘natural') birth.

How can I reduce my risk of passing on hepatitis C to my baby?

If you have been diagnosed with hepatitis C and are not yet pregnant, speak with your doctor about your best treatment options.

If you are already pregnant, your doctor will help you decide the best way for your baby to be born safely, while minimising the risk of infecting your baby with hepatitis C.

Can I still breastfeed if I have hepatitis C?

Yes — breast milk is the healthiest option for your baby, and hepatitis C is not transmitted through breast milk.

If your nipples are cracked or bleeding, ask your midwife or a lactation consultant to show you how to express your breast milk and feed it to your baby. Do this for a few days, until the sores heal, then your baby can continue to breastfeed.

What does hepatitis C mean for my newborn?

After the birth, the hospital's healthcare team will give your baby a bath to wash off any of your blood. Once they are clean, they will receive their vaccinations and vitamin K injections, following the regular guidelines, and you will be able to take your baby home.

Your doctor will test their blood for hepatitis C infection at 2 and 6 months. When your child is between 12 and 18 months old, your doctor will test them again to see if there are signs of infection to hepatitis C. Even if there is, your child is unlikely to have any symptoms.

Resources and support

If you are concerned that hepatitis C could be affecting your pregnancy or newborn baby, you can contact any of the following organisations for help:

• Hepatitis Australia on 1800 437 222.
• Australian Breastfeeding Association on 1800 686 268.