Pregnancy and breastfeeding with hepatitis C

Hepatitis C (hep C) is a viral infection that is carried in your blood and affects your liver.

How is hepatitis C spread?

Hepatitis C can spread when your blood has contact with blood from an infected person. The virus can't be spread through:

• kissing
• touching
• sneezing
• sharing food or cutlery

Ways you can be infected with hepatitis C include:

• during birth or during pregnancy
• from injecting drugs using a dirty needle
• from getting tattoos or piercings without sterile equipment
• from non-sterile medical procedures
• exposure to infected blood

You may not show symptoms of hepatitis C right after catching it. 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 (itching)
• mood swings, depression or anxiety
• nausea (feeling sick) and lack of appetite
• jaundice (yellowing of skin and eyes).

If you think that you might have hepatitis C, you should have a blood test before you get pregnant. It's 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, you may have to do another blood test to confirm the results and check for other infections.

If you have hepatitis C, treatment with direct-acting antiviral medicine is effective. Your doctor will give you medicine to take for a few months. These medicines can help cure you of hepatitis C. Doctors don't have much information yet about if they are safe to use in pregnancy.

Ribavirin is an older type of antiviral medicine. It isn't safe to take during pregnancy or breastfeeding, as the medicine can affect your baby.

If you or your partner are currently taking ribavirin, you should use reliable contraception (birth control). You shouldn't try to get pregnant for at least 6 months after you finish taking ribavirin.

Having hepatitis C shouldn't affect your pregnancy, but there is a chance of passing the infection to your baby during pregnancy, at birth or soon after 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 safest way to do this.

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 done to lower the chance of your baby being exposed to your blood.

Your baby doesn't have a higher chance of catching hepatitis C from you if they are born by caesarean section, compared with a vaginal ('natural') birth.

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.

You will be offered the standard vaccinations and vitamin K injections for your baby. After this, you will be able to take your baby home.

Your baby will need a blood test for hepatitis C infection at 6 months of age. When your child is about 18 months of age, your doctor will test them again for a hepatitis C infection.

Can I still breastfeed if I have hepatitis C?

Yes — you can't pass hepatitis C to your baby through breast milk.

If your nipples are cracked or bleeding, it's a good idea to throw out any milk. Do this for a few days, until your nipples heal. You can then continue to breastfeed your baby.

If hepatitis C is passed to your baby at birth, they are likely not to have any symptoms. The infection may clear up naturally in their first 12 months. If not, your child may develop mild liver inflammation.

About 4 in every 5 adults infected with hepatitis C develop chronic (long-lasting) infection. If left untreated, complications can include liver failure and liver cancer.

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

If you are pregnant, your doctor will help you decide the safest way for your baby to be born.

There is no vaccine to prevent hepatitis C. The best way to protect yourself is with safe sex, and by not having contact with contaminated blood.

If you are concerned that hepatitis C could affect 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.

Hepatitis NSW has a useful factsheet on hepatitis C, pregnancy and babies.

NSW Health has a useful fact sheet on hepatitis C.

Languages other than English

Hepatitis Australia has useful information on hepatitis B and C.

Information for Aboriginal and/or Torres Strait Islander peoples

Hepatitis NSW has a useful booklet on hepatitis C developed for Aboriginal communities.