This sheet is about having hepatitis C in pregnancy or while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.
What is hepatitis C?
Hepatitis C is a type of liver disease caused by infection from the hepatitis C virus. Hepatitis C virus is often called “HCV”. People can have acute (short-term) or chronic (long-term) hepatitis C.
Acute hepatitis C happens in the 6 months after someone is exposed to HCV. Some people have no symptoms, while others might have some or all of the following symptoms: dark colored urine, red colored stool (poop), feeling tired, joint pain, nausea, stomach pain, fever, and jaundice (yellowing of the skin and eyes).
Chronic hepatitis C is a long-term condition that happens if HCV stays in the body long-term. Chronic hepatitis C can cause liver failure and liver cancer. Not everyone who is infected with HCV will get chronic hepatitis C.
How do you get hepatitis C?
Hepatitis C is mostly spread through blood or other bodily fluids that contain blood. Sharing items infected with HCV (such as needles, razors, nail clippers, tattoos or body piercing equipment) or coming in contact with HCV-infected body fluids through sex, blood donation, or a workplace exposure (like a hospital) can cause a person to get hepatitis C.
How can I find out if I am infected with hepatitis C?
To find out if you have hepatitis C, your healthcare provider will take a blood sample to see if you have HCV antibodies (proteins made by your immune system after an infection). If you are found to have HCV antibodies, then you will be tested for an active HCV infection.
The American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) have recommended that everyone who is pregnant get testing for hepatitis C. If you have been diagnosed with hepatitis C, it is important to talk with your healthcare provider as soon as possible about treatment options.
People who have hepatitis C might not feel or look sick. It is important to get treatment for hepatitis C infections as soon as possible to prevent chronic hepatitis C and other complications.
Can hepatitis C be passed to the fetus during pregnancy or at the time of delivery?
Hepatitis C can be passed to the fetus when someone has an active HCV infection. It can happen during pregnancy or at the time of delivery.
When a woman passes an infection to the fetus in a pregnancy, it is called vertical transmission. Vertical transmission can happen at any time in pregnancy, but it is usually more likely to happen when the woman has the infection closer to the time of delivery.
Some children who get HCV infections during pregnancy will get rid of the virus on their own. Others will have HCV but will not have symptoms of an infection (asymptomatic). Some children will develop symptoms of hepatitis C including hepatomegaly (liver larger than expected), fever, diarrhea, and nausea.
I have hepatitis C. What should I talk about with my healthcare team before I get pregnant?
It is important to talk to your healthcare team (including your obstetrician, primary care provider, and hepatologist) about plans for treating your condition before and during pregnancy, during delivery, and after delivery. If possible, talk with your healthcare team before getting pregnant. If your pregnancy is unplanned, contact your healthcare providers as soon as you find out you are pregnant.
Things to talk about with your healthcare team include:
- Ways to monitor your pregnancy and your hepatitis C symptoms.
- Any medications or vitamins you should take during pregnancy.
- Getting any necessary vaccines before and during pregnancy. Many vaccines can be given in pregnancy. For more information, please see the MotherToBaby fact sheet on vaccines at https://mothertobaby.org/fact-sheets/vaccines-pregnancy/.
- Any other questions or concerns you have.
I have hepatitis C. Can it make it harder for me to get pregnant?
In a study of 27,000 women with HCV infections, there was an increased chance of infertility (trouble getting pregnant) when someone had an HCV infection.
Does having hepatitis C increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if hepatitis C increases the chance of miscarriage. In 1 study of 36 women with HCV infections, there was no reported increased chance of miscarriage. In another study with 100 women with HCV infections, an increased chance of miscarriage was reported.
Does having hepatitis C increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like hepatitis C, might increase the chance of birth defects in a pregnancy. It is not known if hepatitis C can increase the chance of birth defects.
Does having hepatitis C increase the chance of other pregnancy-related problems?
Studies have reported that having a hepatitis C infection during pregnancy can increase the chance of preterm delivery (birth before week 37), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), babies who are small for gestational age (measuring smaller than expected for their age), pre-eclampsia (high blood pressure and problems with organs, such as the kidneys), which can lead to seizures (called eclampsia), and infants spending more time in the neonatal intensive care unit (NICU).
Does having hepatitis C in pregnancy affect future behavior or learning for the child?
One study reported a possible link between having a hepatitis C infection and an increased chance of a child having a neurological (brain) condition, including problems with feeding, cephalohematoma (gathering of blood under the scalp), seizures, bleeding in the brain, and problems getting enough oxygen. Having these symptoms might affect behavior or learning in the future.
What screenings or tests are available to see if my pregnancy has birth defects or other issues?
Prenatal ultrasounds can be used to screen for some birth defects. Ultrasound can also be used to monitor the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.
Breastfeeding while I have hepatitis C:
HCV does not usually pass into breast milk. Most women can continue to breastfeed while they have hepatitis C. The CDC recommends that breastfeeding should be temporarily stopped if someone has nipples and/or areolas that are cracked and bleeding. However, it is not known if HCV can pass from the mother’s blood to the nursing infant through dry or cracked nipples. The CDC has a page on breastfeeding with hepatitis C here: https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/hepatitis-b-c.html. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man has hepatitis C, can it affect fertility or increase the chance of birth defects?
Hepatitis C infection can lower the amount of sperm made, change the shape of the sperm, and lower sperm motility (how well the sperm moves). Having hepatitis C might also lower testosterone levels. These changes might affect men’s fertility (ability to get a woman pregnant). Studies have not been done to see if hepatitis C in men could increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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