Ask a pregnant woman or a new mother how she felt when she first learned she was pregnant and the majority will answer "excited," "thrilled," "over-the-moon." But hidden beneath this euphoria is often a real sense of nervousness. Most expectant moms worry about what the next nine months will bring and whether their child will be healthy.

Fortunately, pregnant women in Ontario have access to some of the best prenatal care in the world. It is standard practice for pregnant women to visit their prenatal care provider once a month for the first 28 to 32 weeks, biweekly until 36 weeks and weekly after that. Good prenatal care can have a great impact on the mother and her growing baby and these regular medical visits can help to identify potential problems so treatment can be started as soon as necessary and her baby can be born as healthy as possible.

During the first prenatal visit, the healthcare provider will suggest a series of routine blood tests, including screening for hepatitis B, syphilis, rubella and HIV. These tests have not always been available to women, but fortunately now, these four simple blood tests can make the difference between the birth of a very sick baby and a healthy one.

"Ontario recommends that voluntary HIV screening be offered to all pregnant women," says Dr. Stan Read, Chief, Infectious Diseases, Toronto's Hospital for Sick Children. "This is a tremendous advantage because if treated, the risk of transmission of HIV from an infected mother to her child can be reduced to only one to two per cent. Without treatment, the risk of transmission is 30 per cent."

In 1998, Ontario started offering routine HIV screening to all pregnant women and to those thinking about becoming pregnant – regardless of risk. The HIV test can be done at the same time as other routine prenatal tests, or if a woman prefers, she can be tested at one of Ontario's 33 anonymous HIV testing sites where identifying information is not collected and comprehensive, confidential counselling is guaranteed.

Unfortunately, despite the screening program, 10 per cent of pregnant women in Ontario are still not being tested for the disease. As a result HIV-positive infants continue to be born in the province.

"Some women are not taking the test because they think they are not at risk. Others may not be aware of the test if they are not offered the test by their healthcare providers," says Dr. Read. "This is a tragedy because HIV-positive infants are still being born. Women need to be offered HIV testing because if it is discovered they are indeed HIV-positive, they can begin treatment."

For women who are either pregnant or considering becoming pregnant, an HIV test can provide information that can help them make informed and responsible decisions for the future health of both the mother and her baby.

See also :

• Living With HIV : The Experience of One Mother and Her child
• Treatment for HIV during Pregnancy Protects Baby from Infection
• Article : Uptake for Prenatal HIV Testing in Ontario Increases to 90 per cent

June 2004

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