Some HIV positive women (and their doctors) still think C-sections are necessary to prevent mother-to-child transmission. But other experts say this usually isn’t the case if your viral load is undetectable. For women with a detectable viral load, studies show that an elective or planned C-section—done before the water breaks—can reduce the risk of transmitting HIV by as much as half, since it reduces the baby’s contact with the mother’s blood and fluids during vaginal birth. But if your viral load is undetectable, the chance of HIV transmission is already very low, so there’s no need to take the risks of unnecessary surgery. “Elective C-section is not necessary if women achieve viral loads below 1,000,” says Dr. Cu-Uvin. You may still need an emergency C-section if problems arise during labor. But here, too, if viral load is undetectable, the risk of HIV transmission is very low.
