Since 2002 when we began maternity testing for HBV some 3500 women a year have been diagnosed creating a population of some 50,000 UK mums with HBV. Although a similar size cohort of people to gay men with HIV issues, these innocent women, their children and their famillies have been given almost no funding or publicity, yet they face greater difficulties. Again politics has twisted our priorities, many are even given advice better suited to heroin addicts or gay men, here after counseling hundreds and hundreds of mums over the years we offer answers tailored to their questions.
For mothers diagnosed in early pregnancy with hepatitis b the most important thing to remember is that the UK now has excellent services for
Making certain your baby is born safely and vaccinated immediately
Making certain you are there for the full life journey and
Making certain husbands are vaccinated
We have helped many, many mothers through this journey, do not get lost in Googling this infection just call the helpline and talk to experts with your results to hand.
Covers baby vaccinations, blood hygiene, HBV results explained, liver blood tests explained, HBV explained, Best diet, Toxins to avoid, emotional tips.
Excellent Guide for midwives and also HBV mums from the US Asian American Community
Frequently Asked HBV Mom Questions
Will I live long enough to be there for my baby?
Yes of course. Mums are all diagnosed young and HBV tends to take until 50 to 80 years old to try its worst. Very few mums are diagnosed with serious liver complications and todays excellent liver units and medications can stop your HBV in its tracks if ever it gets active and tries to harm you. At best you will need a check up every year to make sure you are 100% well, at worst you may need an anti viral pill a day. Either way we test all mums to make sure BOTH the baby and they are well and stay well.
Will I infect my baby, it is at risk isn't it?
All maternity units are very careful to deliver baby without cuts and wash and immunise/vaccinate baby on day 1. Sometimes it is reported that there is a risk but this is actually confined to the tiny group of mums who arrive without any previous contact to a hospital with contractions already starting, these ladies are very often health tourists who are afraid to engage earlier. We have attended annual national midwive conferences and they are very good at dealing with HBV moms, after all they have delievered 50,000 babies safely already.
A second line of protection
for baby from infection is the Liver Doctors, who if mum has a very high load of HBV usually 750,000 to 1,000,000,000IU/ml provide anti viral treatment in the last 3 months of pregnancy to remove the load and supply Immuno globins to baby when born.
Then there is the Placenta Barrier, you.
Even though baby is growing inside you the placenta acts as abarrier and does not allow the HBV to enter your foetuses blood stream. So right now you are keeping baby safe.
The last thing a pregnant woman needs is to be up all night googling is she going to give her baby an incurable virus the day it is born, so do not!
We tell all mums, to try to get wise not get worried.
I am scared of Interferons and Anti Virals, they will risk terrible side effects.
Many mums google the word interferon as a treatment they have heard is used for HBV and then get this worry. Todays HBV anti virals have about 1% of the interferon and 99% of agents to target the HBV virus only. So all these stories about Interferon, Hair Loss, Mega Anemia, Ill all day effects belong to people having the 100% doses usually for large aggressive cancers. HBV anti virals are really not like that at all, we hear of a little eczema in 1% of patients and vitamin d deficiency in people who take it for decades and that is about all.
Will Tenofovir or Entacavir harm my unborn baby leaving birth defects?
No. After studying many couples 1500 the only difference at birth was babies measured 1% lighter. This in itself led to normal weight at one year weighing with no appreciable differences at all. Therefore doctors advise in high loads mothers to take these medications in the last trimester as the risk of HBV infection is deemed far greater than any risk from the medication. As a national helpline over 12 years we have not heard of any issues and recommend mothers to co operate in getting baby safe.
I am thinking to terminate my pregnancy as I cannot face the risk of infecting it.
Without wishing to demonise those with anxiety disorders we have noted this worry can be a real issue for them. To date we have never had a report of a mother infecting her child once diagnosed. The vaccine is very effective and on the rare occasions it does not work, we have found every mum has the ability to avoid bleeding on their child's open wounds. You have to trust yourself here. It was undiagnosed mums who infected their children and even more often undiagnosed dads, once diagnosed you know how to avoid infection and you will find you can manage.
I have HBV markers for infection don't I? Meaning HBcAb markers.
For every mum who tests positive for HBV we get about 5 who test positive for HBcAb, meaning Hepatitis B Core Antibodies, sadly some of these poor ladies get confused or have confusing ideas given to them that they have some kind of inactive Hepatitis B. HBV core antibodies are in no way Hepatitis B, they are signs you have had and cleared Hepatitis B in the past. Antibodies are the things that killed Hepatitis B and it is very good to have them, we make the antibody vaccines and put them into people to keep them safe, so that is how good it is to have them.
Can I have sex with my partner ever again?
This question is common right after diagnosis with both partners in a bit of shock. Of course you can have sex and more children, it is just a question of HBV vaccinating your partner, this should be done quickly over 21 days with a blood test 2 months after the last injection to see his level of immunity.
I feel so guilty my partner has it and now my baby will be at risk?
It is so important that women do not shoulder the blame for an infected partner. If a couple are both positive it is next to impossible to guess who infected who and usually useless to try.
I was diagnosed during pregnancy why do they not test at a better time?
Approximately 1 in 33 women from the Pacific rim nations and the sub Saharan African nations have tested HBV positive during routine pregnancy screening since 2002 and it is really a sad indictment of our borders that they do not care more for HBV endemic area survivors. Still being diagnosed now has saved baby from infection and mum from liver disease so we have to be positive and see things in perspective.
Can I breast feed my baby?
Yes , breast milk gives baby all of mums antibodies and this creates a strong immune system to date no babies have been infected by this route in the UK as all are vaccinated.
Can I breast feed my baby while on Tenofovir?
Yes , In controlled medical studies no problems have been reported either by the manufacturers or to us and other HBV charities internationally.
Diet and HBV and being Pregnant?
The need usually to keep eating normally and not either miss meals or comfort eat too much. Baby and mum need a balanced diet as per usual. No alcohol is a must, as always, and a avoidance of fried foods is also recommended
My GP asked lots of questions about my sex life and also about any illegal drug habits!? Basically I feel like a leper.
Sadly too many NHS staff have 1980's information about HBV when it was more confined to sexual and drug taking risks, few understand that 1 in 3 humans have caught it mainly as children or in the course of normal life dealing with blood situations eg cleaning, first aid, etc. Be strong, it is nothing to be ashamed of, simply proof you have blood in your veins and bleed like everyone else.
My GP googled Hepatitis B in front of me!?
The boom in HBV in the UK has left many GP's short on information and remember they tend to know only 6 lines on some 10,000 ailments they are not specialists, we often get them ringing with questions also. The key is to listen to experts, maternity sometimes in cities have a 1 mum per 50 with HBV and are way more tuned in, then your liver team, well HBV is their bread and butter.
What is a healthy carrier?
Many mums get a little baffled by this term, thinking a healthy carrier of a deadly virus and distrust their liver teams. DON'T! Basically they are noting the virus has had no effect on your health yet and such cases seldom get active until mid life.
How do I ever tell my Partner?
Some poor mums find themselves in a situation of trying to explain to their partner both that they have HBV and what it is before they have had any chance to understand it themselves. Sometimes whatever information they can find talks about sexual risks or drug risks and the whole process becomes scary. Download our HBV Accessing Best Care Booklet and have us available on the helpline to answer questions. We have deep experience of "honour" issues with our Muslim HBV mums able to speak Urdu and Arabic. We have deep experience of diagnosed anxiety disorder partners also. Ultimately we are protective of mum and baby. Partners need and should be at mums side when diagnosis is revealed and recommended for vaccination as some information and unfortunately some NHS staff comments has set families on the road to misunderstanding accusation and arguments. Most of all Mums should never confess to previous relationships or be interrogated as sex is almost never the cause of their infection, in fact, it is almost a guarantee they will find active or cleared infections in other birth family members.
My grandparent/relative has HBV is he safe around my baby?
This is an extremely common problem in the UK and across the world where we find a family member other than mum has HBV and struggles to get vaccinated. It is crucial anyone who looks after a baby is screened for HBV and if found positive for HBV the baby needs to be vaccinated quickly. Many GP's do not quickly do this so we often will contact them for you and explain the need and urgency.