Hepatitis C in Pregnancy: Risks, Testing, and Care for Mother and Baby
Infectious DiseasesHepatitis C
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Hepatitis C During Pregnancy: Risks, Testing, Treatment

Hepatitis C During Pregnancy: Risks, Testing, Treatment
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Updated on January 31, 2025
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An estimated 1 to 2.5 percent of pregnant women in the United States have hepatitis C, a chronic viral infection that can potentially cause serious liver damage, liver failure, and liver cancer if untreated.


A person with hepatitis C can transmit the infection to a fetus during pregnancy, which may put the baby at risk for complications. If you are planning to become pregnant and have been diagnosed with hepatitis C, it’s important to be treated as soon as possible. While there are no approved treatments for women with hepatitis C who are already pregnant, receiving prenatal care from an experienced ob-gyn will help ensure the best possible outcome.


Here’s what to know about how hepatitis C spreads, how it can affect you and your baby, and how and when to get tested and treated for the virus.

What Is Hepatitis C and How Does It Spread?

Hepatitis C is a virus that invades cells in the liver (hepatocytes) and causes it to become inflamed. Over time, this inflammation can lead to liver damage and cirrhosis, a life-threatening condition in which scar tissue replaces healthy liver tissue. Hepatitis C often does not cause any symptoms until it has caused significant damage, which is why it’s important to get tested.

In general, men are more likely than women to be infected with hepatitis C and are less likely to clear the virus in the acute phase of infection. Estrogen may have a protective effect in women of childbearing age.


There are two types of hepatitis C:

  • Acute Hepatitis People with acute hepatitis may have symptoms that last up to six months. Sometimes the body can fight off the infection, and the virus goes away, but for most people, a short-term infection leads to chronic infection.
  • Chronic Hepatitis Long-term or chronic hepatitis can last a lifetime if it’s not treated. Without proper diagnosis and medication, it can cause serious health problems, including liver damage, cirrhosis, liver cancer, and even death.

The blood of a person who has hepatitis C can spread the infection. In the United States, most people get the virus by sharing needles, syringes, or other equipment used to inject or snort illegal drugs.

While it is uncommon, the virus can be sexually transmitted or spread via personal items (such as razors or toothbrushes) and unsanitary tattoo and piercing instruments. Prior to 1992, when widespread screening of the blood supply was instituted, it was possible to get hepatitis C from a blood transfusion or an organ transplant if the donor was infected with the virus.


A pregnant woman can pass the hepatitis C virus to a fetus in the uterus through her bloodstream. Around 5 percent of babies whose mothers have hepatitis C contract the infection this way.

Unlike hepatitis A or B, there is no vaccine for hepatitis C, so prevention focuses on avoiding risk factors.

How Hepatitis C Affects Pregnant Women

Pregnant women with hepatitis C may have a higher risk for certain pregnancy complications:

  • Gestational diabetes causes high blood sugar and can affect your pregnancy and your baby's health.
  • Preeclampsia is a serious pregnancy complication that can cause high blood pressure; high levels of protein in the urine, indicating kidney damage; or other signs of organ damage. If left untreated, preeclampsia can lead to serious or even fatal complications for both the mother and baby.

  • Cesarean section (C-section) is required at higher rates.

How Hepatitis C Can Affect a Baby

Research indicates that hepatitis C may cause health issues for babies:

  • Preterm birth (babies born before 37 weeks of pregnancy) is the leading cause of infant death and a risk factor for health and developmental problems at birth and later in life.
  • Low birth weight is defined as less than 5.5 pounds.
If the mother has another infection, such as hepatitis B or HIV, the chances of the baby developing hepatitis C go from 5 percent to about 10 to 15 percent.

Diagnosing Hepatitis C During Pregnancy

The Centers for Disease Control and Prevention recommends that all pregnant women be tested for hepatitis C. Because the infection often comes with no symptoms, testing is required for a diagnosis.

A pregnant woman should be tested as early as possible, ideally at the first prenatal visit.

Knowing a pregnant woman’s hepatitis C status ensures that she will be carefully monitored as the pregnancy progresses. Testing the mother also identifies at-risk infants, so they can be tested and monitored after birth.

How to Treat Hepatitis C During Pregnancy

There are no hepatitis C treatments approved for use during pregnancy due to concerns that the treatment may harm the fetus. Once a woman has given birth and stopped breastfeeding, it is safe to begin antiviral treatment.

However, if you test positive for hepatitis C before becoming pregnant, you can start treatment before trying to conceive. Over 90 percent of people with hepatitis C can be cured within 8 to 12 weeks of treatment with oral therapy.

New antiviral medicines called direct-acting antivirals (DAAs) are used to clear the virus from the body. DAAs have better outcomes, fewer side effects, and shorter treatment times than previous medications. Treatment with DAAs typically lasts for eight weeks. The goal is for the virus to be undetectable in the blood 12 weeks after the treatment ends.

Research evaluating the safety of DAAs to treat hepatitis C during pregnancy is ongoing and may lead to approval or guideline changes in the future.

Monitoring Health During Pregnancy

It’s important for pregnant women to go to all their prenatal visits. This is especially true if you have hepatitis C, so your healthcare provider can monitor your health and your baby’s development and growth. It’s also important to make sure that everyone on your healthcare team is aware of your diagnosis.

Let your provider know all the medicines you are taking, including over-the-counter medications, as some medicines, such as acetaminophen (Tylenol), can make liver problems worse.

Lifestyle and Diet Recommendations

Talk with your healthcare team to get personalized recommendations and support for taking care of yourself and your baby during pregnancy. In general, these guidelines are suggested:

  • Stay away from harmful substances, including illegal drugs and tobacco. If you need help quitting, tell your healthcare team so they can help you get treatment.
  • Do not drink alcohol. Alcohol can damage your liver and harm your baby.
  • Follow your healthcare team’s recommendation for a healthy diet during pregnancy.
  • If you haven’t received vaccines for hepatitis A and hepatitis B, get them. These vaccines are safe during pregnancy.
  • Stay away from people who have colds and other infections.
  • Tell the people you live or have sex with that you have hepatitis C.
  • Don’t share personal items like razors, towels, toothbrushes, or nail clippers.
  • Use a condom every time you have sex.
  • Keep any cuts, scrapes, or blisters covered.
  • If you use drugs, don’t share supplies used to snort or inject them, like needles, syringes, or straws.

How to Avoid Hepatitis Transmission From Mother to Baby

There is no evidence that any preventive treatments can reduce the risk of passing on the virus to a baby, including having a C-section rather than a vaginal delivery.

There is limited evidence that invasive prenatal testing, prolonged rupture of the membranes, and scalp fetal monitoring are associated with a slight increase in the risk for transmission.

Newborn Care

Testing a baby right after delivery can’t provide a definitive diagnosis of hepatitis C infection. Though the risk is low, it is possible for the mother’s hepatitis C antibodies to appear in the baby’s blood for up to 18 months, even if the baby does not have the virus.

Screening guidelines recommend that all babies born to women with hepatitis C get tested for antibodies at 18 months of age; those who have antibodies should get tested after age 3 to confirm or rule out chronic hepatitis C.

If a child tests positive for hepatitis C, they need to see a specialist and receive treatment, even if there are no symptoms.

Is Breastfeeding Safe?

Mothers with hepatitis C can safely breastfeed their infants. There is no evidence that breastfeeding increases the risk of transmitting the infection.

However, if there is any bleeding from the nipples or they are cracked, women should not breastfeed until the bleeding has stopped and the nipples have healed.

The Takeaway

  • Hepatitis C is a viral liver infection that can affect pregnant women and their babies.
  • While the risk of transmitting the virus from mother to baby is generally low, it’s important to understand potential complications, including gestational diabetes, preeclampsia, and preterm birth.
  • Testing for hepatitis C early in pregnancy is recommended to ensure proper monitoring and prenatal care.
  • No antiviral treatments are approved for use during pregnancy, due to potential risks to the fetus, but effective therapies are available after the baby is born.

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Kara Smythe, MD

Medical Reviewer

Kara Smythe, MD, has been working in sexual and reproductive health for over 10 years. Dr. Smythe is a board-certified fellow of the American College of Obstetricians and Gynecologists, and her interests include improving maternal health, ensuring access to contraception, and promoting sexual health.

She graduated magna cum laude from Florida International University with a bachelor's degree in biology and earned her medical degree from St. George’s University in Grenada. She completed her residency in obstetrics and gynecology at the SUNY Downstate Medical Center in Brooklyn, New York. She worked in Maine for six years, where she had the privilege of caring for an underserved population.

Smythe is also passionate about the ways that public health policies shape individual health outcomes. She has a master’s degree in population health from University College London and recently completed a social science research methods master's degree at Cardiff University. She is currently working on her PhD in medical sociology. Her research examines people's experiences of accessing, using, and discontinuing long-acting reversible contraception.

When she’s not working, Smythe enjoys dancing, photography, and spending time with her family and her cat, Finnegan.

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Becky Upham

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Becky Upham has worked throughout the health and wellness world for over 25 years. She's been a race director, a team recruiter for the Leukemia and Lymphoma Society, a salesperson for a major pharmaceutical company, a blogger for Moogfest, a communications manager for Mission Health, a fitness instructor, and a health coach.

Upham majored in English at the University of North Carolina and has a master's in English writing from Hollins University.

Upham enjoys teaching cycling classes, running, reading fiction, and making playlists.

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