During your pregnancy, you'll be offered a blood test for 3 infectious diseases: hepatitis B, HIV and syphilis. This is part of routine antenatal screening and is offered, and recommended, for all pregnant women in England in every pregnancy.
You will usually be offered the blood test at your booking appointment with a midwife. The blood test needs to be done as early as possible in pregnancy, ideally by 10 weeks, so treatment can be started to help reduce the risk of passing the infection on to your baby.
If you already know you have HIV or hepatitis B, you'll need early specialist appointments to plan your care in pregnancy. If your partner has HIV, hepatitis B or syphilis, tell your midwife as soon as possible.
Why are these diseases serious in pregnancy?
Hepatitis B, HIV and syphilis can all be passed from mother to baby during pregnancy and birth.
Hepatitis B affects the liver and can cause immediate (acute) and long-term (chronic) illness. It's passed on in blood and other body fluids through sexual contact or infected needles.
Pregnant women with hepatitis B need specialist care, which you'll be offered if the test is positive or if you already know you have hepatitis B.
If your baby completes a course of vaccinations in their first year, this greatly reduces their risk of developing hepatitis B.
HIV weakens the immune system, making it difficult to fight off infections. If left untreated, it can lead to AIDS (acquired immune deficiency syndrome). HIV is passed on in blood and other body fluids through sexual contact or infected needles.
HIV can be passed from a woman to her baby during pregnancy, birth or breastfeeding if it's not treated.
Syphilis is usually passed on through close contact with a syphilis sore during sex. It can also be passed from a pregnant woman to her unborn baby during pregnancy.
If untreated, syphilis can cause serious health problems for the mother and her baby, or cause miscarriage or stillbirth.
Syphilis is treated with antibiotics. The earlier it's treated, the lower the risk of passing it on to the baby is.
How is the test done and are there any risks?
A blood sample is taken from your arm. There are no risks associated with this test, either for you or your baby.
Do I need to have this test?
It's your choice to be tested for any or all of these infections. The tests are recommended to:
- protect your health through early treatment and care
- reduce any risk of passing an infection on to your baby, partner or other family members
If you test positive for hepatitis B, HIV or syphilis, your partner and other family members may be offered a test for the infection.
What if I decide not to have the blood test for any of the infectious diseases?
If you decide not to have the test in early pregnancy, you'll be seen by a specialist midwife and offered screening again before you are 20 weeks pregnant. The midwife will discuss the benefits of screening for these infections.
You can ask to have a test for hepatitis B, HIV or syphilis at any time if you change your sexual partner or think you're at risk.
Your midwife will usually discuss your results with you either before or at your next antenatal visit and record them in your notes.
A specialist midwife will contact you if you have tested positive for hepatitis B, HIV or syphilis. This is to arrange appointments to discuss your results and organise a referral for specialist care services.
The specialist care team will offer you further tests and examinations to fully assess your condition, and the treatment and care you'll need.
Care and treatment if you have hepatitis B, HIV or syphilis
If you have hepatitis B, you'll receive specialist care throughout your pregnancy and after the baby is born. Your partner and any other children you have should also be offered a test for infection, and vaccinations if needed.
To prevent the baby getting hepatitis B, they will need vaccinations at the following times:
- within 24 hours of birth (with an injection of antibodies if required)
- 4 weeks
- 8 weeks
- 12 weeks
- 16 weeks
- 1 year, with a blood test to check if infection has been avoided
It's very important that the baby has all 6 doses of the vaccine. The doses at 8, 12 and 16 weeks will be given as part of their routine infant immunisations.
The risk of passing HIV to the baby can be greatly reduced by:
- specialist care and treatment
- planned care for the birth
- not breastfeeding
These reduce the risk of passing on HIV to the baby from 1 in 4 to less than 1 in 100. Your partner and any other children you have should also be offered a test.
If you have syphilis, you will need urgent referral to a specialist care team. Treatment is usually a course of antibiotics.
Your care team will also offer to test your partner to see if they need treatment as well so that you don't get reinfected.
Your baby may need to be examined and given antibiotics after birth.
After your test
You can still get these infections during pregnancy, even after a negative test result. Talk to your midwife or GP if you're worried about anything.
You can catch sexually transmitted infections during pregnancy if you or your sexual partner take risks such as having unprotected sex.
You can also get HIV and hepatitis B if you inject illegal drugs and share needles.
Remember, you can ask to be tested for hepatitis B, HIV or syphilis at any time if you think you're at risk or you change sexual partner.
Screening for rubella
Screening for rubella in pregnancy is no longer offered, as rubella is now very rare in the UK because of the high uptake of the measles, mumps and rubella (MMR) vaccine.
The best way to protect you and your baby from rubella is to ensure you have had 2 MMR vaccinations. This will offer protection for any future pregnancy, and give you longer-term protection against measles, mumps and rubella.
You can't have MMR vaccinations while you're pregnant, and you should avoid becoming pregnant for 1 month after MMR vaccination.
If you're currently pregnant and aren't sure whether you've had 2 doses of the vaccine, ask your GP practice to check your vaccination history.
If the records show you haven't been fully vaccinated or there is no record, you can ask for the vaccination at your 6-week postnatal check after your baby is born.
Rash in pregnancy
Tell your midwife, GP or obstetrician immediately if you have a rash or come into contact with someone who has a rash at any time during your pregnancy.
They can arrange tests, if needed, to check if you have rubella. You should avoid any clinic or maternity setting until you've been assessed, and avoid contact with other pregnant women.
You can find more information in the GOV.UK Screening tests for you and your baby booklet.
Other screening in pregnancy
Find out about:
- screening for Down's, Edwards' and Patau's syndromes
- routine checks and tests in pregnancy, such as blood pressure and urine checks
- ultrasound pregnancy scans
See what to expect at your schedule of antenatal appointments.