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Safest Method of Delivery for Mothers with HCV
I am 38 wks. pregnant and infected with Hepatitis C with a very low viral load.  The doctors that I have been seeing admit that there is really no good evidence to support the claim that a c-section reduces the likelihood of transmission compared to a vaginal delivery as does the research that I have done myself.  There is one study, however, that says that the risk of transmission maybe be higher for vaginal delivery, albeit statistically insignificant.  The risk was found to be 1% higher.  This study was not a randomized control study, but an observational study, so the accuracy is very questionable.  My doctors seem to be at a loss as to whether I should have a c-section or vaginal delivery and are telling me that it is up to me.  When I consider the higher risk to the mother of having a c-section, I really don't know what to do.  
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I'm not aware of the studies.  I have never had a c-section.  I have had three children and the past 10 years of my life have been spent in the company of many other women having children.  All of my evidence is strictly anecdotal.

Given that the decreased risk is statistically insignificant I would not opt for the C-section.  Especially given that the risk of transmission is already quite low.  I have to believe that on the balance your risk of complications from C-section are greater than your risk of transmission via vaginal delivery.  Granted, the risks with C-section are also low but it is surgery and the recovery can make caring for a newborn that much harder.

I know there are Hep C moms at this board.  Hopefully they can offer some guidance.

Congratulations!
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Go for the vaginal delivery! I have had two vaginal deliveries and one c-section. All three children have been tested for hep C, none of them have it although I do. The reason for the c-section was breech presentation, not the hepatitis. My doctors did not consider hep C a reason for c-section.

After the c-section I became severly depressed because I felt like I had not given birth to the child. I had problems bonding to her. My belly healed poorly. Don't expose yourself to these risks when you have not even found medical support for a c-section. Vaginal delivery is a wonderful experience (although painful), don't deprive yourself of this.

Best of luck to you and your child!
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