Hepatitis means inflammation of the liver. While several different viruses can cause this condition, the main ones of concern in obstetric practice are Hepatitis A, B, C, D, and E. In pregnant women, viral hepatitis can lead to severe maternal complications, premature delivery, and vertical transmission to the newborn. Understanding these viruses allows midwives to identify at-risk women during antenatal booking and institute timely interventions. Physiological changes in pregnancy do not protect the liver; instead, certain infections like Hepatitis E can take a particularly aggressive course in the third trimester. Midwives serve as the first line of defense through routine screening, education, and advocacy for safe immunization practices across Nigerian healthcare facilities.
Hepatitis A is primarily spread through the fecal-oral route, often via contaminated food or water. In many high-burden settings, most individuals contract the infection during childhood and develop lifelong immunity. Pregnant women who present with acute Hepatitis A typically experience sudden onset of fatigue, nausea, right upper quadrant abdominal pain, and jaundice. Unlike chronic strains, Hepatitis A does not cause chronic liver disease or long-term carrier states. Management focuses on supportive care, adequate hydration, and monitoring for dehydration from severe vomiting. Vertical transmission to the fetus is rare, but severe maternal illness can still trigger preterm labor.
Hepatitis B is a blood-borne and sexually transmitted DNA virus that poses a massive public health challenge. The greatest danger in maternity care is perinatal transmission, which occurs when an infected mother passes the virus to her baby during vaginal delivery. Infants who contract Hepatitis B at birth have a ninety percent chance of developing chronic infection, leading to cirrhosis or liver cancer later in life.
Universal antenatal screening for HBsAg is essential to identify exposed neonates who require immediate post-exposure prophylaxis within twenty-four hours of birth.
Hepatitis C is transmitted primarily through direct contact with infected blood, making unsafe injection practices, unsterilized surgical instruments, and past blood transfusions major risk factors. Pregnant women should be screened using the anti-HCV antibody test. If the antibody test is positive, a confirmatory HCV RNA PCR test is required to prove active viremia, because up to twenty-five percent of people clear the virus spontaneously. Unlike Hepatitis B, there is currently no vaccine available for Hepatitis C, and post-exposure prophylaxis for newborns does not involve immunoglobulin. Midwives must arrange proper pediatric follow-up, as antibody tests in infants can remain positive for up to eighteen months due to passive transfer of maternal antibodies.
Comprehensive midwifery care bridges the gap between clinical detection and community prevention. Antenatal booking visits must include routine counseling and screening panels for viral hepatitis. Midwives must practice strict universal precautions during every labor and delivery to protect themselves and prevent nosocomial transmission. For babies born to Hepatitis B positive mothers, the midwife coordinates the administration of the Hepatitis B vaccine and Hepatitis B immune globulin (HBIG) within the critical first twenty-four hours of life. Furthermore, health education should cover safe sex, avoidance of shared sharp instruments, and the importance of completing the full vaccination schedule for household contacts.