It is every mother’s wish to have a healthy baby. Mother-to-child transmission is the main cause of chronic hepatitis B virus (HBV) infection in China, so prevention for infants and children is emphasized. All pregnant women need prenatal screening for hepatitis B serologic markers (commonly known as hepatitis B two-and-a-half). If a pregnant woman is positive for hepatitis B surface antigen (HBsAg), her newborn is at high risk for HBV infection and must be properly blocked from mother to child. Newborns of HBsAg-positive mothers should be injected with hepatitis B high-valent immunoglobulin (HBIG) at a dose of ≥100 IU as early as possible within 24 h after birth (preferably 12 h after birth), and 10 μg of recombinant yeast hepatitis B vaccine should be administered at different sites, and the second and third doses of hepatitis B vaccine should be administered at 1 and 6 months of age, respectively, to significantly improve the effect of interruption of mother-to-child transmission. HBV DNA levels are the most critical factor influencing mother-to-child transmission of HBV. in addition to intramuscular HBIG and hepatitis B vaccination after birth, the application of oral antiviral drugs to this group of mothers in the middle and late stages of pregnancy (see below for details) can (See below for details.) This can reduce the prenatal serum levels of HBV DNA in pregnant women and improve the success rate of mother-to-child interruption in newborns. Pregnancy-related management of patients with chronic hepatitis B who have fertility requirements should be treated with interferon or nucleoside (acid) analogs (NAs) prior to pregnancy, if indicated for treatment, with a view to completing treatment in the first 6 months of pregnancy. Reliable contraception should be used during treatment. For patients with hepatitis B exacerbations during pregnancy, mild elevations in transaminases can be closely observed. For more severe liver lesions, antiviral therapy with tenofovir (TDF) or telbivudine (LDT) can be used after full communication with the patient and weighing the pros and cons. For patients with unintended pregnancy during antiviral therapy, termination of pregnancy is recommended if interferon therapy is applied. If oral NAs drugs are applied: if the drugs applied are pregnancy class B drugs (LDT or TDF) or lamivudine (LAM), treatment can be continued with full communication and weighing the pros and cons; if the drugs applied are entecavir (ETV) or adefovir (ADV), with full communication and weighing the pros and cons, treatment needs to be continued by switching to TDF or LDT and termination of pregnancy is not recommended. High serum HBV DNA load in pregnant patients is one of the high-risk factors for mother-to-child transmission. Standard hepatitis B immunoprophylaxis for newborns and effective antiviral therapy for mothers can significantly reduce the incidence of mother-to-child transmission of HBV. If the HBV DNA load is greater than 2×106 IU/ml in mid- to late pregnancy, TDF, LDT or LAM can be given from the 24th to 28th week of gestation after full communication with the patient and weighing the pros and cons. It is recommended to stop the medication 1–3 months after delivery and breastfeeding is possible after discontinuation. With the right measures, mothers with hepatitis B can still have healthy babies.