What if I'm pregnant and I get genital herpes?
A specialist will normally advise about what to do if you develop genital herpes whilst you are pregnant, or if you have recurrent genital herpes and become pregnant. This is because there may be a chance of passing on the infection to your baby.
A first episode of genital herpes whilst you are pregnant
If you develop a first episode of genital herpes within the last six weeks of your pregnancy, or around the time of the birth, the risk of passing on the virus to your baby is highest (there is about a 4 in 10 chance). The baby may develop a very serious herpes infection if he or she is born by a vaginal delivery.
Therefore, in this situation your specialist is likely to recommend that you have a caesarean section delivery. This will greatly reduce the chance that the baby comes into contact with the virus (which is mainly in the blisters and sores around your genitals). Infection of the baby is then usually (but not always) prevented.
However, if you decide against a caesarean and opt for a vaginal birth, the specialist is likely to recommend that you be given antiviral medication (usually aciclovir). This is given into your veins (intravenously) during your labour and birth. They may also suggest that antiviral medication should be given to your baby after he or she is born.
If you develop a first episode of herpes infection during the first stages of your pregnancy, there is not thought to be any extra risk of miscarriage or of abnormalities in the baby.
As long as there are two months between you catching the virus and the birth of your baby, a normal vaginal delivery is likely to be safe for the baby. This is because there will be time for your body to produce protective proteins called antibodies. These are passed on to the baby through your bloodstream to protect it when it is being born. The specialist may advise that you should be treated with antiviral medication at the time of infection. This helps the sores to clear quickly. In addition, your doctor may advise that you should take antiviral medication in the last four weeks of pregnancy to help prevent a recurrence of herpes at the time of childbirth. Antiviral medicines such as aciclovir have not been found to be harmful to the baby when taken during pregnancy.
If you have recurrent genital herpes and become pregnant
If you have recurring episodes of genital herpes, the risk to your baby is low. Even if you have an episode of blisters or sores during childbirth, the risk of your baby developing a serious herpes infection is low. This is because you pass on some antibodies and immunity to the baby during the last two months of pregnancy.
For most women with recurrent genital herpes, it is felt to be safe to have a normal vaginal delivery. This is even the case if you have a recurrence whilst giving birth. However, you and your specialist will weigh up the pros and cons of vaginal delivery vs caesarean section. If you do have a recurrent episode when you go into labour, you should discuss your options with your specialist and together decide the best way that your baby should be delivered.
Often antiviral medication will be advised in the last four weeks running up to childbirth. This may help to prevent a recurrence of blisters during childbirth. Again, your specialist will be able to advise on the pros and cons.
A first episode of herpes around the time of birth can be serious for the baby and a caesarean section is usually advised. In any other situation - an earlier primary infection or a history of recurrent episodes - the risk to the baby is low and your specialist will advise on possible options.
Did you find this information useful?
- Herpes simplex - genital; NICE CKS, September 2012 (UK access only)
- 2014 UK National Guideline for the Management of Anogenital Herpes; British Association for Sexual Health and HIV (2014)
- Management of Genital Herpes in Pregnancy; British Association of Sexual Health and HIV and Royal College of Obstetricians and Gynaecologists (Oct 2014)
- 2017 European guidelines for the management of genital herpes; International Union against Sexually Transmitted Infections (IUSTI) (2017)
- 2015 Sexually Transmitted Diseases Treatment Guidelines - Genital Herpes; Centers for Disease Control and prevention CDC, (2015)
- Hollier LM, Wendel GD; Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus (HSV) recurrences and neonatal infection. Cochrane Database Syst Rev. 2008 Jan 23 (1):CD004946.
- Kang SH, Chua-Gocheco A, Bozzo P, et al; Safety of antiviral medication for the treatment of herpes during pregnancy. Can Fam Physician. 2011 Apr 57(4):427-8.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.