Genital herpes in pregnancy

If you have a herpes simplex 2 (or even herpes simplex 1 or both) diagnosis, and are pregnant, you are probably concerned about passing the herpes virus on to your baby, which is a fair worry. A baby can get pretty sick if it has the herpes virus, as its immune system is so underdeveloped at that point.

Contracting herpes during pregnancy

If you catch herpes during pregnancy, there is a risk your baby could catch it too, albeit small. This is called neonatal herpes. Usually your body has time to make antibodies to herpes simplex prior to giving birth, and immunity is passed on to your baby before it’s born.

This applies even if you have a breakout of herpes sores late in your pregnancy, and even if it’s still active while you give birth. Although this situation will be more painful for you (as if you need any more of that), it it usually fine. Neonatal herpes, however, can be fatal, so make sure you tell the people who are caring for you during your pregnancy so they can act appropriately.

If you contract herpes during your first trimester, it may lead to miscarriage. This is rare, so don’t panic, but it’s possible. If you are infected in the first trimester your doctor may give you antivirals, aciclovir, to reduce your symptoms and speed up resolution. Aciclovir is thought to be safe to use during pregnancy, but as with all medications, it’s better to stay away if you can.

Second and third trimester infections, particularly in the last six weeks, are more risky because your body may not have had enough time to make antibodies to the virus, meaning none can be passed on to your baby. Your baby can catch the virus during birth from an open sore.

I already have herpes

Most babies are born healthy, unless you have an outbreak at the time of birth. This would need to be considered by your health care practitioners.

What is neonatal herpes?

Neonatal herpes is when newborn babies are infected with their mother’s herpes virus during birth. Most recover well if they have the infection in their skin, eyes or mouth, because these are pretty easy to treat. It’s when the infection affects the baby’s nervous system or organs that the problems arise.

Treatment for herpes works, but damage, particularly to nerves, may remain. Occasionally babies die from neonatal herpes, but it certainly isn’t the norm. Usually this occurs when mothers don’t know they have herpes.

Should I have a C-section?

If you become infected early on in your pregnancy, you are usually given aciclovir every day for the last four weeks of pregnancy, and you should be able to have a vaginal birth. The transmission rate is extremely low in this case, even if you have a breakout during labour.

Speeding up your labour is also an option to reduce transmission possibilities. This is because you will have had a chance to make antibodies, making your baby immune.

If you get your first attack during your pregnancy, particularly later on, you may need a caesarean section. If you have a breakout for the first time in the last trimester, make sure you tell your health care providers, so they can do tests on your blood and sores to see if it really is your first attack.

You may have already had an attack without realising, which means you will already have antibodies. Otherwise a planned C-section will probably be planned.

The vaginal birth, and strategies to avoid infecting your baby

Your doctor or midwife will do as little as possible to interfere with labour, and avoid breaking your waters. Additionally, less-invasive testing methods will be preferred, such as taking blood samples or using electrodes on the baby’s head.

Aciclovir may be used via drip during labour to reduce the baby’s chances of catching herpes, and they may also give the baby aciclovir after birth.

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
Read more about Jessica and My Vagina's origin story.
Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

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