Genital Herpes: how it could affect you and your baby during pregnancy
When you are pregnant (or thinking of becoming pregnant) and looking forward to the joys of imminent parenthood, the last thing you want to be worrying about is a sexually transmitted infection (STI).
It goes without saying that precaution should always be exercised to prevent against the risk of disease as a result of unprotected sex; but, mistakes do happen and infections can be passed on. Genital herpes is caused by a virus which is transmitted by skin contact with the affected area of a person who has it. It is rarely a problem for expectant mothers who have had it before pregnancy.
Recurrences of genital herpes during pregnancy do not affect the unborn baby, but those caught during pregnancy can be more serious in regards to the baby’s health, particularly in the last trimester.
For most women affected, a normal birth can be expected. If you are pregnant and have had genital herpes, or think you may be at risk of genital herpes, ensure to contact your doctor or a health professional, who should give you all the information you need.
What if I had genital herpes before I got pregnant?
Before you even thought about having a baby, there could have been an occasion where unprotected sex left you with a case of genital herpes, which is particularly common amongst those aged 20 to 24. Though the health of a future baby may not be the first thing that comes to mind, especially if you are young and not planning on becoming pregnant, it is important to realise that the effects of some STIs can matter. Your midwife will advise you on what tests are routinely done for pregnant women.
Fortunately, herpes simplex is usually of little risk to your baby, especially if you have kept yourself in good health; your body, in all its wonder, has a great ability of being able to defend itself. A full term baby will have all the same antibodies that you do, which will protect the unborn child through the birthing process and for a time afterwards. Yet, these protective proteins which are produced by your body when you catch herpes simplex need several months to be at their most effective, so the longer ago the case of infection, the less risk there should be.
If you have any concerns about previous cases of STIs and how they could affect your pregnancy, be sure speak to your doctor or midwife.
When genital herpes matters
If you are experiencing multiple outbreaks of genital herpes during your pregnancy, you can take a course of antiviral medication, such as aciclovir, in the later stage of pregnancy until birth. Catching genital herpes during pregnancy, however, can be serious, and the level of risk of infecting your baby depends on what trimester of pregnancy you are at.
During the first trimester (up to the 13th week), contracting this STI could pose a risk of infection or, more seriously, could trigger a miscarriage. Though this risk may be small, antiviral treatment should be prescribed to prevent such eventualities.
Getting genital herpes for the very first time in the third, and final, trimester (from the 27th week of pregnancy onwards), increases the risks for your baby, with a 40% risk of infection when the baby is born. As the birth comes closer, the body doesn’t necessarily have enough time to provide the antibodies needed to protect the baby, though by this point the baby has protective proteins of its own to help fight against infection.
In such circumstances, appropriate antiviral treatment can be taken and a Caesarean delivery may be suggested to avoid the infection spreading by vaginal birth. In the very rare possibility that the baby is infected at birth (neonatal herpes), the skin, brain and various organs may be affected. Less severe cases can be treated with antiviral medication, but more serious cases can be fatal. Only 12 babies - of the three quarters of a million born every year - will catch herpes simplex during the birthing process per year.
In most women, genital herpes can lie dormant for years without giving you too much, if any, hassle. If it becomes active again, it can be successfully treated with antiviral medication. When the life of your unborn baby could be at risk - however low - from catching this infection during pregnancy, you should endeavour to keep in good health, use suitable contraception (if you don’t have it, but your partner has had genital herpes) and take the recommended treatment if it is needed.
As stated by NICE guidelines, and affirmed by Marian Nicholson, Director of the Herpes Viruses Association (HVA), most women affected should experience no problems in birth, even with recurring outbreaks of genital herpes.
Many thanks go to Marian Nicholson for her assistance in this post.