✓ Avoiding sex during an outbreak
Genital herpes is easily spread during skin-to-skin contact, so avoid sexual contact until the sores have gone away, and if you get outbreak symptoms like tingling and itching.
Genital Herpes and Pregnancy
Medically reviewed by
Dr Clair GraingerLast reviewed: 02 Jan 2026
Genital herpes is a common sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). There are 2 main types of HSV that can cause genital herpes: HSV-1 and HSV-2. Both are spread via skin-to-skin touching during oral, vaginal, and anal sex. There is no cure for herpes, so once the infection is in your body, it will stay there for life, and you may get periods where you have no symptoms followed by an outbreak.
Genital herpes can be managed with a combination of antiviral medications and self-care measures, but it can cause complications during pregnancy and childbirth if it is not managed correctly.
Here, we discuss the importance of managing herpes while pregnant, how it is spread, and what you can do to prevent genital herpes during pregnancy.
How herpes is transmitted during pregnancy
Herpes is mainly passed to the baby during pregnancy through contact with the virus during a vaginal delivery. It can also be passed on in the womb or after birth through contact with a person who has an active infection.
You can reduce the chance of herpes transmission to baby by recognising the signs and symptoms of an outbreak, such as:
- tingling, burning, or itching in the genital area usually means an outbreak is coming
- small blisters that burst to leave red, open sores around your genitals, anus, buttocks, and thighs
- pain when going for a pee
- abnormal vaginal discharge
- flu-like symptoms (first outbreak)
First-time infection vs recurrent herpes outbreak pregnancy
The key difference between a first and recurrent genital herpes outbreak during pregnancy is the severity of the symptoms. When your first infection happens during pregnancy is also important.
| First-time infection | Recurrent outbreak | |
|---|---|---|
| Symptom severity | Usually more severe, with sore and painful blisters and sores and flu-like symptoms. | Normally milder, may only get minor tingling or itching. |
| Duration | Can last 1 to 2 weeks. | Much shorter, usually a few days. |
| Antibodies | Mother has no antibodies. | Some antibodies offer partial protection. |
| Risks to baby | High chance of passing onto the baby, especially if it occurs in the 2nd half of pregnancy. | Low chance of passing the infection on, as the baby will have some antibodies against the infection. |
| Delivery | C-section may be offered if infection occurs in the third trimester, particularly within 6 weeks of the due date. | Vaginal delivery is possible with antiviral medication from week 32 of pregnancy. |
Risks to the baby
If you have your first outbreak of genital herpes during pregnancy or an outbreak when you give birth, there’s a chance your baby can develop neonatal herpes, a rare but serious condition.
Research has shown that there are around 10 cases of neonatal herpes per 100,000 live births, and if left untreated, there is a 60% chance of infant death.
If you have had genital herpes before, and you do not have symptoms at birth, the chance of your baby developing neonatal herpes is low, around 1%, because you will have passed on protective antibodies via the placenta during pregnancy.
However, if you get genital herpes for the first time during the last trimester, the chance of neonatal herpes is 30 to 50%, because there is not enough time for your immune system to develop antibodies that can protect the baby from HSV.
Discussing the infection with your doctor or midwife is important so that you can get access to antiviral medication if needed and to decide whether it is still safe and recommended to have a vaginal birth. In most cases, it will be, but if you get your first outbreak during the last trimester or particularly within 6 weeks of the expected due date, you may be offered a planned C-section.
Dr Clair Grainger
Online Doctor
Factors that increase or decrease herpes transmission to baby
Several factors can increase HSV-1 and HSV-2 pregnancy risks, such as:
- first infection – higher chance of passing HSV on, especially in the last 6 weeks of pregnancy
- weakened immune system – conditions that weaken the immune system can increase the frequency and duration of outbreaks
- kissing – kissing a newborn baby, particularly if you have cold sores, can cause neonatal herpes
- active outbreak during childbirth – an active genital herpes outbreak during a vaginal delivery can leave the baby exposed to the virus
Some of the things that can reduce the chance of passing herpes on to your baby include:
✓ speaking to your midwife – tell your doctor or midwife if you think you have genital herpes symptoms during pregnancy
✓ taking antiviral medication – getting genital herpes treatment as early as possible can lower the chance of spreading HSV to your baby
✓ using condoms – always use a condom during sex, especially in the third trimester and avoid sex if you or your partner has an outbreak
✓ giving birth via C-section – if you have had your first outbreak in the last 6 weeks of pregnancy, and can be recommended if the outbreak occurs at anytime in the third trimester
✓ getting tested for genital herpes – if you think you may have genital herpes, request an at-home test kit
Treating genital herpes while pregnant
Treating genital herpes during pregnancy focuses on antiviral medication and self-care measures to help manage pain and discomfort. You may be offered aciclovir 400mg tablets to treat a genital herpes outbreak or suppress the virus during pregnancy, depending on your situation. It’s vital that you attend all of your prenatal visits if you have herpes to keep you and your baby safe.
Treatment for managing herpes while pregnant includes:
| Treatment | |
|---|---|
| First infection during the 1st or 2nd trimester | 400mg aciclovir tablets 5 times a day for 5 days |
| First infection during the 3rd trimester | 400mg aciclovir tablets 5 times a day for 5 days |
| Recurrent outbreaks | 400mg aciclovir tablets 5 times a day for 5 days |
You may be offered suppressive aciclovir therapy from weeks 32 to 40 and a:
- vaginal delivery if your first outbreak occurred in the 1st or 2nd trimester, or you have a history of genital herpes
- planned C-section if your 1st outbreak happened in the third trimester
If you are thought to be at higher risk of delivering your baby before 37 weeks, you may be offered suppression treatment from 22 weeks.
Alongside antiviral medication, you can also manage genital herpes outbreaks by:
- applying numbing cream like lidocaine 2% gel (discuss this with your doctor to see if it is appropriate) or petroleum jelly to sores to deal with the pain
- taking paracetamol
- washing your hands before and after touching the affected area, and avoiding touching sores unless applying cream
- pouring water over your genitals when going for a pee
- applying an ice pack wrapped in a towel to the area to relieve pain
- not having sex until the sores have healed and gone away
Preventing herpes
There are several things you can do to stop getting herpes or passing the infection on to others. The most important way to prevent genital herpes is to practice safe and protected sex by always using a condom during oral, vaginal, or anal sex or when using sex toys.
Other ways to prevent herpes include:
✓ Talking to your partner
Be open and honest with your partner about a genital herpes diagnosis or symptoms so you can understand the risks and take preventative measures together.
✓ Taking antiviral medication as prescribed
Antiviral medication can shorten the time outbreaks last for, reduce their frequency, and stop you passing the infection on.
✓ Knowing your triggers and avoiding them
If you know that factors like poor sleep, stress, diet, or sun exposure result in an outbreak, try to avoid the triggers where you can.
✓ Speaking to a doctor
Get advice from a doctor after your first outbreak to get access to antiviral tablets, suppression therapy, and advice during pregnancy.
FAQs
Will I need a C-section because of herpes?
You may be offered a planned C-section if you have your first genital herpes outbreak within 6 weeks of your due date to lower the chance of passing the infection on to your baby. It may also be recommended if you have your first outbreak anytime within the third trimester. However, if you have a history of genital herpes and take antiviral medication to suppress the infection, a vaginal birth may be possible.
Can I prevent herpes outbreaks during pregnancy?
Yes, you can prevent a genital herpes outbreak during pregnancy by taking daily antiviral medication, using a condom every time you have sex or avoiding sex if you have an active outbreak. You should also avoid your triggers, like stress and fatigue, if possible.
Can I take a herpes test while pregnant?
Yes, genital herpes tests are not invasive and are safe to use during pregnancy. The at-home test supplied by Superdrug Online Doctor only requires a swab sample from an active sore.
Is it dangerous to have herpes while pregnant?
Yes, herpes can be dangerous for a baby, especially if you get your first outbreak late in pregnancy or during childbirth, as it can lead to a serious infection called neonatal herpes. If you have a history of herpes before pregnancy, the risk is lower as you will have passed on protective antibodies to your baby, and there are medications available to suppress the infection.
Can having herpes cause miscarriage?
No, there is no increased chance of miscarriage if you have genital herpes.
Do they test for herpes when you get pregnant?
No, testing for genital herpes is not part of any routine screening, but if you have a history of the infection or have symptoms, a doctor will test for it. If you think you may have come into contact with the virus, you should speak to your doctor or midwife about testing.
Sources
- First estimates of the global and regional incidence of neonatal herpes infection, The Lancet [accessed 26 November 2025]
- Genital herpes, NHS [accessed 26 November 2025]
- Genital herpes in pregnancy, Royal College of Obstetricians and Gynaecologists [accessed 26 November 2025]
- Genital herpes: Learn More – Genital herpes in pregnancy, Informed Health [accessed 26 November 2025]
- Herpes simplex - genital: Scenario: First episode, National Institute for Health and Care Excellence [accessed 26 November 2025]
- Herpes Simplex Virus Infection in Pregnancy, Infectious Diseases in Obstetrics and Gynecology [accessed 26 November 2025]
- Mother-to-Child Transmission of Herpes Simplex Virus, Journal of the Pediatric Infectious Diseases Society [accessed 26 November 2025]
- Neonatal herpes (herpes in a baby), NHS [accessed 26 November 2025]