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Herpes During Pregnancy
What does herpes mean for your pregnancy and baby?
Women who experience genital herpes during pregnancy generally have normal births and healthy babies. However, there is a small risk of complications if you have herpes while you're pregnant. The risk depends on what stage of pregnancy you are at and whether you have had attacks of genital herpes before.
Your midwife, GP, local genitourinary medicine (GUM) or sexual health clinic can give you advice if you are pregnant and think you may have genital herpes.
Last reviewed: 16-04-2020 by Dr Simran Deo
Herpes during pregnancy
The severity of your symptoms may vary depending on whether you have had attacks before and how far into your pregnancy you are.
If you have already experienced a genital herpes attack before you got pregnant, you will have developed antibodies to the herpes virus. Therefore, the risk to your unborn baby is very low as these antibodies will protect your baby from the virus.
If you have your first attack of herpes during the first trimester of pregnancy (the first three months) then this carries a small risk that you will miscarry. There is also an increased risk that you will pass the virus on to the foetus.
If you contract genital herpes at a later stage of pregnancy, the risk of passing the virus on to your unborn baby is higher. The risk is particularly high if you have a herpes attack around six weeks or less before you are due to give birth.
What are the symptoms?
Genital herpes is a common sexually transmitted infection. It is caused by the herpes simplex virus and there are two types:
- type 1 (HSV-1)
- type 2 (HSV-2)
The main symptoms of herpes during pregnancy are:
- outbreaks of sores or blisters in the genital area
- sores and blisters that sometimes also appear around your bottom or your thighs
Both types of virus can cause genital herpes but can also cause cold sores (sore, flaky and itchy patches) on and around the mouth.
Once you have had the first attack of herpes, the virus stays inside your body. It can become active again at any time after the first episode and people can suffer repeated outbreaks, although these are often not as severe as the first time.
How is it transmitted?
You can get genital herpes through contact with an infected person in the following ways:
- skin-to-skin contact with an area of affected skin
- foreplay, including oral sex
- sexual intercourse - including vaginal penetration and anal sex
- sharing sex toys with someone infected with the virus
Is it dangerous to have herpes during pregnancy?
Although many women who have herpes during pregnancy go on to deliver healthy babies, the virus can cause some problems while you are pregnant. There is also a risk that the virus could be passed on to the baby while you are giving birth.
If you develop genital herpes for the first time within the first 26 weeks of pregnancy (through the first or second trimester of pregnancy), you could be at a higher risk of miscarrying. The risk of passing the virus on to your unborn baby is also high.
If you experience a herpes attack for the first time after week 27 (the third trimester of pregnancy) then the risk of passing the infection to the foetus is much higher. To prevent passing the virus on to your baby, you may be advised to have a caesarean section. This removes the risk of passing the virus on to the baby during a vaginal birth.
If you have active genital herpes blisters or sores present and you give birth vaginally, there is a high chance of passing on the virus to your baby.
Can you get tested during pregnancy?
Genital herpes tests are not invasive and are safe during pregnancy. The risk of complications through leaving the virus untreated is significant so if you are pregnant and think you may have symptoms of herpes, visit your doctor or local GUM or sexual health clinic.
If you have symptoms of herpes, the most common test is a viral culture, where fluid or cells from the active sore are sent to the lab to be tested.
If you don’t have symptoms, a blood test can determine if you have the virus that causes genital herpes.
Can my baby get herpes?
The closer to birth that you contract genital herpes, the greater the risk to your baby. Although it is rare, it can be very serious if the baby contracts the herpes virus. This is known as neonatal herpes.
Symptoms of neonatal herpes include blisters on the skin, irritability, tiredness, and a loss of appetite. These symptoms can appear up to four weeks after birth and need immediate medical attention.
Are there treatments available that are safe during pregnancy?
If your first ever episode of genital herpes occurs while you’re pregnant, an antiviral medicine called aciclovir may be used to treat the virus before your baby is born. This medicine has not been shown to pose any risk to the unborn baby.
If you get an attack during pregnancy and this is not the first time you have suffered from genital herpes, aciclovir may be used to treat the virus from week 36 to clear it up and reduce the risk of passing it on to your baby when it is born.