Genital herpes in pregnancy

Women who become infected with herpes before pregnancy, or in the first three months of pregnancy, only rarely infect their child with it. One big study found that 1 out of 100 babies became infected during childbirth.

Pregnant women who have genital herpes should talk to their doctor about it. He or she can then check the skin for signs of an outbreak shortly before the birth. It’s also important to tell the doctor if there are any early signs of an outbreak, such as tingling in the genital area, around the time of the birth. If there are no signs of an outbreak, there’s no reason why the woman shouldn't give birth naturally. If there are, she is usually advised to have a Cesarean section. This greatly lowers the risk of infecting the baby.

It is estimated that about 13 out of 100 pregnant women who have genital herpes have an outbreak at the time of the birth. The risk of this happening can be reduced by preventive treatment with antiviral medication, which is then taken every day from 35 weeks of pregnancy until the birth. This also increases the chances of the woman being able to have a natural birth. Research has found that Cesarean sections were carried out in

• 13 out of 100 people who didn’t have preventive treatment with antiviral medication, compared to
• only 4 out of 100 women who did have preventive antiviral treatment.

In other words, the use of medication meant that 9 out of 100 pregnant women with genital herpes didn't have to have a Cesarean section because of an acute outbreak.

The drug acyclovir is generally used for this purpose because it is the drug that doctors have the most experience with. Studies haven’t found any evidence that it harms the baby.

Women can decide for themselves whether or not they would like to take medication to prevent a herpes outbreak: Some women really don’t want to take any medication while they are pregnant. Others would really like to give birth naturally if possible. And some trust that everything will go well, even without preventive treatment.

If women become infected with genital herpes in the last three months of pregnancy, the virus is passed on to their baby in about 30 to 50 out of 100 births. Because of this risk, women who get genital herpes in the last trimester of pregnancy usually have a Cesarean section in order to protect the child. It’s also a good idea to talk with a doctor who is specialized in the treatment of infectious diseases.

In order to prevent infection in the last three months of pregnancy, it’s best to avoid sex with people who have (or could have) genital herpes. This is also true when it comes to oral sex with people who have cold sores.

Because initial outbreaks of genital herpes usually cause more severe symptoms, they are often treated with acyclovir in pregnant women, too. If the symptoms are particularly severe, the medication can be given intravenously (through an IV drip).

After that, further outbreaks are normally a lot milder, so antiviral drugs are often no longer used. But medication may be considered if the symptoms are severe or if complications arise.