Herpes in Pregnancy

In some cases herpes is transmitted to infants at the time of delivery if the baby comes into direct contact with herpes on the way through the birth canal. Herpes infections in newborns are rare, but they can be life-threatening. For this reason, pregnant women and their partners are well-advised to take steps to keep this risk to a minimum.

If you already have genital herpes: If you had genital herpes before you became pregnant, your risk of transmitting the infection to your baby during childbirth is very low as long as no active herpes signs or symptoms are present in or near the birth canal at the time of delivery.

If no signs or symptoms of herpes are present when you go into labor, you can expect to have a normal vaginal birth. Women who have long-standing herpes infections transmit protective antibodies to their fetuses during pregnancy. The antibodies help to protect the baby from an infection, even if some virus is present in the birth canal.

If you do have signs or symptoms of herpes when you start labor, your doctor will deliver your baby by cesarean section (abdominal delivery). This will protect your baby from exposure to the large quantities of virus that are likely present in the birth canal or on the skin during a herpes outbreak.

If you do not have genital herpes: If you have never had genital herpes, you will need to take steps to ensure you do not get the infection during your pregnancy. A woman who gets herpes for the first time while pregnant has a significant risk of transmitting the virus to her baby during childbirth. One reason for this is the relatively high rate of viral shedding in the first six months after acquiring infection. Another is the fact that the mother will not have developed her immune response to herpes, including the antibodies that are passed to the fetus in the uterus.

If your husband or partner has genital herpes and you don't, your doctor may recommend that you use condoms every time you have intercourse throughout your pregnancy. In addition, your doctor may recommend that you abstain from intercourse during your last trimester, which is the most dangerous time to develop a first-episode infection. If you have questions about whether you or your partner are infected, a type-specific blood test can tell you.

If you become infected in the first trimester, vaginal delivery may still be possible. With a new infection after the first trimester, however, your doctor will deliver your baby by cesarean section whether or not active herpes signs or symptoms are present at the time of delivery. Your doctor also may recommend antiviral medication during pregnancy.

How Can a Blood Test be Used During Pregnancy?

Because the highest risk of neonatal herpes occurs when a woman acquires herpes during pregnancy, some experts advocate testing to find out whether a woman is at high risk. Those in the high-risk category are women who test negative for HSV-1 and HSV-2 but have a partner who has herpes. Therefore, a woman who tests negative will need her partner’s cooperation as well.

What Are the Signs of Herpes in a Newborn?

Skin sores, fever, listlessness and lack of appetite are among the early symptoms or neonatal herpes. Without prompt treatment, brain or nervous system damage may occur, and some babies will die from this infection.

While herpes infection can be devastating to a newborn, it is rare. Nearly one in every three women of childbearing age in the United States today has the virus that causes genital herpes. Yet fewer than 1 in every 2,000 newborns develops the infection. Good prenatal care may reduce this already small risk even further.