Herpes and pregnancy: What you need to know

Genital herpes can lead to complications during pregnancy, since the virus can be passed to the baby during labor and birth. If you or someone you know has herpes and is expecting or trying to get pregnant, read on to learn some important information about herpes and pregnancy. 

How can the herpes virus be passed to a baby?

Although a woman is most likely to pass herpes to her baby if she has a genital herpes outbreak for the first time during pregnancy, herpes can be passed to the baby any time there is an active infection.  

Genital herpes can be passed to a baby in three ways: 

  1. Before birth (intrauterine herpes): Although rare, the herpes virus can be passed to the baby in the uterus.
  2. During labor and birth (birth-acquired herpes): This usually happens when a baby passes through an infected birth canal, and it’s the most common way babies become infected with the herpes virus. Though it’s rare, a baby can also be infected without passing through the birth canal.
  3. After birth: The virus can be passed to the baby after birth by the mother or another person. For example, if a person with a herpes sore on their lip kisses the baby, the virus can be passed to him or her. In rare cases, the herpes virus may be spread by touch if someone touches an active cold sore and then immediately touches the baby.

What pregnancy complications can herpes cause?

There are several complications that herpes can cause during pregnancy, including:

  • Premature birth
  • Miscarriage
  • Neonatal herpes (babies up to 28 days old infected by herpes): This is a rare but life-threatening disease. Neonatal herpes can cause eye or throat infections, damage to the central nervous system and even death.

How should genital herpes be treated during pregnancy?

How genital herpes is handled during pregnancy depends on the woman’s history with herpes, as well as whether there are signs of an active infection at the time of birth.

Women who have previously experienced a herpes outbreak will need to communicate this to their healthcare provider. The healthcare provider will carefully monitor her for any signs of an outbreak throughout her pregnancy.

For women taking antiviral drugs for herpes, they will need to consult with their healthcare provider as to whether they should continue doing do during their pregnancy.

Women who have their first genital herpes outbreak during pregnancy and those who get outbreaks frequently may be treated with an antiviral medicine during the last month of pregnancy. This medicine may help prevent an outbreak around the time of birth.

If there aren’t any signs of an active infection, a vaginal birth may be safe. However, for those who do have an active infection, a cesarean birth (C-section) is typically performed as a precautionary measure to help prevent the herpes virus from being passed to the baby.

Which babies are most at risk? 

Babies are most at risk of contracting neonatal herpes if the mother contracts genital herpes for the first time late in pregnancy. This is because a newly infected mother doesn’t yet have protective antibodies against the herpes virus. Also, a new herpes infection is usually active, which means there’s good chance that the herpes virus will be present in the birth canal during delivery.

Women with an older herpes infection (whether the initial infection occurred early in their pregnancy or they had genital herpes before getting pregnant) have antibodies against the virus that help protect the baby.

Protecting the baby after birth

A baby can get neonatal herpes in the first eight weeks after birth, and infections are almost always passed on to babies when they are kissed by an adult with a cold sore. For this reason, anyone with a cold sore needs to avoid kissing the baby and wash their hands before touching the baby.

It’s extremely important to monitor babies for herpes symptoms several weeks after they are born. Neonatal herpes symptoms can include:

  • Blisters on the skin
  • Fever
  • Tiredness
  • Irritability
  • Lack of appetite

While these are also symptoms of a variety of mild illnesses, if you or someone else who has been around the baby has genital herpes, it is always better to be safe than sorry. If your baby is experiencing any of these symptoms, see your pediatrician as soon as possible. 

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