How to Handle Herpes and Pregnancy

Genital herpes is a sexually transmitted infection. This means that it can be passed along to another person through sexual contact. This includes genital sex, oral sex, and anal sex. Pregnancy does not protect you from getting herpes, and it can be dangerous to your baby.

Types of Herpes

While it was previously considered more common for herpes simplex virus type 1 (HSV-1) to cause cold sores on the lips—also known as fever blisters—and herpes simplex virus type 2 (HSV-2) to cause genital herpes (genital area, anus, thighs, etc.), both strains can cause infections in either area of the body. Both forms of HSV stay in your body forever, and symptoms can recur. But with a strong immune system, they remain in a dormant state. HSV-1 typically recurs less frequently than HSV-2.

When the virus is dormant, you are not showing outward signs of infection. Although it is rare, some people will shed virus and be contagious even when asymptomatic.

Symptoms of Herpes

Symptoms vary widely and may go unnoticed because the person doesn't recognize the symptoms of herpes. 

• Itching or burning feeling in the genitals or anal area
• Pain in the genital area
• Discharge of fluid from the vagina
• Lesions on the cervix or in the vagina
• With the first outbreak, you may have flu-like symptoms as well.

Usually, once you've been exposed you will get sores within 2 to 10 days. These symptoms can last 2 to 3 weeks. After this initial outbreak, future outbreaks, which may come a couple of times a year or not at all, may be less severe.

Genital Herpes Treatments

Currently, there is no cure for herpes. Once you have it, you will always have it, though there are medications that can lower your risk of future outbreaks. These medications have not been shown to increase the risk of birth defects when taken in pregnancy:

• Acyclovir (Zovirax)
• Valacyclovir (Valtrex)

Herpes Outbreaks in Pregnancy

Herpes while pregnant takes some management. If you have your first outbreak of herpes in pregnancy, it is possible to transmit herpes to your baby. This means that your baby may be born prematurely or even die. However, if you have had outbreaks before and you are simply having a recurrence, this is generally not a risk for your baby unless you have an active genital lesion at the time of delivery.

During an active herpes episode, whether the first episode or a repeat one, you should follow a few simple steps to speed healing and avoid spreading the infection to other places on the body or to other people.

• Don't touch the sores.
• Keep them clean and dry.
• Do not have sexual contact with anyone until you are completely healed.
• Wash your hands frequently.

Herpes Outbreaks Near Labor

If you are symptom-free and you go into labor, this will not change your plans for labor. The only risk of being infected is if you have an outbreak and the baby comes into contact with the active sore during the birth. This would be a reason to do a c-section. Talk to your doctor or midwife about watching for signs of an outbreak to prevent neonatal herpes.