Help! I have herpes and I am pregnant!

First, take a breath. Herpes is very common especially in reproductive age women. Though there is a chance for transmission between mother to baby there are step to take to minimize this risk.

Herpes virus includes HSV-1 (herpes simplex virus 1) and HSV-2 (herpes simplex virus-2). Traditionally, HSV-2 is considered the genital form of herpes but often, HSV-1 can be found in genital sores as well. Again, the herpes virus is found very commonly in the United States. Roughly 12% of the population between 14-49 years old are HSV-2 positive. There are over 500,000 new genital herpes infections diagnosed every year. There are likely more people infected but not everyone has signs or symptoms.

HSV is transmitted when there is contact with a herpes sore on the genitals or mouth. Even if a sore is not visible HSV can be transmitted between partners.

The first time herpes sores are noticed (first ‘outbreak’) is called a primary infection. Repeat episodes of herpes sores are called recurrent herpes.

Most people with HSV have no symptoms or have mild symptoms that are often missed. When sores do appear they can occur in clumps of sores or a single sore. They are usually found around the genitals, rectum or mouth. They look like small blisters and can be very painful. The sores take about 2-4 weeks to heal.

Neonatal herpes (infant herpes) can be very serious and cause life-threatening complications for a newborn. When meeting your doctor for your pregnancy make sure to let them know you have had herpes in the past. Herpes can be passed from mother to child during the pregnancy or during childbirth. If the primary infection occurs close to delivery the risk to the baby is greater than if there is a recurrent infection.

To decrease the risk of a herpes outbreak close to delivery, most pregnant woman are offered an antiviral medication starting around 36 weeks of pregnancy. This is taken by mouth daily until birth. If there are lesions at the time of birth a cesarean section may be offered instead of a vaginal birth.

Though the steps above can reduce the risk of herpes transmission between mother and baby, no intervention eliminates all risk. The main thing to remember is that the complications from herpes are still rare and neonatal herpes infection only impacts about 22 births out of 100,000. Discuss the possible risks of herpes infection to your pregnancy with your doctor.

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