Genital herpes and pregnancy

Genital herpes is a sexually transmitted disease (also called STD). An STD is a disease you can get from having sex with someone who has the disease. You can get an STD from vaginal, anal or oral sex. Most people get genital herpes from having sex with an infected person, but it’s possible to get it without having sex. 

Genital herpes is caused by a virus. When you’re infected, small, red bumps may develop in the area where the virus first entered your body, like the vagina or mouth. These bumps can become blisters that break, leaving behind painful sores (also called ulcers). 

About 1 in 5 (20 percent) women in the United States has genital herpes. 

Can genital herpes cause complications during pregnancy?

Yes. Genital herpes can lead to:

  • Premature birth. This is birth that happens too early, before 37 weeks of pregnancy. 
  • Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.

You can pass the herpes virus to your baby during labor and birth. This can cause serious health problems for a baby, including a deadly infection. You can pass genital herpes to your baby in three ways: 

  1. Before birth (also called intrauterine herpes). You pass the virus to your baby in the uterus (also called the womb). This kind of herpes is rare.
  2. During labor and birth (also called birth-acquired herpes). This usually happens when a baby passes through an infected vagina (also called birth canal). It’s the most common way babies get infected with the herpes. A baby can get infected without passing through the vagina, but this is rare. It can happen if the amniotic sac breaks before birth. This is the sac (also called the bag of waters) inside the uterus that holds your baby. It’s filled with amniotic fluid.
  3. After birth. You or another person can pass the virus to your baby after birth. For example, if you have a herpes sore on your lip and you kiss your baby’s skin, you can pass the virus to her. 

You’re most likely to pass herpes to your baby if you have a genital herpes outbreak for the first time during pregnancy. But you can pass herpes to your baby any time you have an active infection.  

How is genital herpes treated during pregnancy?

There is no cure for genital herpes. If you’ve had it before, your provider checks you carefully for any signs of an outbreak during pregnancy.

If you had your first genital herpes outbreak during pregnancy, or if you have outbreaks often, your provider may treat you with an antiviral medicine called acyclovir (also called Zovirax® Injection or acycloguanosine) during the last month of pregnancy. This medicine may help prevent an outbreak around the time you give birth.

If you don’t have signs of an active infection, it may be safe for you to have a vaginal birth. But if you have an active infection, you usually need a cesarean birth (also called c-section). Having a c-section may help prevent you from passing the herpes virus to your baby. Cesarean birth is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.

How do you know if you have genital herpes? 

Most people with genital herpes have no signs or symptoms and may not know they have it. Signs and symptoms may develop within 2 weeks of getting infected. If you have any of these signs and symptoms, tell your health care provider: 

  • Body aches 
  • Burning feeling when you urinate
  • Clusters of small, red sores or blisters in the genital area, the anus or the mouth 
  • Fatigue (feeling very tired)
  • Feeling pressure in the area below your belly
  • Fever
  • Itching, burning or tingling feeling in the genital or anal area
  • Nausea (feeling sick to your stomach)
  • Swollen glands
  • Vaginal discharge or bleeding between periods

To diagnose this infection, your health care provider may use these medical tests:

  • Physical exam to look for sores
  • A swab of fluid and skin cells from the sores
  • Blood test to check for the antibodies that the body makes to fight the virus that causes genital herpes

Once you have genital herpes, the virus that causes it never leaves your body. If you have an active infection, you may have outbreaks of sores and blisters a few times each year. Or you may not have symptoms at all; this is called a silent infection. Over time, outbreaks tend to happen less often and be less severe. Taking medicine every day may help manage symptoms, prevent outbreaks for a long time and lower your chances of passing the virus to others. 

A herpes outbreak can be caused by: 

  • Being sick
  • Fatigue
  • Fever
  • Having sex
  • Having your period
  • Stress

How does genital herpes spread?

Genital herpes is caused by two viruses called herpes simplex viruses (also called HSVs):

  1. HSV-1. This virus usually causes cold sores and fever blisters on the mouth and lips. The virus spreads from the mouth to the skin
  2. HSV-2. This virus causes most cases of genital herpes. It spreads through sex and skin-to-skin contact.

Fluid in genital herpes sores carry the herpes virus. Your skin also can release the virus, even if you don’t have a sore you can see. 

If you have direct contact with an infected person’s sores or skin, the herpes virus can pass into your body through a break in your own skin. If you touch a herpes sore or the fluid from a sore, you can spread herpes from one part of your body to another. For example, if you touch a herpes sore on your lips and then rub your eye, you can spread the herpes infection to your eyes. If you do touch a herpes sore, wash your hands right away to help avoid spreading the infection.

Can genital herpes cause other health problems for you?

Yes. Genital herpes can cause health problems, including:

  • Bladder problems. The open sores caused by genital herpes can cause the urethra to swell. The urethra is the tube that carries urine out of the body from the bladder. The swelling can cause the urethra to close for several days. A tube called a urinary catheter can be used to drain and collect urine from the bladder until the urethra opens.
  • Meningitis. The herpes virus can cause meningitis, an infection that causes swelling in the brain and spinal cord.
  • Other STDs. Having open sores can make it easier for you to catch or pass on other STDs, including the human immunodeficiency virus (also called HIV).
  • Proctitis. This is inflammation (redness and swelling) of the lining of the rectum, where bowel movements leave the body. 

How can you protect yourself from genital herpes?

Here’s what you can do:

  • Get tested and treated. If you find out you have genital herpes, get treated right away. If you or your partner has an untreated infection, you can pass it back and forth to each other. Taking an antiviral medicine may help prevent you from passing the virus to each other. 
  • Don’t have sex. This is the best way to prevent yourself from getting an STD, including genital herpes.
  • If you have sex, have sex with only one person who doesn't have other sex partners. Use a condom if you’re not sure if your partner has an STD. Ask your partner to get tested and treated. If you know you or your partner has genital herpes, use condoms and dental dams every time you have sex. A dental dam is a square piece of rubber that can help protect you from STDs during oral sex. If you or your partner has a herpes outbreak, don’t have sex (even with a condom or dental dam) until all sores have healed. 

See also:
 Herpes and your baby 

Last reviewed: August, 2014