Genital Herpes and Pregnancy
In most cases, a woman with genital herpes can have a normal vaginal delivery. However, neonatal herpes is a potential risk. Severe brain damage and loss of life have been reported in more than 40 percent of newborns infected with herpes. The best way to prevent neonatal herpes is for pregnant women without genital herpes to avoid exposure to the herpes virus near the end of pregnancy.
For most women with genital herpes, pregnancy is no different than in women who do not have genital herpes. In fact, a woman with genital herpes can easily deliver a healthy baby. Most can have a normal vaginal delivery.
However, herpes infection of the newborn (known as neonatal herpes) is extremely serious; therefore, knowing about genital herpes during pregnancy and protecting your baby is extremely important.
Less than 0.1 percent of infants born in the United States each year get infected with genital herpes during birth. Yet for newborns infected with herpes, the consequences are devastating. More than 40 percent die or have severe brain damage. Others may have severe, lifelong disabilities.
Neonatal herpes usually results from exposure of the baby to the virus during delivery. A few cases may result from being kissed by someone with oral herpes. The highest risk for neonatal herpes occurs when the mother first contracts genital herpes during the third trimester of pregnancy. This is because the mother does not have time to build up antibodies.
The main way to prevent neonatal herpes is for pregnant women without genital herpes to avoid exposure to viruses that cause it -- herpes simplex 1 (HSV-1) or herpes simplex 2 virus (HSV-2) -- near the end of pregnancy. A pregnant woman without herpes must not have intercourse with anyone with genital herpes. Similarly, she should not permit oral sex by a partner with oral herpes.
For women who contract genital herpes later in pregnancy, a cesarean section is often recommended (a cesarean section delivers the baby by surgery, so the infant does not pass through the vagina).
Women with longstanding recurrent genital herpes infections are at low risk for transmitting the virus to their babies. A mother who was infected with herpes prior to getting pregnant passes herpes antibodies on to her fetus, protecting it from becoming infected with the virus. After birth, as the baby develops its own immune system, it loses these antibodies. To be safe, however, a cesarean section is often done if a woman with recurrent herpes has an outbreak when she goes into labor.