Key takeaways

  • Herpes affects approximately 2% to 3% of pregnancies in the United States. Transmission from parent to baby is rare, but if it occurs, it can be serious.
  • Antiviral medications, such as acyclovir or valacyclovir, can be prescribed around 35 weeks of pregnancy to reduce the likelihood of a herpes outbreak during delivery.
  • If you have an active genital herpes outbreak when labor begins, a C-section delivery can prevent the transmission of the virus to the baby.

Herpes is a health condition caused by the herpes simplex virus (HSV). Herpes symptoms can be inconvenient, but for most adults, they aren’t dangerous.

But if you have active genital herpes during pregnancy, it’s possible to transmit the HSV to your baby. You’ll need to make a plan with your doctor to prevent that from happening.

With medical care, most people with genital herpes give birth to healthy babies and don’t pass on the virus.

Here’s what we know about having genital herpes when you’re pregnant.

Herpes is a condition caused by the virus HSV. This virus can transmit through contact with someone who has HSV on their skin, or with the fluid that comes from herpes sores.

There are two main types:

  • HSV-1: This type causes sores around the mouth known as cold sores, fever blisters, or oral herpes. However, HSV-1 can also cause genital blisters if transmitted during oral sex.
  • HSV-2: This type causes sores or blisters in the genital area, known as genital herpes. HSV-2 can also cause oral infections through exposure during oral sex.

After you’ve had an initial outbreak of herpes simplex, the virus remains present in your body in a dormant state, meaning it can’t spread to others. However, it may reactivate later on.

It’s estimated that between 2% and 3% of pregnant people in the United States have HSV.

Yes, it can be. While HSV is not dangerous for most adults, there is a small risk that it could pass to the baby during or after delivery.

When newborns contract herpes, it’s known as neonatal herpes or birth-acquired herpes. Neonatal herpes is rare, but when it does happen, there can be serious complications, such as:

  • permanent injury to the baby’s nervous system
  • developmental disabilities
  • death

The level of risk depends partly on the timing of the infection. If you get herpes in the first 3 months of pregnancy, the risk of passing it to the baby is low, at around 1 in 100 births.

The risk is higher if you get an outbreak in the last 3 months of pregnancy, where transmission occurs in 30 to 50 out of 100 births.

Herpes can also transmit to babies after delivery if someone with herpes elsewhere on the skin, such as around the mouth, kisses or touches a newborn.

However, with diagnosis, treatment, and a plan in place, it is possible to prevent.

HSV can be asymptomatic, meaning it may not cause noticeable symptoms. The World Health Organization (WHO) estimates that most people who have new herpes infections have no symptoms.

When symptoms do occur, they may include:

  • tingling, itching, or burning on the skin
  • sores or blisters that eventually break open and ooze a clear liquid before crusting over
  • fever
  • swollen lymph nodes
  • body aches

If you develop a herpes infection for the first time during pregnancy, your symptoms may present as more severe or noticeable than they would outside of pregnancy.

To diagnose herpes, a health professional may take a fluid sample from your genitals using a cotton swab. A laboratory will test the sample for viruses and bacteria.

A doctor may also suggest an antigen blood test, which involves giving a small blood sample.

The American College of Obstetricians and Gynecologists (ACOG) currently does not recommend that every pregnant person receive routine screening for herpes during pregnancy, but your doctor may recommend it if you:

  • know or suspect that a sexual partner has genital herpes
  • notice what could be symptoms of herpes
  • have never been tested for herpes before

If you have genital herpes, a doctor may prescribe an oral antiviral medication, such as acyclovir, valacyclovir, or famciclovir, starting at around 35 weeks.

The drugs can’t cure HSV entirely, but they can help speed up healing if you have an outbreak of genital herpes and reduce the possibility of future outbreaks. This increases the likelihood you’ll be able to give birth vaginally, if that’s what you’d prefer.

As your labor begins, your doctor will carefully check for any genital herpes blisters or sores. If you don’t have any signs of an active outbreak of genital herpes when labor starts, you will probably be able to safely have a vaginal delivery.

If there are genital herpes lesions present during your labor, you will likely need to have a C-section delivery to prevent transmission. Your doctor will discuss your options with you prior to your due date.

While genital herpes is often the most immediate concern for people about to give birth, herpes elsewhere on the skin can also pose a risk to newborn babies after delivery.

For example, if parents, relatives, or visitors with oral herpes kiss a newborn baby, they can potentially transmit HSV. Particularly during the first 8 weeks of life, people who may have herpes should:

  • not kiss the newborn
  • wash their hands before touching a newborn
  • wash their hands before breastfeeding or chestfeeding
  • avoid breastfeeding or chestfeeding if there are sores on the skin
  • cover up herpes sores until they heal

The United Kingdom’s National Health Service (NHS) recommends limiting the number of people who kiss or handle the newborn in general.

If you have concerns that you may have herpes during pregnancy, speak with your doctor as soon as you can, especially if you are in your third trimester.

A doctor can help create a plan you feel comfortable with that will reduce the risk of transmission.

After giving birth, seek immediate medical attention if the baby shows symptoms, such as:

  • fever
  • sores or a rash, including around their eyes or inside the mouth
  • loss of appetite
  • listlessness or tiredness

Be aware that newborns with herpes do not always have the typical blisters or sores.

Below are answers to some frequently asked questions about herpes and pregnancy.

Yes, it is possible to have a vaginal delivery if you do not currently have an active herpes outbreak, especially if you contracted herpes in early pregnancy or before pregnancy.

If you do have active sores or contracted herpes in the third trimester, the risks of a vaginal birth are much higher, but antiviral medication may lower them.

It is your decision whether you tell a healthcare professional that you have herpes, including during pregnancy.

However, it is vital to understand the potential risks of not seeking medical advice. Discussing herpes with a medical professional can give you all the information you need to make a decision.

This is possible, according to the Centers for Disease Control and Prevention (CDC), but transmission is most likely to happen during labor.

Herpes can present challenges during pregnancy, but it is possible to prevent the herpes virus from affecting your baby.

Seek a diagnosis if you may have herpes or have been in close contact with someone who has it. A health professional can provide advice and help create a plan to minimize the risks.

While herpes during pregnancy can be worrying, it is important to remember that in most cases, HSV does not pass to the baby, especially when you follow medical guidance.