Genital herpes and pregnancy: your questions answered

What is genital herpes?

Genital herpes is a sexually transmitted infection caused by herpes simplex virus type 1 (HS1) or type 2 (HS2).

Genital herpes is contagious from when you get your first symptoms (a tingling or itching sensation) until the sores have healed.

Once you have had the virus, herpes simplex stays in your body in a nearby nerve. That means you could have another outbreak of genital herpes at any time.

How do you get genital herpes?

Genital herpes can be passed on by:

• skin-to-skin contact with the infected area – including vaginal, anal and oral sex (NB: it can take months or years to appear)
• when a cold sore touches genitals
• transferring infection on fingers to genitals
• sharing sex toys with someone who has herpes.

Don’t panic about other types of contact though: herpes isn’t transmitted by sharing towels, cutlery or cups. The virus dies quickly when it’s away from the skin (NHS Choices, 2017).

What are the symptoms of genital herpes?

Symptoms of genital herpes are:

• tingling or itching sensation
• small blisters that burst to leave red, open sores around your bits
• pain when you wee
• vaginal discharge that’s different to usual.

What are the risks of genital herpes in pregnancy?

If you’re pregnant and you think that you have genital herpes, give your midwife or GP a shout straight away (NHS Choices, 2017; RCOG, 2014).

Genital herpes won’t put you at higher risk of a miscarriage but it can be passed onto babies during pregnancy. It can cause a serious illness called neonatal herpes.

Neonatal herpes is rare in the UK but risks are highest if you get a new infection (primary infection) in your third trimester or within six weeks of having your baby (RCOG, 2014).

If you’re pregnant and have genital herpes, you’ll be referred to a genitourinary medicine physician for treatment (RCOG, 2014).

What are the symptoms of neonatal herpes?

Neonatal herpes is a serious viral infection that can, sadly, be fatal (RCOG, 2014). There are three subgroups of neonatal herpes depending on the site of infection:

• skin, eye and/or mouth
• affecting central nervous system (CNS)
• infection that’s spread and involves multiple organs.

If neonatal herpes is just on the skin, eye and/or mouth, it has the best chance of being cured. If neonatal herpes has spread to multiple organs, that’s when it can be much more serious (RCOG, 2014).

How can I prevent my baby from getting neonatal herpes?

Parents or visitors can pass herpes onto a baby unwittingly in the first few weeks of their life. There are a few steps you can take to reduce the risk.

• If you are breastfeeding and develop a lesion on your breast or nipples, you should stop feeding from that breast straight away. See your GP as soon as possible, and they can test the lesion for neonatal herpes simplex virus (HPV).
• If you have a cold sore, ensure it is covered and wash your hands thoroughly and regularly. Treat the cold sore with a topical aciclovir cream until it is healed, and don't kiss your baby while you still have the cold sore.
• Request that visitors wash their hands before holding your baby. Ask them politely not to kiss your newborn baby, especially if they have a cold sore.
• For more information see the Kit Tarka Foundation website.

What treatment can I get if I have a genital herpes outbreak in pregnancy?

If you have genital herpes, an antiviral drug called aciclovir is recommended. Aciclovir isn’t licensed for use during pregnancy but is considered safe and hasn’t been associated with an increased incidence of birth defects (RCOG, 2014). Antiviral treatment is offered:

• to treat outbreaks in pregnancy
• from 36 weeks to reduce the chance of an outbreak during birth
• from diagnosis until birth if a pregnant woman gets a primary infection after 28 weeks of pregnancy.

(NHS Choices, 2017)

Can I still have a vaginal birth if I have genital herpes?

Many women can still have a vaginal birth. Although, depending on the circumstances, you might be offered a caesarean (NHS Choices, 2017).

How can I avoid another outbreak of genital herpes?

As the herpes virus stays in the nerves near where the infection first appeared, it will come back in the same area. Recurrent infections can be triggered by:

• ultraviolet light
• sex, tight clothes or anything that causes friction around your vagina
• being unwell
• your period
• having surgery on or around your vagina
• a weakened immune system – for example if you’re going through chemotherapy or HIV (genital herpes can be more serious in people suffering from HIV).

(NHS Choices, 2017)

Obviously, a lot of these things are pretty difficult to avoid though. But the risk of genital herpes can be reduced by:

• Using a condom every time you have sex (vaginal, anal or oral). The condom needs to cover the infected area.
• Avoiding vaginal, anal or oral sex if you or your partner has sores or blisters, or a tingle or itch that means an outbreak is coming.
• Not sharing sex toys (or using them with a condom on them).

(NHS Choices, 2017).

This page was last reviewed in February 2018

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

You might find attending one of our NCT New Baby groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.