Herpes During Pregnancy: Risks, Treatment, and How to Protect Your Baby
29 Apr 2025
Genital herpes is a common sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). If you’re pregnant and have herpes—or were recently diagnosed—you may be concerned about how it could affect your baby. The good news? With the right precautions and medical care, most women with herpes have healthy pregnancies and deliver healthy babies.
Here’s everything you need to know about herpes during pregnancy, including risks, treatment options, and how to reduce the chances of passing it to your baby.
Natural birth is often possible if there are no active sores at delivery.
Your doctor may prescribe antiviral medication (acyclovir or valacyclovir) starting at 36 weeks to prevent an outbreak before labor.
Your body hasn’t developed antibodies, making transmission more likely.
If herpes is active at delivery, a C-section is recommended to protect the baby.
Acyclovir (safe during pregnancy).
Valacyclovir (safe during pregnancy).
Started at 36 weeks to prevent an outbreak at delivery.
Avoid intercourse or oral sex if your partner has active herpes symptoms.
Use condoms and dental dams (though they do not provide 100% protection).
Wash hands after touching a sore to prevent spreading the virus to other areas.
If you have oral herpes (cold sores), avoid kissing the baby until sores heal.
Avoid sex during outbreaks.
Use condoms for all sexual activity.
Your partner may consider taking daily antiviral medication to reduce the risk of transmission.
What Is Herpes and How Is It Transmitted?
There are two types of herpes simplex virus:- HSV-1 (commonly causes cold sores, but can also cause genital herpes).
- HSV-2 (typically causes genital herpes).
- Through direct skin-to-skin contact (including vaginal, oral, or anal sex).
- From mother to baby during delivery (neonatal herpes, which can be serious but is rare).
How Herpes Affects Pregnancy and Baby
1. If You Had Herpes Before Pregnancy (Recurrent Infection)
Low risk to baby – Your body has already developed antibodies that provide some protection to the baby.Natural birth is often possible if there are no active sores at delivery.
Your doctor may prescribe antiviral medication (acyclovir or valacyclovir) starting at 36 weeks to prevent an outbreak before labor.
2. If You Contract Herpes for the First Time During Pregnancy (Primary Infection)
Higher risk to baby, especially if infection occurs in the third trimester.Your body hasn’t developed antibodies, making transmission more likely.
If herpes is active at delivery, a C-section is recommended to protect the baby.
3. Risk of Neonatal Herpes (Rare but Serious)
Neonatal herpes occurs when a baby contracts the herpes virus during birth. It can lead to:- Skin, eye, or mouth infections (mild, treatable with antivirals).
- Central nervous system issues (can cause seizures or brain damage).
- Disseminated herpes (severe and life-threatening), affecting multiple organs.
- If herpes is recurrent, the risk of transmission is less than 1%.
- If herpes is a new infection near delivery, the risk can be 30-50%.
Treatment & Prevention During Pregnancy
1. Antiviral Medications
Doctors often prescribe antiviral medications to manage herpes outbreaks and reduce the risk of transmission:Acyclovir (safe during pregnancy).
Valacyclovir (safe during pregnancy).
Started at 36 weeks to prevent an outbreak at delivery.
2. C-Section vs. Vaginal Birth
- Vaginal Birth – Safe if there are no active sores or symptoms at delivery.
- C-Section (Cesarean Delivery) – Recommended if active sores or prodromal symptoms (itching, tingling) are present to prevent transmission.
3. Preventing Transmission to Baby
Take antiviral medication as prescribed.Avoid intercourse or oral sex if your partner has active herpes symptoms.
Use condoms and dental dams (though they do not provide 100% protection).
Wash hands after touching a sore to prevent spreading the virus to other areas.
If you have oral herpes (cold sores), avoid kissing the baby until sores heal.
What If My Partner Has Herpes but I Don’t?
If your partner has genital herpes and you don’t, you should take extra precautions to avoid contracting herpes during pregnancy, especially in the third trimester:Avoid sex during outbreaks.
Use condoms for all sexual activity.
Your partner may consider taking daily antiviral medication to reduce the risk of transmission.
When to Call Your Doctor
Contact your healthcare provider if:- You develop new herpes sores during pregnancy.
- You have an active outbreak close to your due date.
- You experience flu-like symptoms (fever, chills) along with an outbreak.
- Your baby develops blisters, fever, or appears unwell after birth (signs of neonatal herpes).
