First-Time Genital Herpes in Pregnancy: Is My Partner Cheating? Will My Baby Be OK?

Pregnancy can be an exciting yet overwhelming time for expectant parents, and it often brings about many concerns and questions. One concern that may arise for some women is the discovery of a first-time genital herpes infection during pregnancy. This can lead to a number of worries, particularly about the health of both the mother and the baby, as well as potential relationship anxieties. If you’re facing this situation, it’s important to understand the implications of genital herpes during pregnancy, the impact it may have on your baby, and how to address any emotional concerns. In this article, we’ll explore the various aspects of antenatal care concerning genital herpes, how it can affect pregnancy, and most importantly, how to manage it with the guidance of healthcare professionals.

What is Genital Herpes?

Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus: HSV-1, which is typically associated with oral cold sores, and HSV-2, which primarily causes genital infections. However, both types can affect either the mouth or the genital area. Genital herpes causes outbreaks of sores or blisters in the genital and anal areas, and the infection can be transmitted through skin-to-skin contact, even when no visible symptoms are present. For many individuals, the first time they contract genital herpes may come as a shock. However, many people with the virus are unaware of their infection, as it can remain dormant for long periods with no obvious symptoms.

First-Time Genital Herpes in Pregnancy: What Are the Risks?

For those who have not previously had herpes, contracting the virus during pregnancy can raise important concerns. It is particularly crucial to assess when the infection occurs during the pregnancy and how to manage it to avoid potential risks to the baby. Here’s what you need to know:

Timing of the Infection:

The risk of transmission to the baby depends on the timing of the infection during pregnancy. There are generally three main scenarios:

1. First-episode genital herpes early in pregnancy (first trimester): If you contract genital herpes early in your pregnancy, the risk of transmission to your baby is very low. However, early infection can increase the risk of miscarriage, preterm labour, and birth defects in some cases. Antenatal care teams will monitor your pregnancy closely and may advise antiviral medication to reduce the risks.
2. First-episode genital herpes later in pregnancy (third trimester): The risk of transmission to the baby is higher if the infection occurs closer to delivery. This is because the virus can be passed on during childbirth as the baby passes through the birth canal. If you experience an outbreak of genital herpes around the time of delivery, doctors may recommend a caesarean section (C-section) to reduce the risk of the baby contracting the virus.
3. Recurrent herpes infection during pregnancy: If you have had genital herpes before pregnancy and have had recurrent outbreaks, the risk of transmission to the baby is significantly lower. In such cases, the virus is more likely to remain dormant, and outbreaks tend to be less severe. However, antenatal appointments will likely include discussions on antiviral medication to prevent outbreaks and protect your baby.

Risk to the Baby:

If the virus is transmitted to the baby, it can cause neonatal herpes, a potentially serious condition. Neonatal herpes can affect the skin, eyes, or mouth, but it can also spread to the internal organs, including the brain, which can be life-threatening. Fortunately, neonatal herpes is relatively rare, and there are precautions that can be taken to minimise the risk.

• C-sections are recommended in cases where the mother has an active outbreak of genital herpes near the time of delivery. This method prevents the baby from being exposed to the virus during the birth.
• Antiviral treatment can help reduce the frequency of outbreaks and the likelihood of transmitting the virus to the baby. In many cases, antenatal care teams will prescribe antiviral medication such as aciclovir to manage symptoms and reduce the risk of transmission.
• Antiviral therapy during labour: In some cases, if there is a known risk of herpes transmission at the time of delivery, doctors may administer antiviral medications during labour to reduce the risk further.

Is My Partner Cheating?

A common emotional concern for many women diagnosed with genital herpes for the first time during pregnancy is whether their partner may have been unfaithful. However, it is important to understand that genital herpes can remain dormant for long periods and may not cause symptoms for years. In fact, many individuals with genital herpes are unaware they have it, as the virus can stay dormant in the body without triggering outbreaks.

• Asymptomatic shedding: Even when no symptoms are present, herpes can still be transmitted. This is known as asymptomatic shedding, and it is one of the reasons the virus can be spread unknowingly. Your partner may not even know they have the virus.
• Prior infections: If your partner has had cold sores or a history of genital herpes, it’s possible they could have transmitted the virus to you even if they weren’t showing symptoms at the time. HSV-1, which causes cold sores, can also be transmitted to the genital area through oral-genital contact. It’s essential to approach the situation with open communication. Having a conversation with your partner about their health history and any potential risks can help alleviate emotional stress. It’s also crucial to remember that antenatal support teams can guide you in understanding how genital herpes works and what steps to take to protect your pregnancy and baby.

Managing Genital Herpes During Pregnancy

The best way to manage genital herpes during pregnancy is through proper medical care and communication with your antenatal clinic. Here are key steps that will help protect both you and your baby:

1. Early diagnosis and regular monitoring: If you suspect you have genital herpes or have been diagnosed, it’s essential to have regular checkups with your healthcare provider. Antenatal checkups will monitor the progression of the infection and ensure that any outbreaks are properly managed.
2. Medications: Antiviral medications can significantly reduce the risk of transmission to your baby. Your doctor may prescribe medications like aciclovir to prevent outbreaks, especially in the third trimester when the risk of transmission is higher.
3. Preventing outbreaks: Managing stress, getting enough rest, and eating a balanced diet rich in vitamins and nutrients can help reduce the frequency of outbreaks. Antenatal vitamins may be recommended to ensure your immune system stays strong during pregnancy.
4. Delivery planning: If you have an outbreak of genital herpes near your due date, a caesarean section may be recommended to protect the baby from potential exposure to the virus.
5. Emotional support: Dealing with a genital herpes diagnosis during pregnancy can be stressful. Seeking support from a counsellor, joining support groups, or talking openly with your antenatal support team can help you navigate the emotional aspects of the condition. While genital herpes during pregnancy can be concerning, it is important to remember that with proper care, the risk of transmission to the baby can be significantly reduced. Regular monitoring, antiviral treatment, and careful planning for delivery can help protect both you and your baby from potential complications. Open communication with your partner and your healthcare team is crucial to navigating this situation effectively. By taking the necessary precautions and receiving the right antenatal care, most expectant mothers with genital herpes have healthy pregnancies and babies. If you are ever uncertain or worried, don’t hesitate to speak with your doctor or midwife, who will be able to provide tailored advice and support throughout your pregnancy journey.