Should I Have a Vaginal Birth With Herpes?

Julie Kirk
Pregnant woman in the doctor's office

If you are pregnant and have the herpes simplex virus (HSV), you may wonder if you are able to have a vaginal birth. While it is possible to have a vaginal birth, it is important that you are aware of the potential risks of the herpes virus and how it can affect your baby.

Understanding the Risks of Neonatal Herpes

Neonatal herpes (transmission of herpes to a newborn) is quite rare but can be life threatening. Approximately 25 to 30% of pregnant woman have herpes, however, only 0.1% of newborns born in the U.S. will actually contract the disease.

The greatest risk of transmitting herpes to your baby occurs if you contracted herpes for the first time late in your pregnancy. You may not know you have the virus and therefore have a high risk of infecting your baby. However, if you had herpes prior to becoming pregnant or contracted it early in the pregnancy, the chances of transmitting the infection decreases significantly to less than 1%.

How a Newborn Contracts the Herpes Virus

The transmission of herpes to a newborn is most common during delivery while the newborn is in the birth canal. This occurs in 85% of the cases. With an active outbreak during delivery, the newborn may come in contact with HSV-1, which is the virus that commonly affects the mouth and produces cold sores, or the HSV-2 strain which causes genital herpes. In only 5% of the cases of mothers who have herpes, the virus passes the placenta, infecting the fetus. In 10% of the cases, the herpes virus is contracted after delivery.

How a Kiss or Touch May Spread the Herpes Virus to Your Baby

Another way herpes can be transmitted to your newborn baby is if a person with a cold sore (HSV-1 or oral herpes) kisses the eyes or mouth of your baby. There is also the rare chance herpes can be transmitted by touch when a person touches their active cold sore and then touches the baby.

There are simple precautions you can take that will help prevent spreading the virus and exposing your baby to herpes. If you have an active cold sore, simply do not kiss your baby and remember to wash your hands before touching your baby. If you have visitors that happen to have cold sores, you will have them follow the same precautions as well.

How Your Newborn Is Naturally Protected

The good news is that if you've had herpes for years, your body has most likely built up antibodies to the virus, which crossed the placenta to help protect the fetus. These antibodies will also protect the newborn against contracting the virus in the birth canal.

The Risks of Contracting Herpes During Pregnancy

The greatest risk to a newborn is if the mother contracts herpes during the last few weeks of pregnancy. While the first and second trimesters don't pose as much of a risk because there is enough time for antibodies to be produced and shared, the last trimester may not offer enough time for the antibodies to develop and cross the placenta. The other problem lies in that the mother may not experience symptoms and may not even know she has the virus, increasing the chance of having an outbreak during delivery.

The Effects of Neonatal Herpes on a Newborn

If the newborn does contract the virus, it can put them at high risk for issues such as:

  • Small blisters on the skin, eyes, or mouth that crust over
  • Encephalitis, which is an inflammation of the brain that can cause seizures and other brain and spinal cord problems
  • Disseminated herpes, which is a dangerous herpes infection that can cause fatal organ damage to the liver, lungs, and kidneys
  • Viral infections such as viral meningitis
  • Blindness and deafness

Determining if you Should Have a Vaginal Birth With Herpes

Whether you should have a vaginal birth depends on when you contracted the virus and if you are having an outbreak during delivery. Your doctor may also recommend taking an antiviral medication at 36 weeks gestation until delivery. This will help suppress a potential outbreak in the last month of pregnancy, and a vaginal delivery may be possible. However, if you do have a herpes outbreak at delivery, your doctor will need to perform a c-section.

Do Not Take Any Chances

If you don't know if you have herpes but suspect that you might, it is imperative that you speak to your obstetrician so you can get tested. Don't ignore symptoms, especially if you suspect that you may have contracted the virus. With all the preventative resources available, there is no need for putting your baby at unnecessary risk.

Should I Have a Vaginal Birth With Herpes?