What to Expect When You’re Expecting-With Herpes
When I discovered that I was pregnant, three years after I knew I had herpes, I immediately asked my obstetrician what I could expect from my usual symptoms during pregnancy. She told me she probably would not change much.
It turned out she was wrong. She had chronic outbreaks, which consisted of nerve pain, itching, and tingling. These symptoms persisted for most of my pregnancy, but my caregiver seemed surprised and did not know what to do, a common problem for pregnant women in my position, I soon learned.
It was not that I did not know how to treat my genital herpes during my pregnancy – I was prescribed a higher dose of antiviral medication, according to the guidelines – but I did not really seem to have any idea of what might happen next.
“Between the second and seventh month of my pregnancy, I had herpes symptoms more days than I did.”
Dr. Sheila Chhutani, an OB / GYN board member in Dallas, Texas, says that the symptoms of herpes during pregnancy really depend on what the symptoms are before conception. “If you are the person who gets two outbreaks a year, I would not necessarily expect you to get more than that,” he explains. “If you are someone who gets sprouts frequently, you will probably continue to get sprouts frequently.”
And while that may be the case for some, it was not for me.
My pregnancy brought about an increase in the frequency and severity of my herpes symptoms. Between the second and seventh month of my pregnancy, I had symptoms of herpes more days than I did. It was uncomfortable and, frankly, frightening, especially since my doctor seemed to be as confused as I was.
But the simultaneous burning sensation and morning sickness aside, what may be more difficult to be pregnant with herpes is the isolation. Since herpes is not something that many people talk about publicly, finding support, particularly as a soon-to-be parent, can be difficult. When I was pregnant, and did not have much more than Google searches to guide me, I landed on a pile of fear-mongering stories about fatal herpes infections in newborns. And that’s it.
Chelsea, a 30-year-old mother of two in Nashville and a certified doula, started an online support group for mothers with HSV (herpes simplex virus) in pursuit of one and found none. She had been in herpes support groups online for a while, but sought more specific support upon learning that she was pregnant.
“More than 30 percent of pregnant women in the United States have a genital HSV infection.”
“What I have seen that is different from other groups is that pregnancy and childbirth itself are some of the most intimate things we spend as women, so going through that and also sharing the same diagnosis and stigma, that the unions so much, “Chelsea says of their support group, which can be accessed through Community Support on ProjectAccept.org.
But this lack of support does not reflect the statistical reality. The CDC estimates that one in six people in the United States has genital herpes, which correlates with a large number of pregnant women with the virus: According to a study in the New England Journal of Medicine, more than 30 percent of pregnant women In the United States has a genital infection with HSV. “If people started talking about herpes, they would find that there are probably many more people who have it than they never realized,” says Dr. Chhutani.
While treated herpes is quite benign in adults, it can be fatal for babies who become infected during labor. Dr. Anna Wald, a professor of medicine, epidemiology and laboratory medicine at the University of Washington, tells MarieClaire.com that newborns who get herpes can get sick and die, even with antiviral treatment, and some have brain damage and neurological complications. . According to Wald, between 400 and 4,000 babies born in the United States contract herpes every year every year. But because most states do not cite herpes as a “notifiable disease” (a disease that is required by law to be reported to the government for monitoring), there is no reliable way to tell it.
People who know they have herpes have the lowest risk of transmitting herpes to their babies, says Wald. But statistically, most people who have herpes do not know they are infected. Providers regularly deliver babies to people with herpes without necessarily knowing it. The lack of transmission between mother and baby is largely due to fate: “If the mother has never had a primary outbreak, the probability of having one is very small,” explains Dr. Chhutani. In turn, the risk of transmission is incredibly low. “The result that worries us most about pregnancy is neonatal herpes, and that’s when women get herpes at the end of pregnancy for the first time,” she says. Neonatal herpes is more likely to occur during labor, and is more common with a vaginal delivery, but it can also occur during a cesarean section.
These are women who get herpes late with their pregnancies and are at a greater risk of birth complications. Think about it this way: If you are acquiring HSV as an infection, you do not have the antibodies yet. Unfortunately, “we do not have a way to identify these patients,” warns Wald. “There is also no way to test people for this.” Current treatments are not effective in pregnant patients who are having their initial outbreak of herpes.
“Feeling of simultaneous burn and morning sickness aside, what may be more difficult to be pregnant with herpes is the isolation.”
In fact, the American Congress of Obstetricians and Gynecologists does not recommend testing all pregnant people for the virus because of the small chance of a lethal break. The medical community has determined that the result is generally good for babies delivered by asymptomatic parents. “As long as they do not have symptoms – including prodromal symptoms like burning or tingling – they will not affect their mode of delivery,” Dr. Chhutani explains. “As long as they do not feel any symptoms and there are no visible lesions, then we can proceed with a vaginal delivery.”
The problem? This places the momentum for proper preventive care, and the safety of the child, only in the patient. Unless they reveal their herpes status, the care provider will operate under the assumption that they do not have the virus.
Knowledge is power, and in this case, security. For those of us who know that we have herpes and get pregnant, our prognosis is generally good. Transmission rates are extremely low – for a woman who has had recurrent outbreaks of the virus before pregnancy and is asymptomatic at birth, the risk of fetal infection is only 0.02-0.05 percent. To help reduce this possibility, providers will often prescribe an antiviral-acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex) – at 36 weeks of pregnancy, to be taken until delivery, for patients who do not they are in one.
Conclusion: As long as there are no symptoms that go into labor, vaginal delivery is perfectly safe. I know from experience. I was able to have a successful vaginal delivery and avoid transmitting herpes to my daughter, despite having symptoms for most of my pregnancy. Eventually, my provider and I were able to find a dose of acyclovir that kept my outbreaks at bay and had no symptoms when I went into labor.
Now I am pregnant with my second child. At least, this time, I know what to expect.