I am pregnant and about to enter my third trimester. I’ve had herpes for almost 3 years, but this is my first pregnancy. I’ve talked with my OB/GYN about my herpes and she seems pretty knowledgeable and thinks that I should be able to have a vaginal birth with no problems. I think so too, but just want to be sure. Is there anything else to think about other than making sure I don’t have an outbreak or any symptoms when I’m ready to deliver?
You and your doctor are right on target here: many women with genital herpes have vaginal births, with no problems. Women who acquire genital herpes before they become pregnant have a very low risk of transmitting the virus to their babies. In part, this is because their immune systems will make antibodies that are passed to the baby through the placenta. Even if herpes is active in the birth canal during delivery, the antibodies help protect the baby against herpes infection. Additionally, you have talked about this with your provider and will take precautions to look for any sign of an outbreak at the time of delivery.
There are some additional considerations, however, that you’ll want to keep in mind. First, ask your doctor not to rupture the membrane, or “bag of waters,” around the baby unless it is medically necessary. The membrane will help protect the baby against any virus in the birth canal. Additionally, ask your doctor to avoid the use of instruments during delivery that could damage the baby’s scalp, such as a fetal scalp monitor (scalp electrodes) or a vacuum or forceps, unless medically necessary. These instruments make tiny punctures in the baby’s scalp, which may allow herpes virus to enter. You can request that an external monitor be used instead.