Herpes in pregnancy

Dr Trisha Macnair responds

Try not to let your worries about what's a very small risk of problems spoil your enjoyment of your pregnancy. (Of course, I know only too well that dealing with one worry during pregnancy simply lets you move on to worry about something else and it never stops once the baby is born - that's the joy of parenthood!) But seriously, although genital herpes can have implications for women who are pregnant, in your case it's unlikely to cause trouble.

Risk of shedding virus

The main risk to a baby is from a mother who's actively shedding the virus through open sores.

Once a person has had an infection with genital herpes, the virus lies dormant in the body and can occasionally flare up (in a similar way to cold sores). Then ulcers develop in the genital area, and the virus is shed into the birth canal with a risk that the baby will be in contact with the herpes virus when it's born.

This can lead to complications such as a herpes pneumonia which, in a tiny baby, can be a very severe illness. Treatment immediately after birth with anti-viral drugs can reduce the risk of damage.

If it isn't the woman's first or primary outbreak of genital herpes then the amount of virus shed is usually small and the risk of her baby being infected during delivery is very low. If there are herpes ulcers around the birth canal during labour the doctor may recommend that the baby is born by caesarean to be sure of avoiding the virus. But few women have active infection at this time and most deliver quite normally.

If your initial infection was many years ago, and you haven't had any recurrences in recent years, it's very unlikely your herpes will flare up again now, especially if you're otherwise fit and well.

First episode can be more dangerous

If a woman has her first episode of genital herpes while she's pregnant, the virus can be passed on to her unborn child with serious consequences. About half of those babies infected this way are either stillborn or suffer damage to the brain, nerves, eyes or skin.

Should your husband know?

There's no reason why your husband should find out that you've had herpes in the past. Your doctor is obliged to keep all your health information strictly confidential.

However, you might want to think about telling your husband at some point - it is, after all, something that happened many years ago and nothing to be ashamed of. There's also a small risk that it might flare up and you could then pass it to him.