It's relatively common to get herpes during pregnancy, usually type 1, which is most common in the mouth. But many mothers-to-be worry about getting herpes outbreaks and how this might affect the baby. In this article, we cover everything you need to know about herpes.

What is herpes?

Herpes is caused by a virus and comes in two types, herpes simplex type 1 and type 2. Type 1 is most commonly found on the lips and type 2 is most commonly found on the genitals, although type 1 can also occur on the genitals. The symptoms of herpes outbreaks vary. Some people experience mild symptoms such as tingling, itching and increased discharge (genital herpes), while others experience blisters, sores, fever, swollen lymph nodes and/or fever. The symptoms are usually worst the first time you get the infection, but you may then have a relapse. The virus lies dormant in the body in between. Relapses often occur when the immune system is affected, for example during a cold or pregnancy. You may not always notice when you have an outbreak.

How common is herpes during pregnancy?

About 70% of all pregnant women in Sweden have had type 1 herpes (most common in the mouth). About 15-30% have had genital herpes (type 2), but only about a fifth of these women know they have a herpes infection. Symptoms are no different if you are pregnant, but it is more common to have outbreaks during pregnancy.

How is herpes transmitted?

The incubation period, the time from when you are infected with the virus to when you develop symptoms, is between one and seven days. Herpes is transmitted by mucous membranes or damaged skin coming into contact with the fluid in the sore or blister caused by herpes. You are most likely to be infected if the person infecting you has the infection for the first time. In the case of a first-time infection, you can become infected even several weeks after the blisters or sores have healed. Herpes is destroyed by water, detergents, disinfectants and drought.

What are the risks to the baby if you get herpes while pregnant?

It is very rare for the fetus to become infected in the womb, but there is a much higher risk of the baby becoming infected during delivery or in the first weeks of life if you have an outbreak then. The risk is higher for a first-time infection and much lower if it is a recurrent infection. In the case of a recurrent infection, the baby has had time to acquire antibodies from the mother and the viral load is much lower. If the child becomes infected, the clinical picture varies here too. It can range from minor symptoms, such as blisters or eye symptoms, to more severe symptoms, such as encephalitis.

Tips to consider to prevent the spread of infection to the child:

During pregnancy It is important to tell your midwife if you know you have herpes. There are antiviral drugs that can be used if you have recurrent outbreaks during pregnancy. If you have blisters in your abdomen when you are approaching childbirth, you may need a caesarean section. Therefore, if you know that you have genital herpes and the risk of having an outbreak close to delivery is considered high, preventive treatment may sometimes be necessary.

If the mother gets a primary infection after childbirth it's important to take antiviral medication to contain the outbreak. It is also important to be careful with hand hygiene, not kissing the baby and having your own towels. Close contact with other pregnant women or babies should be avoided. If the mother has a recurrent infection, the risk of transmission to the baby is very low, but as long as she has blisters or oozing sores, it is important to behave in the same way as for a primary infection. The same rules of conduct apply to other members of the household who get a herpes infection.

Can I breastfeed if I have a herpes outbreak? Yes, breastfeeding is fine as long as there are no blisters on the breasts.

Are you pregnant and want to read more about itching? Click here for more information!