Genital Herpes is a sexually transmitted infection caused by the herpes simplex virus. It is a chronic condition that can recur. Some people infected with the virus may only experience genital herpes once, whereas others may develop the genital lesions on a number of occasions.
Symptoms of genital herpes
Symptoms of genital herpes include tingling or itching on or around the genital area, painful blisters or ulcers on the genitals, and feeling generally unwell. Some sufferers experience a warning tingling sensation just before a sore appears.
How common is genital herpes?
Genital herpes is quite common. Even if a person shows no symptoms of the infection, they may still be able to transmit the disease to others through sexual contact. It is estimated that 80% of sufferers will be unaware they have the infection. Typically, flare ups become less frequent, and less severe, as time progresses.
Genital herpes and pregnancy
If you or your partner have ever been diagnosed with the herpes simplex virus, you must tell your healthcare provider at your first appointment. If you caught the infection pre-pregnancy, it is likely that your immune system will protect your baby during pregnancy. If a previously diagnosed herpes infection flares up during pregnancy, this should not affect your baby.
If you contact genital herpes for the first time during the first trimester, there is a slight possibility that the baby will be infected via the placenta. If this is the case, there is an increased risk of miscarriage. There is also a slightly increased risk that your baby will develop birth defects in the womb.
If you contract the infection during the last six weeks of pregnancy, your immune system will not have time to produce antibodies to protect the baby. If the baby has not received protection via your immune system, there is a chance that the virus could be transmitted during the birth.
Getting over the genital herpes ‘hump’
Getting over the hump of letting your caregivers know that you have the herpes virus can make you feel so much better. The build up and pressure of just saying the words can be the most difficult part, according to the women I spoke to.
“To be honest after my initial discussions with my doctor and midwives I didn’t give the virus any more thought. It was never made to be a big deal by anyone treating me in my pregnancy and I was issued the antivirals at 36 weeks and didn’t have any outbreaks before the birth. I made sure I was always open and honest about my condition with whoever was treating me so everyone knew what was going on, this way I never put myself or my baby at risk.”
If a caregiver is treating you badly or being discriminative because of your condition, you’ve just found an unprofessional, uncaring caregiver and it’s time to find a new one. Its nothing to do with you.
Will I need to have a c-section if I have genital herpes?
If you have genital herpes, it does not mean that you automatically need a caesarean section. However a caesarean may become your best option if you have active genital herpes prior to the birth.
If the herpes virus is not active, then a vaginal birth is perfectly fine – you will be treated like any other low risk woman. In the weeks leading up to the birth, your doctor may prescribe medication to prevent an outbreak of herpes, in which case you have the all clear and peace of mind to birth whatever way you please.
Giving birth with genital herpes
Most women with genital herpes are able to have a healthy baby vaginally. One of the only exceptions to this rule are women who caught genital herpes for the first time during the last six weeks of pregnancy.
If you have sores and blisters when labour starts, your healthcare provider will discuss your options with you. You may be offered a caesarean section. The risk of passing on a recently caught infection during birth, is around 40%. Neonatal herpes is a serious but rare condition that causes infection of the skin, eyes and mouth. In most cases of neonatal herpes, the mother has not been diagnosed at the time of the birth. This is a very rare occurrence.
To increase the chance of women with recurrent genital herpes being able to birth vaginally, many experts advise taking antiviral medication from week 36. This will reduce the likelihood of developing an outbreak at the time of delivery. Speak to your healthcare provider if you would like to find out more.
Something to keep in mind is if you have scar tissue from lesions, scar tissue will not usually stretch. Vickie, a doula who has supported women who have had scar tissue (but not active herpes) said that of four women she supported, one birthed fine, two others needed episiotomies (a small cut to the perineum) and another tore raggedly around the scars. If you have active lesions then perineal massage is not an option. If you have concerns about this, its important for you to speak to your doctor who can help you make the best decision for you.
Dealing with the emotions of genital herpes and pregnancy
Being pregnant and giving birth can bring up many emotions and feelings. It can be difficult enough dealing with herpes, but being pregnant can bring it all back to the surface, as it needs to be addressed and it effects the baby growing inside of you. It can be a difficult time emotionally, but also needn’t be too.
Below are some stories are from women who have been pregnant with genital herpes. I have not included their names to protect their privacy.
“I knew my husband had the virus but when he had been diagnosed not much was really said to me about what might happen in the future. When I got back to Australia I consulted a doctor and he said it was inevitable I would get the virus from my husband no matter how hard we tried to prevent it as there is just too much opportunity for the virus to spread between us. It has taken me quite some time to get over the fact that my husband has given me something that will stay with me for life and can be quite discomforting but I believe this is the first step you need to take in order to accept and therefore take charge of it in your life rather than it controlling you.”
“I contracted genital herpes 11 years ago and have been fortunate enough to rarely experience any symptoms at all. I was therefore pretty horrified when during my first pregnancy I started to have regular recurrences of symptoms and symptoms were worse than I had experienced before.
I spoke with my GP who said that this was happening because my immune system was suppressed during pregnancy and there was increased blood flow to the genitals. She also mentioned that this may impact on my ability to have a safe, natural birth. With much awkwardness, I then raised this with my midwife who suggested that I try homeopathic treatment to try to prevent outbreaks. She told me that if I had an outbreak in the weeks leading up to birth then I may need to take anti-viral drugs to try and get rid of them, and if the blisters were present near the birth canal when it came time to birth that we may have to discuss the option of a caesarean section due to risks to baby.
To be honest, I blocked a lot of these latter possibilities out as I found it so shaming to think of. What if it happened that way and someone asked my why I had a section? I didn’t want to admit to having an STD, and what’s more, this affecting the safety of my baby… so I kind of buried my head in the sand and focused on treatment options.
I saw the homeopath a few times but in spite of individualised assessment and treatment and taking what she gave me religiously, I continued to have outbreaks. After double checking on safety, I started taking lysine at the first sign of on outbreak and this actually prevented symptoms from developing as far and it resolved faster. Fortunately, at the time I went into labour, I had no symptoms, so never had to face my fears around possibly choosing a section. I have since had another pregnancy and birth and similarly, had more flare-ups during the pregnancy but managed these fine with lysine and had no symptoms at birth.”
Can I Have A Waterbirth With Genital Herpes?
If you do not have active herpes at the time of birth, you are able to have a waterbirth. A mother shares her experience:
“My first baby was born at a birthing centre and I very much wanted to have a waterbirth with baby number 2, but didn’t think it would be wise because of my condition. I also presumed I would be put in the high risk category and wouldn’t be allowed to birth in the birthing centre. So I decided to talk to my doctor who was a women’s specialist and a birthing doctor. After consulting with my doctor about the risks of vaginal birth I realised it actually wasn’t as bad as I thought. They can give you antibiotics in the 4 weeks leading up to the birth to prevent and control outbreaks which is turn means that a vaginal delivery is perfectly safe. This got me thinking that having a waterbirth or any type of birth I wanted was entirely possible. So I went back to the birthing centre, talked to them about my condition and subsequently booked in for a waterbirth. I wasn’t marked at high risk, it really wasn’t even much of a concern for them. As long as I was on the antibiotics and didn’t have an outbreak at the time of birth I was perfectly fine to birth how I chose.”
Advice from mothers
“I am now pregnant with baby number three and I have learnt a lot since baby number two. While breastfeeding him, I ate almonds on a daily basis to help keep my milk supply up but in turn I found that I was getting more outbreaks of the virus. So I did some research and found that what you eat can really effect your virus. The key is eating foods high in lysine, like dairy products yoghurt, cheese, milk, lots of fruit and vegetables, fish, chicken and eggs. Increasing your vitamin c and zinc intake as well as changing to coconut oil as an everyday product brings immense benefits to people living with the herpes virus. Avoid where possible foods that are high in arginine like chocolate, nuts, oats and protein or muscle supplements. I wish my doctor who had diagnosed me had explained what I could do to help reduce the severity or even reduce outbreaks just by adjusting the foods I ate and how it can make the difference. There is so much information on the internet now about what kinds of foods to eat if you have the herpes virus I would strongly recommend anyone who has it to do your research. I now know how to balance my diet in a way that helps keep the outbreaks low. It is certainly tough sometimes especially when I tend to crave chocolate in my pregnancies!”
“There are a couple of things I would like to say to other mothers or to-be mothers that are living with this virus. It is not something to be ashamed about, there are many people living with this virus and there are ways of learning how to cope with it and live a normal life. It doesn’t mean you have done anything wrong or that anyone has the right to judge you because of it, it just means you need to be a little more aware of your hygiene practices around other people and your children to ensure you don’t spread the virus to anyone else. It doesn’t change how you want to birth your baby, a vaginal birth is perfectly safe if you are upfront with your caregivers. Make sure you take the antivirals and inform them if you have an outbreak at time of birth. Eat the right kinds of foods and avoid those that cause the virus to flare up. Knowledge is power, so use the internet as your tool for seeking information on how best to control the virus on a daily basis. Knowing all this information myself I can’t wait to meet baby number 3 and once again we will be trying for a waterbirth, hopefully this one is keener to come out and meet her family!”