Having a herpes simplex virus (HSV) infection, whether Type 1 or Type 2, does not prevent you from having children. People with a history of genital or oral herpes can conceive and give birth to healthy babies. Established medical protocols allow healthcare providers to manage the condition effectively throughout pregnancy and delivery. By communicating openly with your medical team, you can ensure preventative measures are put in place to minimize any potential risk to the newborn.
Herpes Simplex Virus and Fertility
The presence of the herpes simplex virus does not interfere with a woman’s ability to conceive naturally or through assisted reproductive technologies. The virus primarily affects the skin and nervous tissue where it lies dormant, and it does not impact the function of the ovaries or egg quality. For men, some research suggests a possible association between HSV infection and a slightly reduced sperm count or quality, but this does not cause infertility. Most couples living with HSV are able to conceive without significant difficulty.
If a person has an active outbreak, medical guidance suggests abstaining from sexual intercourse to prevent transmission to a partner. This may require a temporary pause in conception efforts, but it is not a permanent barrier to having children. Once the outbreak has resolved, the couple can resume trying to conceive. The virus does not cause the inflammation or scarring in reproductive organs that can lead to infertility.
Prenatal Management of HSV
The management of herpes during pregnancy begins with informing your obstetrician or midwife about your history of HSV, even if outbreaks are infrequent or mild. This information allows the medical team to determine the risk level and plan appropriate preventative care. The greatest concern for the baby is a primary, or first-ever, HSV infection in the mother during the third trimester, especially within six weeks of delivery. This occurs because the mother has not had time to produce protective antibodies that can cross the placenta and shield the fetus.
For women who have a history of recurrent herpes, the risk of transmission to the baby is significantly lower, typically less than three percent, even if a lesion is present at delivery. To reduce the likelihood of an outbreak at the time of birth, suppressive antiviral therapy is often initiated in the late stages of pregnancy. Medications like acyclovir or valacyclovir are commonly prescribed, usually starting around 36 weeks of gestation. This therapy reduces the frequency of recurrences and asymptomatic viral shedding, lowering the chance of needing a Cesarean delivery.
Antiviral medications are safe for use during pregnancy and are continued until delivery. This preventative strategy is the cornerstone of prenatal management for women with a history of recurrent genital herpes. The goal is to create a virus-free environment in the genital tract when labor begins, offering the best chance for a vaginal delivery. Women who acquire a primary infection in the third trimester may also be advised to continue antiviral treatment until after the baby is born.
Delivery Strategy to Prevent Neonatal Transmission
The mode of delivery is the primary factor in preventing neonatal herpes, which is a serious condition for the newborn. The decision between a vaginal delivery and a Cesarean section (C-section) is made based on the presence of active lesions or prodromal symptoms at the onset of labor. If the mother has no visible genital lesions, sores, or symptoms suggesting an imminent outbreak, a vaginal delivery is safe.
If active genital lesions are present when labor begins, or if the mother is experiencing prodromal symptoms, a C-section is recommended. This surgical delivery bypasses the birth canal, preventing the newborn from coming into direct contact with the virus during passage. This protocol is followed because the highest risk of transmission occurs when the baby is exposed to the virus in the genital tract during labor. This practice significantly reduces the rate of transmission to the infant.
The timing of the C-section is important, with delivery prior to the rupture of membranes offering the most protection. If a primary infection occurred late in the third trimester, a Cesarean delivery is often recommended even without visible lesions, due to high asymptomatic viral shedding and lack of maternal antibodies. Medical staff also take precautions during labor, such as avoiding invasive fetal monitoring devices, which could create a break in the baby’s skin and increase the risk of infection.
Postnatal Precautions and Infant Safety
Once the baby is born, the focus shifts to preventing postnatal transmission through careful hygiene and awareness of new outbreaks. Breastfeeding is safe and encouraged, as the herpes virus is not transmitted through breast milk. The only exception is if the mother has an active herpetic lesion directly on the breast or nipple, in which case feeding from that breast should be temporarily avoided.
For lesions located elsewhere on the body, including genital lesions or oral cold sores (HSV-1), strict handwashing is the primary defense. Parents should wash their hands thoroughly with soap and water before handling the baby to prevent accidental transfer of the virus. Any active lesion on the body should be completely covered with clothing or a bandage. This covering prevents the baby from touching the lesion directly.
A precaution involves cold sores on the mouth, which are caused by HSV-1. Because neonatal HSV can be severe, parents or other caregivers with an active cold sore should avoid kissing the newborn. When a cold sore is present, wearing a disposable face mask can provide protection during close contact with the infant. These simple, consistent hygiene practices are effective in ensuring infant safety after delivery.