Updated in October 2025
Genital herpes, caused by the herpes simplex viruses HSV-1 and HSV-2, affects a significant number of people worldwide. During pregnancy, this condition can raise concerns for both the expectant mother and her baby.
Can you pass genital herpes to your baby during pregnancy? Unfortunately, yes — but the risk depends on the timing of infection and whether the virus is active during delivery. Most women with genital herpes still give birth to healthy babies, so while awareness is important, there’s no need for panic.
What is Genital Herpes?
Genital herpes is a chronic viral infection caused by herpes simplex viruses (HSV). The most common types are HSV-1 and HSV-2.
- HSV-1 is traditionally associated with oral herpes (cold sores around the mouth).
- HSV-2 is more commonly linked to genital herpes.
However, changes in sexual behaviors, including oral-genital contact, mean HSV-1 is increasingly causing genital infections as well. Both HSV-1 and HSV-2 can affect either the mouth or genitals, even if one type is more commonly associated with a specific area.
💡 It’s important to note that both HSV-1 and HSV-2 can cause either oral or genital herpes, although they have traditionally been associated with different locations!
Transmission and Symptoms
Genital herpes is a sexually transmitted infection, spread through genital secretions or saliva.
Symptoms may include:
- Painful blisters or sores on the genitals or mouth
- Itching, irritation, or burning during urination
- Fever, headache, muscle aches
- Swollen lymph nodes in the groin
Many people, however, may not recognize their infection. Even without visible sores, the virus can still be transmitted to others.
Signs of Genital Herpes in Pregnancy
Signs of genital herpes during pregnancy differ between initial (primary) infections and recurrent outbreaks.
Primary Infection:
The first (primary) infection is usually the most severe and may include:
- Tiny painful blisters or genital ulcers
- Vaginal discharge
- Fever, headache, muscle and joint pain
- General malaise
Recurrent Outbreaks:
Recurrent outbreaks are generally milder and less frequent. A pregnant woman may notice:
- Slight pain or irritation in the genital area
- Minimal or no systemic symptoms
Many parents I’ve spoken to say recurrent outbreaks often feel like minor irritation compared with the first infection, but they still check in with their healthcare provider for reassurance.
💡 A healthcare provider can confirm genital herpes through visual examination or tests such as viral culture, PCR (detecting viral DNA), or antibody testing.
Treatment During Pregnancy
Managing genital herpes during pregnancy is focused on protecting both mother and baby.
- Antiviral therapy is often recommended in the last month of pregnancy to reduce the risk of a flare-up at delivery.
- If you suspect you have genital herpes while pregnant, consult your obstetrician or midwife promptly. They can confirm the diagnosis and prescribe treatment if needed.
Note: Always follow medical advice — over-the-counter treatments may not be safe during pregnancy.
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Risks for the Baby
The risk to the baby from genital herpes depends on when the mother contracts the infection.
1. Primary Infection
The most dangerous situation is a primary herpes infection in late pregnancy, because newly infected women don’t have antibodies, leaving the baby without natural protection during birth. If a pregnant woman gets genital herpes for the first time late in pregnancy, the risk of transmission to the baby during delivery is between 30% and 50%. In contrast, infections before pregnancy or early in pregnancy carry a much lower risk, around 1%.
2. Secondary Infection
Secondary infections are usually less risky and are typically treated only if they occur in the last weeks of pregnancy. Recurrent infections generally cause milder symptoms and rarely pose a serious threat to the baby.
3. Active Disease During Delivery
The highest risk for the baby occurs when active lesions are present during labour. If blisters or ulcers are visible on the vagina, cervix, or rectum, a Cesarean section is advised. This significantly reduces the likelihood of transmission and helps prevent neonatal herpes.
A study published in JAMA found that for women presenting with their first clinical episode of genital herpes at delivery, a cesarean section is justified to prevent neonatal infection. However, the same research also highlighted that performing cesarean sections routinely for women with a history of genital herpes lesions results in a large number of extra operations relative to the number of neonatal cases averted — underscoring the need for careful risk assessment.
Genital Herpes and Newborns
Newborns can experience a range of symptoms if infected, from mild skin lesions to severe systemic illness.
- Mild infection: limited to skin, eyes, or mouth; may recur in the first year but is usually treatable.
- Severe infection: can affect the central nervous system, potentially causing seizures, unconsciousness, or long-term neurological issues.
Prompt medical attention is essential if a baby shows any signs of herpes.
Frequently Asked Questions about Genital Herpes in Pregnancy
Conclusion
Genital herpes during pregnancy can sound frightening, but most women with this condition deliver healthy babies. The key is awareness and communication with your healthcare provider. Knowing whether your infection is new or recurrent, starting antiviral therapy if recommended, and planning delivery with your care team all play crucial roles in keeping both you and your baby safe.
If you’re living with herpes, remember that you’re not alone — this condition is far more common than most people realize. With proper medical care and emotional support, pregnancy and birth can still be a positive, empowering experience.