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General Info And Links For Pregnant Women (AKA: Don't Panic!)

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Just to clarify the risk for giving herpes to your baby during pregnancy ... I'm making this discussion for reference so you can get facts. Bottom line is you are at FAR higher risk of your baby acquiring Flu from you than Herpes ... although if you got Herpes in the last Trimester the risk is much higher and you REALLY need to work in close contact with your OBGYN to protect the baby from the virus.


From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671497/ :


"the pregnant woman who acquires genital herpes as a primary infection in the latter half of pregnancy, rather than prior to pregnancy, is at greatest risk of transmitting these viruses to her newborn. Additional risk factors for neonatal HSV infection include the use of a foetal-scalp electrode and the age of the mother less than 21 years. "


"in US, approximately 22% of pregnant women are infected with HSV-2, 10% are at risk of acquisition of genital HSV from their infected partners (during periods of asymptomatic viral shedding) and 2% of women acquire genital herpes during pregnancy, "


"The risk of neonatal infection varies from 30% to 50% for HSV infections that onset in late pregnancy (last trimester), whereas early pregnancy infection carries a risk of about 1% ".


So if you already have and are aware that you have HSV2 (or 1 for that matter) then the risk is VERY low for transmission to the baby especially if you make the Dr aware and they monitor your status and put you on Valtrex for the last month. As mentioned, MANY die from flu (especially babies) every year... you *rarely* hear about babies getting or dying from Herpes.


Either way, the bottom line is to make sure your Dr knows you have Herpes, and to work with them to protect the baby. I had one by Caesarean because I was bullied into it by the Dr I had at the time (this was 30 yrs ago with much less info available to the public AND the Dr's). I had my second naturally. Neither ever got it from me and they are now 30 and 26. I have a 5 yr old granddaughter and she is also HSV-. Work with your Dr, get informed, and odds are VERY high that your baby will be just fine :)

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I'll add some info from ASHA that refers to pregnant women with genital herpes of both types, type 1 and type 2.




Excerpt from link:


"While neonatal herpes is a serious condition, it is also very rare. Less than 0.1% of babies born in the United States each year get neonatal herpes. By contrast, some 25-30% of pregnant women have genital herpes. This means that most women with genital herpes give birth to healthy babies.


Babies are most at risk for neonatal herpes if the mother contracts genital herpes late in pregnancy. This is because a newly infected mother does not have antibodies against the virus, so there is no natural protection for the baby during birth. In addition, a new herpes infection is frequently active, so there is an increased possibility the virus will be present in the birth canal during delivery.


Women who acquire genital herpes before they become pregnant have a very low risk of transmitting the virus to their babies. This is because their immune systems make antibodies that are temporarily passed to the baby through the placenta. Even if herpes is active in the birth canal during delivery, the antibodies help protect the baby. In addition, if a mother knows she has genital herpes, her doctor or midwife can take steps to protect the baby."

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  • 3 weeks later...

I recently read another statistic in the Westover Heights Handbook that may be helpful in calming fears of those who are already HSV+ and plan to have children in the future.


According to that handbook, I believe written by Terri Warren, women who go into pregnancy with established genital herpes infections rarely pass on herpes during the birth process. This occurs in roughly 1/5500 births.


However, women who contract genital herpes (HSV1 or HSV2) for the first time during late pregnancy have a 30-50% chance of passing on herpes during the birth process. This is where there is significant risk, new infections contracted in late pregnancy.








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@MMissouri I would guess they arrived at that number in a scientific manner that includes rough percentage of pregnant women infected with HSV2 and the proportion of neonatal herpes cases caused by HSV1 (1/3) and HSV2 (2/3).


But the testing question is interesting because her precautionary recommendations are most focused on identifying the 2/3 to 3/4 of pregnant women who are HSV2 and GHSV1 *negative* during pregnancy as they are at highest risk of contracting genital herpes from a partner in late pregnancy and therefore at exponentially higher risk of passing on herpes during birth. She recommends screening to determine the woman's positive or negative status, and if they are negative, screening their partners to assess whether the partners pose a risk through oral sex or intercourse.


I wonder if any doctors discuss this with their patients. Or if the pregnancy books go into this. I remember reading that I shouldn't change a litter box (toxoplasmosis!) and I shouldn't eat unpasteurized cheese (listeria!) but I don't remember ever hearing about preventing contracting HSV during pregnancy. I could be wrong though.

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@MMissouri I know they don't recommend screening to find out if people are positive, but I find it interesting that Terri Warren's literature is more focused on identifying women who are negative. Her literature indicates 2-3% of pregnant women contract genital herpes during pregnancy. Of those, the portion who contract it late in pregnancy are at perhaps 2,000x greater risk of birthing a child with neonatal herpes than are pregnant women with established infections. So it makes sense you'd want to know who is vulnerable to contracting it during pregnancy. And yet, I can imagine the turmoil that would result from all that testing. Based on what she is advising, routine testing would first identify the 25-30% of pregnant who are positive. Then it would identify the positive partners of the pregnant women who are negative. And knowing how people react to getting a diagnosis of herpes, that would be a whole lot of drama for individuals and couples during pregnancy. But it's an interesting idea.

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If they are going to do that, they may as well test everyone in routine screenings, since most people eventually have children. Why wait til pregnancy, that makes no sense. And like you said, the drama that would ensure would be astronomical lol.


But, since they recommend not testing period, this might be the way in (using the risk to babies as a reason for testing). But I'm guessing this argument has been had already. (Who wouldn't think of the risk to babies?) And the risks of transmission are still too low for them to take it seriously. Less that 0.1%? I hate to be the downer, but that percentage doesn't even seem worth it to me.

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Just wanted to add. Her idea is all good if the person that's pregnant is in a committed relationship- but what about those that aren't? And continue to have sex with multiple partners? Drag all one night stands in for testing before sex? It won't happen.


Now I'm curious on just how many of those newly acquired cases during pregnancy were from someone in a monogamous relationship vs those that aren't.

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@MMissouri I think she would recommend abstinence from oral sex, intercourse or both (depending on the women's status) in cases of women having new partners of unknown status. She has a full page chart detailing what course of action to take based on various combinations of discordant status.

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@MMissouri Sorry, I missed your earlier comment before responding the first time. Routine screenings wouldn't necessarily negate the type of screening she suggests because she is suggesting identifying those who are negative at a very specific point in time, during pregnancy. It's true the women who had already tested positive for HSV2 would be off the hook for screening during pregnancy. Everyone else would still have to be screened during pregnancy.


I agree with you that it's highly impractical and won't happen, but I do find it interesting that women are encouraged to avoid changing cat litter boxes to avoid taxoplasmosis but are not really educated about avoiding contracting genital HSV during late pregnancy. Yes, the overall incidence of neonatal herpes is extremely low, but if a woman contracts HSV2 or GHSV1 in late pregnancy, the risk of neonatal herpes is extremely high.

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Just wanted to add. Her idea is all good if the person that's pregnant is in a committed relationship- but what about those that aren't? And continue to have sex with multiple partners? Drag all one night stands in for testing before sex? It won't happen.


Now I'm curious on just how many of those newly acquired cases during pregnancy were from someone in a monogamous relationship vs those that aren't.


Actually testing might *cause* a woman who might have multiple partners to actually be more cautious about her dalliances... the prospect of a Cesarean or a seriously ill baby is a pretty strong incentive to consider your partner choices :p

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I agree..


I just find this all pointless. Focusing on testing those that are pregnant. 2-3% of woman get it while pregnant and a portion of those get it in the last trimester? What is the portion? .5%?


I'm not in any way trying to say that it's not important to protect them babies. And any testing that is required at this point is a good thing. I'm just stuck on the fact if they would test everyone on a regular basis, then it would be so much more beneficial than this.


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