Many mothers-to-be worry that herpes outbreaks can affect their baby during and after pregnancy. In this article, we go over 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 often found on the lips and type 2 is most often found on the genitals, although type 1 can also occur on the genitals. The symptoms of herpes outbreaks vary. Some get mild symptoms such as tingling, itching and increased discharge (genital herpes), while others get blisters, sores, fever, swollen lymph nodes and/or fever. The symptoms are usually worst the first time you get the infection, but you can then have a relapse. In between, the virus lies dormant in the body. 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 in pregnant women? About 70% of all pregnant women in Sweden have had herpes type 1 (most commonly in the mouth). Approximately 15-30% have had genital herpes (type 2), but only about a fifth of these women know that they have had a herpes infection. The symptoms are no different if you are pregnant, but it is more common for you to have an outbreak during pregnancy.

How does herpes spread? The incubation period, i.e. the time from when you are infected with the virus to when you get symptoms, is between 1 and 7 days. Herpes is transmitted by mucous membranes or damaged skin coming into contact with the fluid in the wound or blister caused by herpes. You are most likely to be infected if the person infecting you has the infection for the first time. With 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 dryness.

What are the risks for the child? It is very rare for the foetus to get infected in the womb, but the risk is significantly greater that the child will become infected during birth or their first weeks of life if you have an outbreak then. The risk is higher in the case of a first-time infection and much lower if it is a recurrent infection. In the event of a recurrent infection, the child has had time to receive antibodies from the mother and the viral load is much lower. If your child becomes infected, the clinical picture varies. This can range from minor symptoms such as blisters or symptoms from the eyes, to more severe illness such as encephalitis (which is, however, very rare).

Tips to keep in mind to prevent the spread of infection to your child:

During pregnancy, it is important that you tell your midwife if you know you have herpes. There are antiviral drugs that can be used if you have recurrent relapses during pregnancy. If you have blisters in your abdomen as you approach delivery, you may need to have a C-section. Therefore, preventive treatment may sometimes be necessary if you know that you have genital herpes and the risk is judged to be high that you will have an outbreak close to childbirth.

If the mother gets a primary infection after delivery, it is important to take antiviral medication to suppress the outbreak. It is also important to be careful with hand hygiene, do not kiss your child and have your own, separate towels. Close contact with other pregnant women or infants should be avoided. If the mother gets a recurrent infection, the risk of infection to the baby is very small, but as long as she has blisters or oozing wounds, it is important to behave in the same way as with a primary infection. The same rules apply to other members of the household who get a herpes infection.

Is it possible to breastfeed if you have a herpes outbreak? Yes, it is fine to breastfeed as long as there are no blisters on your breasts.