Genital herpes and pregnancy

[Shadow1986]

It's my due date in a few days so I'm a bit anxious and emotional anyway, and now it looks like I'm having a flare up of herpes, absolutely gutted. Some of you may know this can cause problems in pregnancy.

Bit of background, I was diagnosed with genital herpes a few months into relationship with my now DH (10 years ago). I was told it must be from him as he was the only person I was sleeping with when I had the first outbreak, although he's never had any symptoms, and therefore nothing came up on STD tests we both did when we wanted to stop using condoms. I had one really bad flare up that first time and in the ten years since I get the very occasional flare up, maybe once every 6 months and it's so mild it causes me no problems.

This is my second pregnancy and it caused no problems first time as I had no flare ups. I did however have a really horrible labour and was so looking forward to hopefully a natural problem free labour this time, in the midwife led unit.

Upon discovering signs of a flare up this morning I called my doctors asking for an urgent call back from a doctor - I've already discussed this issue with my GP who said any flare ups at this stage I would need anti viral meds urgently, however the receptionist couldn't offer anything - not even a call back, until 4 days time. Well I could have had a baby by then so that's no good. Next I called the labour ward, when trying to explain I obviously encountered someone inexperienced as she said 'well you're probably going to need a c section now so will have to call you back' - she was just so Matter of fact when saying this potentially really upsetting news to me!

Anyway a better midwife called me back with an appt for first thing to get the viral meds and said she didn't think a c section would be uncessary. Feeling a bit better, but still gutted to get so close and now have this worry.

Has anyone else had a flare up at the time of labour? If it is herpes coming out it's obviously very mild, I am beginning to wish I never said anything now but I know that wouldn't have been the right thing to do for my baby.

[Grapefruitforever]

No experience as such I'm afraid but it was thought I did have HSV for a while (it's turned out to be something else) so I did lots of research about flare ups during pregnancy. As I understand it, because your primary outbreak was pre-pregnancy, you will have antibodies to HSV which you will pass on to your baby, making the risk of neonatal herpes low. I was told even if I had an outbreak at labour time, the likelihood was still a vaginal birth and some antiviral meds too. That said, I think if things
weren't progressing, they would suggest c section over instrumental birth. I guess different places may have different policies on this but I hope you get some sensible, helpful information tomorrow OP. All the best!

[Shadow1986]

Thanks Grapefruit for your response. Yes I've read up too and see that I should have passed antibodies on to the baby so the risk is low. I wasn't sure if baby will need to stay in afterwards to receive anti viral treatment - something I'll feel horrible about if they do. I wanted to get back them home straight away. I didn't even want to go to hospital I wanted a home birth but settled on the midwife led unit. Feel like everything I wanted has gone out the window.

I was just so upset earlier, getting no where with my doctors surgery when I could give birth any second. Then to call the hospital, and the advice was 'well your first port of call is the gum clinic' err why? I know what it is and what I need, and then to say 'you're probably going to need a c section now' - how about if you're not 100% sure don't say anything so you don't scare someone like that.

Hopefully I'll get some better help tomorrow. Most woman at this stage can't wait for their baby to come, now I'm praying he stays put for a while. Thanks Grapefruit.

[Grapefruitforever]

No problem, sorry it's not more help! I'm not surprised you're feeling upset and annoyed by the insensitive responses - really not helpful and they should know that. Tomorrow will be a better day I'm sure. Try to stay positive about your impending arrival, I'm just a couple of weeks behind you 😊

[Shadow1986]

Oh exciting! Good luck to you as well then! 😀

[Shadow1986]

Just an update for any future people looking for advice on this subject, spoke to the doctor today at the hospital and was told my GP should have put me on anti viral meds from about 36 weeks to prevent an outbreak occurring at this stage. Feeling pretty let down.
It's still up in the air about what this will mean for my labour etc. I'm currently 39+4 with an active lesion so if I go into labour soon it could still mean a c section, it would be down to the consultant at the time. Looks like a birth in the midwife led unit is definitely out the window now.
So basically if you have herpes, make sure you let your GP know you will need anti viral medication from 36 weeks.

[MoonriseKingdom]

I am sorry this has happened and I really hope you get the birth you want

I am not sure the hospital doctor is fair to say the GP should have known to prescribe for you at 36 weeks. Many women will go through their whole pregnancy without seeing a GP at all. GPs have relatively little to do with pregnancy these days and may well not be aware of the most up to date guidelines on something like herpes in pregnancy. Really I think your midwife should have been aware of this and advised you on the guidelines. She could have then requested for your GP to prescribe the antivirals.

[Shadow1986]

Yes you're right. Midwives advice was to book in to see the GP which is what I did. GP mentioned anti viral meds but only said I would need them should a break out occur after 36 weeks, no mention of taking them as a preventative. Since having this outbreak and doing lots of research myself I can see lots about it so I also have to take responsibility myself.
Just seems crazy for a potentially life threatening risk to baby (although small risk) it seems to be such a grey area. I'm not even sure at my booking in appointment whether I was asked specifically about herpes or whether I volunteered the information. Pretty sure herpes is not that uncommon so id expect midwives to be a bit hotter on the topic. Anyway thanks for the 💐 sure everything will work out in the end.

[DocMcFanjo]

Shadow, I'm so sorry you're going through this.

I must admit, I'm a GP and wouldn't have known to put a lady with a past history of herpes on antivirals automatically at 36 weeks. Will be looking into this now. I do agree that it's something the hospital team perhaps ought to have flagged as I doubt your GP and I are the only ones not to have known of this advice.

I do hope everything goes well for you with the delivery (very much the most likely outcome as PPs have said) and that you will be happily snuggling up to a newborn soon. Best of luck

[Shadow1986]

Doc, thank you. That's great to hear you'll be looking into it for your own future reference.

Like the PP said, most women wouldn't even see their GP in pregnancy, only their midwife, so it does seem like midwives should be making more of a point to find out if a mother has a history of herpes, and if so, to flag it up for later in the pregnancy to discuss options. Seems like a safer option for unborn babies. I remember being asked about STDs like chlymdia at booking in, but not herpes (although I could have forgotten). As its so important it should maybe be a separate question.

Thanks doc