STDs While Pregnant

Sexually transmitted diseases or STDs differ in many ways but they affect millions of people every day. However, some STDs affect pregnant mothers more than others because they can pass from the mother to the fetus, harming either or both if left undiagnosed and untreated.

Key Takeaways

• Sexually transmitted infections are extremely common, affecting millions of people in the United States every day.
• Certain STIs can be passed to a baby during childbirth, and it’s extremely important to seek immediate treatment for an STI while pregnant to reduce the risk of harming the child.
• With proper treatment and open communication with your sexual partners, it’s entirely possible to have a healthy, happy pregnancy and fulfilling sex life despite a positive STI test.

What Are STDs?

Sexually transmitted diseases (STDs) occur when infectious microorganisms pass from one person to another primarily through bodily fluids like blood, saliva, or genital fluids. Additionally, STDs can also be spread through extended skin-to-skin contact. 

Though STDs can be spread through sex, they can also be passed during transfusions, during pregnancy, birth, or when sharing hypodermic needles. STDs can be bacterial, viral, fungal, or parasitic, and they are extremely prevalent. The Centers for Disease Control estimate there are somewhere around 68 million active STDs in America at any given time.

Some of the most common forms of STIs are bacterial, including gonorrhea, chlamydia, and syphilis, and are easily treated with antibiotics in many cases. Other viral STIs are more difficult to treat, like HIV, human papillomavirus, and genital herpes simplex virus.

Difference Between STDs & STIs

STDs and STIs are often used interchangeably but are a bit different. So what is the difference between the two? As the name suggests, sexually transmitted infections (STIs) are infections. ​​One gets an infection when viruses, bacteria, or parasites enter your body and start to multiply. Infections signal a disease but not all progress into a disease but clear on their own. On the other hand, all STDs start as STIs or infections. 

How Are STDs Diagnosed While Pregnant?

STD transmission during pregnancy is a possibility and pregnant women should get tested during pregnancy to prevent any complications during pregnancy and childbirth. In most cases, a healthcare provider will do a test for common STDs following a positive pregnancy test to determine what, if any, risks there might be of transferring it to the baby. This test usually requires either a blood or urine sample and can be done relatively quickly at any healthcare premise, including fertility clinics like  Ivy Fertility.

The CDC’s 1997 STD Treatment Guidelines recommend that pregnant women should be screened for:

• Chlamydia
• Gonorrhea
• Hepatitis B
• HIV
• Syphilis

If you are pregnant and have new sexual partners while pregnant, or if you have reason to believe you could have been exposed to an STD from your current partner, it is important to get tested again to determine whether a new infection has taken place. 

You should request these tests because some doctors do not routinely perform them. Even if a woman has been tested in the past, she should be tested again when she becomes pregnant or before delivery.

What Are the Symptoms of STDs?

There are many common STDs with diverse symptoms, and each case may present differently, depending on the individual. 

Chlamydia

• Pain or burning sensation during urination
• Abdominal or lower back pain
• Discharge from the penis or vagina
• Fever
• Pain in the vagina, testicles or rectum

Gonorrhea

• Cloudy or bloody discharge from the vagina, penis, or anus
• Pain or burning feeling during urination
• Pain during bowel movements
• Itching sensation around the anus
• Heavy bleeding during or between periods

Trichomoniasis

• Discharge from the penis or vagina with a clear white or greenish-yellow color
• Itching, burning, or soreness on the penis or vagina
• Strong odor from the vagina, often described as “fishy”
• Pain during sex or urination

HIV

• Fever, headache and sore throat
• Chills and night sweats
• Rashes or ulcers on the mouth
• Fatigue

Genital Herpes

• Small, open sores on the genitals or rectum
• Pain and itching around the genitals and rectum
• Vaginal discharge

HPV

• Small warts on or around the genitals, sometimes with a cauliflower appearance
• Itching and discomfort in the pelvic region
• Bleeding during sex

Hepatitis

• Nausea, vomiting and upset stomach
• Dark urine or clay-colored stool
• Yellow, jaundiced skin
• Fever
• Pain near the liver, under the ribs on the right side of the body
• Fatigue

Syphilis

• Rash anywhere on the body, typically without any itching
• Fever, sore throat and fatigue
• Headaches and swollen lymph nodes
• Weight loss or sudden baldness

STD Treatment While Pregnant

STD treatment must be done by a medical professional when you are pregnant as they will be able to offer the best options. Bacterial STDs like chlamydia and gonorrhea are treated with antibiotics during pregnancy. Some antibiotics are safer for pregnant women to take, and you may need to choose a medication based on how far into your pregnancy you are.

Unfortunately, there is no cure for viral STDs like genital herpes or HIV. There are treatment options in the form of antiviral medications that can reduce symptoms in pregnant women. In addition, the risk of passing HIV infection from mother to baby is dramatically reduced when a mother takes treatment. 

Risk of STDs for the Baby While Pregnant

As already mentioned, STDs can be passed onto the baby during pregnancy and childbirth. If you have been exposed to an STD while pregnant, it is best to seek treatment immediately to reduce the risk of spreading the infection. For women with active genital herpes lesions at the time of delivery, a cesarean section may be performed to protect the newborn against infection.

Other more serious ones, like HIV, can be suppressed using modern antivirals during pregnancy and childbirth to dramatically reduce the risk of spreading the infection to the child. According to the National Institutes of Health, using the right antiviral medication during pregnancy can reduce the risk of passing HIV to the child to below 1 percent in most cases.

Additionally, the CDC, shows that STDs in pregnant women can increase the risk of giving birth to a baby with a birth defect, otherwise known as a congenital disability. Quick detection and treatment can prevent challenges in developing fetuses and newborns. 

STD Prevention While Pregnant

Complete abstinence from sexual activity can be a sure way to prevent STDs during pregnancy. However, this may not be necessary particularly if you and your partner(s) regularly screen for STDs. The risk of acquiring a new STD in a monogamous relationship is also low, but it might put your mind at ease to have your partner take a test as well to make sure there’s no unnecessary risk to the baby.

When having sex with a new partner, condoms can prevent many of the most common STDs. However, they are not completely effective in preventing infections like genital herpes and HPV, which can spread through skin contact in areas not covered by a condom.

It’s important to remember that washing the genitals, urinating, or douching after sex does not prevent any STD infections. 

STDs While Pregnant FAQ

Can I breastfeed if I have an STD?

In most cases, yes. This highly depends on the STD you have contracted. HIV can spread through breast milk, and breastfeeding should be avoided if you’ve been diagnosed with it. Still, other infections like chlamydia, gonorrhea, HPV, and trichomoniasis will not be passed through breastfeeding. Conditions that cause sores, like syphilis and herpes, can be passed if the child’s mouth or pumping equipment comes in contact with an active sore, but otherwise will not be passed through breast milk.

Can you be born with an STD?

Yes, if left untreated some STDs can be passed to the child during delivery. When and how the infection is passed depends on the specific STD, but any active STD during pregnancy should be addressed quickly to minimize the possibility of harm to the child.

Can You give birth naturally with genital herpes?

Yes, if you do not have any active sores before and during delivery. Many healthcare providers will recommend an antiviral treatment, like Valacyclovir, in the weeks before delivery to reduce the likelihood of an outbreak.

The Bottom Line

Navigating an STD during pregnancy can be daunting but with the right diagnosis and treatment, you can prevent harming the baby or passing an infection on to them during childbirth. By communicating openly with your sexual partners and healthcare providers, many STDs can be successfully avoided. If there’s a positive diagnosis, take the medications prescribed by your healthcare provider.