An illustration of a mother with flowing hair, cradling her pregnant belly with care.

STDs and Pregnancy

The relationship between STDs and pregnancy is a fraught one. If you’re pregnant and are infected with an STD or STI, there’s a possibility that your infection is affecting both you and your unborn baby. That can be scary because many STDs are asymptomatic. This blog will talk about what the STD testing process is like during prenatal doctor appointments and which STDs pose a threat to pregnant women and their babies.

What STDs are You Tested For During Pregnancy?

Regardless of whether or not you are currently pregnant, part of the reason why getting tested is such an important part of being proactive about your health is because so many STDs are asymptomatic, meaning you can carry the infection and not know it or show signs. So, it’s easy to see how someone could become pregnant and not know that they have an STD.

Because STDs can be asymptomatic, these infections can go undetected in pregnancies. Pregnant women may assume that they do not have an infection, will be tested for STDs and/or those symptoms of possible infections will be clear to their doctors. Those assumptions are not always the case. Doctors will most likely screen for STDs at the first prenatal appointment, but it is unlikely that screenings will happen during subsequent visits. Just like any other visit to the OB-GYN doctor, you can’t assume that your doctor will be able to spot the signs of an STD, even if they’re examining the areas likely to show symptoms of the infection.

If you’re pregnant, you should clarify with your doctor that you get screened for STDs at your first prenatal visit and be clear with them about which infections they’re testing you for. If possible, the best course of action is to get tested before you even become pregnant.

After being tested before you become pregnant or at your initial prenatal appointment, the doctor is unlikely to perform a test for STDs again during the course of your pregnancy. If you suspect that you’ve been exposed to an STD at any time after your initial visit, you’ll need to request you be tested again.

Effects of STDs and Pregnancy

Most people think of STDs and STIs as infections that are spread through sexual contact, and while sexual activity does account for the majority of transmissions, there are other ways to pass STDs from one person to another–and that includes pregnancy. When it comes to STDs and pregnancy, infections can be passed from mother to child during pregnancy and vaginal delivery. Also STDs can have adverse effects during pregnancy, some of which can be harmful to the baby.

Here are a few of the STDs that can be passed to your baby during pregnancy.

  • HIV: HIV can potentially be passed to babies during pregnancy, labor and vaginal delivery. It also has the potential to be passed in breast milk after the baby is born. However, thanks to modern medicine, if the mother is HIV positive, the chances of passing the infection to the baby can be curbed dramatically with medications and other preventative measures.
  • Herpes: If the mother is experiencing an active outbreak of genital herpes and the infant is delivered vaginally, the chance of passing the infection is high. Many parents with genital herpes will give birth via cesarean section to help prevent this transmission. While the transmission of oral herpes doesn’t pose a threat during delivery, many parents with oral herpes will pass the infection to their child by giving them a kiss on the lips.
  • HPV: If you have a form of HPV that causes genital warts, hormones from pregnancy can cause the warts to become inflamed and grow larger, so much so that they could become large enough to block the birth canal.
  • Gonorrhea: If left untreated, gonorrhea can cause severe complications during pregnancy. Gonorrhea can increase risks of miscarriages, preterm delivery, prematurely ruptured membranes and low birthweight. Babies born to a mother with an active infection can develop blindness or infections of the joints or blood.
  • Chlamydia: Chlamydia, if left untreated, can cause an increased risk of miscarriage, preterm delivery, prematurely ruptured membranes and low birth weight. Newborns exposed to chlamydia can contract severe eye infections and pneumonia.
  • Syphilis: Syphilis is an infection that can easily be passed to a child. Infants born to mothers with syphilis are often premature and syphilis infections in newborns can be fatal. In addition to premature birth, syphilis infections have been linked to stillbirth and, in rare cases, death after birth. Untreated infants who survive tend to develop multiple health problems which may involve the brain and nervous system, eyes, ears, liver, bones and skin.
  • Hepatitis B: Hepatitis B is transmitted from mother to child through the placenta about 40% of the time. An infected newborn can carry the hepatitis B virus with them for life, which can lead to liver disease and even death. However, treatment of the Hepatitis B positive mother during pregnancy with antiviral medications and treatment of her infant(s) within 12 hours of birth with both Hepatitis B vaccine and Hepatitis B immune globulin will help prevent the chronic infection and early death for the child.
  • Hepatitis C: Research suggests pregnant mothers infected with hepatitis C are at higher risk of premature birth and low birth weight. 5% of newborns whose mother is hepatitis C positive will be exposed to the virus during childbirth. If the mother has both positive hepatitis C and HIV infections or has a highly infectious hepatitis C virus blood level, the infant faces a significantly increased risk of hepatitis C infection. Breastfeeding is safe for the infant; it does not transmit the hepatitis C virus to the infant. No hepatitis C vaccine or treatment is currently available for newborns. Children born to mothers with positive hepatitis C should be tested at 18 months. Between 25 and 50% of children born to a hepatitis C positive mother will overcome the hepatitis C infection (blood levels of HCV RNA virus disappear) by age 3. Children born to hepatitis C mothers need lifelong follow-up to monitor and manage their health.
  • Trichomoniasis: A mother infected with trichomoniasis is at a higher risk of having a preterm baby, low birth weight and preterm premature rupture of the membranes. Routine prenatal care does not include testing for trichomoniasis. Testing, diagnosis and treatment with appropriate antibiotics will help protect your and your baby’s health. If untreated, the infection may (rarely) pass from mother to baby, especially female newborns who would have vaginal discharge after birth. It is unknown whether trichomoniasis can cause other long-term issues if left untreated. With most of these infections, treatments or preventative measures are available to cure the infection and/or reduce the risk of transmission to your newborn. Some viruses, including herpes, hepatitis and HIV, cannot be cured. Chlamydia, gonorrhea, syphilis and trichomoniasis can all be treated and cured with antibiotics that are safe to take during pregnancy. However, these infections can also be asymptomatic, so the only way you can get treated is to be diagnosed and tested.

With most of these infections, treatments or preventative measures are available to cure the infection and/or reduce the risk of transmission to your newborn. Some viruses, including herpes, hepatitis and HIV, cannot be cured. Chlamydia, gonorrhea, syphilis and trichomoniasis can all be treated and cured with antibiotics that are safe to take during pregnancy. However, these infections can also be asymptomatic, so the only way you can get treated is to be diagnosed, and the only way you can be diagnosed is to get tested.

When it comes to STDs and pregnancy, in order to keep you and your baby safe while you’re pregnant and afterward, be sure to perform STD testing before and during your pregnancy. To reduce your risk of STDs and pregnancy, use protection and only engage with sexual partners who have recently tested negative for STDs.