Herpes and pregnancy
This is the one area where herpes genuinely needs planning rather than reassurance — and planning is exactly what it gets. It is a known situation with an established approach, managed routinely in the NHS every week. The thing that makes it go well is simply telling your midwife.
This page cannot advise you, and it is not trying to. Pregnancy care is individual and it belongs with your midwife, GP or obstetrician. What follows is orientation — the shape of the situation, so the conversation you have with them is less frightening and more useful.
If you are pregnant and think you may be having a first herpes episode, particularly in the third trimester, contact your maternity team promptly rather than waiting for your next appointment.
Timing, more than the diagnosis itself.
The central question in pregnancy is not whether you have herpes. It is when you acquired it, because that determines what protection your baby has.
If you have had herpes for a while before conceiving, your body has already made antibodies, and those cross the placenta. Your baby arrives with a degree of borrowed protection. This is the common situation, and it is generally considered low risk.
A first ever infection acquired late in pregnancy is the situation that needs more active management, because there has not been time to build and pass on that protection. This is uncommon — but it is the reason maternity teams ask, and the reason a new episode late on is worth reporting quickly.
Which produces a slightly counter-intuitive summary: long-standing herpes is the reassuring version, and brand-new herpes near the end of pregnancy is the one that changes the plan.
The shape of the care.
Broad strokes only — your team will make the actual decisions with you.
You tell them
At booking, or whenever you find out. It goes in your notes as a normal piece of clinical information. Midwives are not surprised by this and it does not change how you are treated as a patient.
A plan is made for the last stretch
Suppressive antiviral medication towards the end of pregnancy is a common approach, intended to reduce the chance of an outbreak being present at delivery. Whether it applies to you is a clinical judgement.
Delivery is decided near the time
Most people with long-standing herpes have a vaginal birth. A caesarean is generally considered when there are active lesions at the point of labour, or after a very recent first infection.
The questions that come up.
Will I have to have a caesarean?
Not usually. For most people with herpes acquired well before pregnancy and no lesions present in labour, a vaginal birth is the expected route. The decision is made close to the time, on the situation in front of your team.
Can I take antivirals while pregnant?
Antivirals are used in pregnancy, and this is routine ground for maternity teams. What, whether and when is a prescribing decision for the clinicians looking after you — not something to start, stop or self-manage on the basis of a website.
Can I breastfeed?
Genital herpes does not prevent breastfeeding. Ordinary hygiene applies, and lesions should not come into contact with the baby. If you have a cold sore, the advice is not to kiss the baby while it is active, and to wash your hands.
Could I have passed it on already, in the womb?
Transmission during pregnancy itself is rare. The point of concern is delivery, which is precisely why delivery is what gets planned.
My partner has herpes and I do not. Does that matter?
It is worth raising with your midwife, because avoiding a new infection late in pregnancy is the specific thing worth protecting against. That conversation is a reasonable one to have early rather than at 36 weeks.
Tell your midwife. That single act does most of the work.
It is not a confession and it will not change how you are cared for. It is the piece of information that lets the plan exist at all — and the plan is what makes this ordinary.
This page is educational and is not medical advice. Pregnancy care must come from your own midwife, GP or obstetrician. Contact your maternity team promptly if you develop symptoms in pregnancy, and urgently if you think you are having a first episode in the third trimester.
Interval’s care service is not yet open, and we do not provide care in pregnancy. This page is written by non-clinicians from the sources listed at the foot of the page, and has not been independently reviewed by a clinician.
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- NHS. Genital herpes. www.nhs.uk
- Patel R et al. British Association of Sexual Health and HIV UK national guideline for the management of anogenital herpes, 2024. Int J STD AIDS. pmc.ncbi.nlm.nih.gov
Last checked 10 August 2026. Read our editorial policy for how we source and review these pages.