Herpes and Childbirth

Archived Q&A and Reviews

Anti-viral therapy during pregnancy?

August 2003

Since I get recurrent herpes outbreaks and am pregnant--my doctor has suggested that i go on a suppressive therapy for the last month or two of pregnancy to avoid an active outbreak during labor/delivery (which would warrant a c-section). i am wondering if anyone has taken the anti-viral therapy for herpes during pregnancy. I'm not too comfortable with it but would like to avoid a c-section if possible. thanks

I took a viral suppressant (Valtrex?) for the last month of my pregnancy, had no side effects, suffered no outbreaks, and delivered a happy, healthy baby. I didn't do my own research, but my well-informed ob/gyn assured me that there's no evidence of ill effects from viral suppressants on infants. I had one outbreak early in my pregnancy, and I preferred the slight, unknown risk of taking the drug to the clearly increased risk of c-section. anon
I have had 2 children and went on supressive therapy for both. I also was quite concerned about it (both kids were born naturally with no drugs, and I even went off coffee during the pregnancies), but both kids are fine. All the research I found indicated that it was pretty safe. In addition, the alternatives are worse (ie, either a cesarean or really worse, not and passing the herpes to the child during childbirth). Good luck to you! Been there
I think that your doctor would have you take Zovorax or Acyclovir which is the common antiviral for herpes. It shouldn't be a problem for your baby. I have cold sores and often take acyclovir for outbreaks. My doctors have told me that it's not a problem taking them with breastfeeding and i think they also said that they give antivirals to preemies for various viral infections. Please double check with your doctor but i think it is okay. ouch...
I took acyclovir for both of my pregnancies. I had wonderful normal labors and vaginal births; I'm fine, my kids are fine. anon
Know that vaginal herpes can transmit itself to the neonate's eyes thus causing ocular herpes, and, in some scenarios, cause a quality of corneal scarring that can impair vision, or, in some instances, leave one blind. I urge you to take the antibiotics course
Adamant and knowledgeable about this one
I would recommend you get answers from your OB/midwife to have a clearer understanding of suppression methods and medication. Generally, though, acyclovir (zovirax) taken starting at about 34-36 weeks has been shown to reduce outbreaks at term and did not show toxicity in babies (in the limited studies available). Apparently Lysine is often recommended as a dietary supplement. Here's some links, but do not hesitate to have an informative discussion with your care provider as well. I'm a doula, and a few of my clients have successfully treated with zovirax and had vaginal deliveries.


Certain recommendations like reducing stress, avoiding certain foods can also help with reducing your risk of outbreak close to the end of term. Good luck! Laurel

I went on suppressive therapy for the last month of both of my pregnancies, and ended up delivering two perfectly healthy daughters. The suppressive therapy is about more than just avoiding a c-section should you have a known outbreak. Remember, it is possible that you could be shedding the herpes cells during labor and not know it, the consequences of which could be fatal to your baby. I don't want to scare you, but I just think the negatives to taking the preventative medication are minor compared to the major complications of passing on herpes to a baby. Best wishes to you and your baby.
concerned mama
I have herpes and have had three successful vaginal births. I don't have very frequent outbreaks, so I chose not to take acyclovir, which DOES cross the placenta, though (I believe) it's not known how it affects the fetus. But I did do a serious diet modification at the end of each pregnancy, avoiding foods with arginine (such as nuts, chicken, chocolate, dairy, meat) and trying to eat more lysine-rich foods. I also took lysine supplements. There are many other recommendations for avoiding outbreaks (recommendations that are less invasive than acyclovir), including echinacea; vitamins C, B complex, E and A; chlorophyll, wheatgrass and blue-green algae; zinc; acupuncture, etc. I definitely didn't do all of these, but I did some of them, and never had an outbreak when I was ready to deliver my babies. I would urge you to look into alternative ways to suppress herpes. Also, just because you have an outbreak doesn't mean you have to have a C-section. The risk is greatest with the first outbreak, and not so great with subsequent ones. Depending on where your lesions are, your doctor or midwife may be able to ''tape'' over them when you're delivering, or so I've been told. Anyway, good luck. anon
Do a careful assessment of the risks for your infant. I had two vaginal births and a caesarian and in the end felt no difference in the experience - no special gain from having done the vaginal births, and no loss from having a caesarian. If you are fit - I left the hospital the day after the caesarian - you'll find out that it's what happens after the birth that dominates the experience ultimately. anon
I took acyclovir to suppress herpes towards the end of both of my pregnancies. While I was told that a severe infection passing onto the baby during a vaginal birth was unlikely if it was not a primary breakout (happening for the first time), no one could tell me that there was no chance of this happening. Given the severity of the type of infection and disability that can occur in a newborn from herpes exposure and the number of women who take acyclovir in pregnancy with no problems, for me it was pretty obvious what I would do. An ob/gyn friend who works at Kaiser also said that taking acyclovir under these circumstances is pretty standard. Good luck deciding and have a great birth. anon
I also have recurring outbreaks. I was prescribed Acyclovir in the last 3 week of pregnancy. I wish I had taken it sooner because I had an outbreak at about three weeks and my son was born 2 1/2 weeks early(no connection). I was really upset at the prospect of a C-section for this reason since it could have been avoided. This story has a happy ending though, since my outbreaks are very short, about 1 1/2 -2 days and it was gone by the day he was born. Also, the location was in a 'safer' spot. I was able to have a great vaginal birth which was also quick and unmediated. It was luck that I had this experience but I certainly wouldn\x92t have had it with an active outbreak. If I had had an outbreak my (and my son's) birth experience would have been much different, guaranteed. I'm sorry I wasn't on the Acyclovir long enough to have any feedback about effect on me or the baby but I am pregnant again and will be starting the suppressive therapy at 4-6 weeks this time. I have spoken to 2 or 3 OBs and all say the Acyclovir has been used for years (decades?) with no ill effect but I haven't done any in depth research. All I know is that I trust my OB and I don't want to risk a C-section if I don't have to. I'd rather save that option for the unavoidable emergency. Anon
I, too, have herpes and have had two children. In both cases my OB recommended taking Zovirax (orally) during the last two months of pregnancy, even though my outbreaks are rather rare. In neither case did I have any adverse reactions or any effects that I was aware of. I think there's been quite a bit of research on the effects of these anti-virals on pregnancy and the potential benefits (i.e. avoidance of infection of newborn) far outweigh any risks of the anti-virals themselves. I'm no expert on this, though. but in my case(s) I didn't have any problems. As an aside, for completely separate reasons I ended up having two c-sections, and even though they were both unexpected they went extremely smoothly, I had very little pain or discomfort (relatively speaking) and both were still very special birth experiences. I'm certainly not advocating c-section as a first choice, but if for some reason you require one it really can be an OK experience. At least, they were for me. Hope this helps. anon