You probably haven't thought about STDs since your carefree college days, but here's one sobering reason to think about them now: about two million pregnant women harbor STDs such as herpes or chlamydia, according to the Centers for Disease Control (CDC). Many have no clue that they have these diseases, but if left untreated, the infections can harm both you and your unborn baby. That being said, there's no reason to panic. There is every reason to be tested, so you can take steps to protect yourself and your baby. Here, the scoop on five common STDs.
What it is: An STD caused by the herpes simplex virus (HSV). Most cases of genital herpes are due to HSV-2, although some may be caused by HSV-1, the virus that typically causes cold sores. About 25 to 30 percent of pregnant women have the herpes virus, according to the American Social Health Association (ASHA), but only 5 to 10 percent have had active outbreaks of blisters or sores around their vagina and buttocks.
Why it's dangerous: Less than 0.1 percent of babies born in the United States contract herpes, according to the ASHA, which is reassuring. But those who do get the virus suffer severe consequences: neonatal herpes can damage the central nervous system, cause mental retardation, and even cause death. "Your baby is most at risk if you contract genital herpes while you're pregnant -- because you're newly infected, you don't have any antibodies to the virus, so you can't pass them on to your baby for protection," explains Lisa Hollier, MD, MPH, associate professor of obstetrics and gynecology at the University of Texas in Houston. In addition, if you have a first-time outbreak at delivery, the risk of transmission is anywhere from 30 to 60 percent.
Should you be tested? If you've never shown signs of a herpes infection, probably not. Groups like the American College of Obstetricians and Gynecologists (ACOG) currently don't recommend routine HSV screening of pregnant women. "Many women who test positive for the virus are unaware that they even have it because they had a very mild case that never presented symptoms," Dr. Hollier explains. "We don't want to alarm them unnecessarily, because the risk of passing it on to their babies is very, very low." The one exception: if your partner has herpes, it's recommended you take a blood test to see if you have antibodies from a previous infection. If you're negative, it's recommended you use condoms throughout the pregnancy and abstain from sex if he's having an active outbreak.
Treatment: If you've had herpes outbreaks in the past, be prepared for another bout, as about 75 percent of these women experience at least one recurrence during pregnancy. Ask your doctor about trying a suppressive treatment, such as valacyclovir during your last month of pregnancy -- a 2006 study found it decreased the rate of outbreaks at delivery by 69 percent. If you have no signs of an outbreak, it's safe to have a vaginal delivery.