I have Genital Herpes

Caitlin - posted on 01/14/2010 ( 39 moms have responded )

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would it still be better/safer to have a C-section even if im not on a breakout during birth?

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Caitlin - posted on 01/17/2010

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yes i have heard from many sources including medical professionals that if i choose to have a c-section...the risks of known complications are low but the odds of a complication with the mother are higher than with the baby. honestly, i would rather put myself at risk (what little risk there is for me) with a c-section than to put my child at risk of complications and health problems he/she would have to live with the rest of its life or possibly even be fatal due to my own selfishness in choosing to deliver vaginally knowing that i have herpes and my childs whole body will be passing through the area that is infected. my childs lif is more important to me than my own and considering the risks of each form of delivery i think c-section would be the safest. im sorry some of you think that my decision is "sad" or you think lower of me because i said the complications of c-section dont bother me in relation to the ones of vaginal delivery with herpes but honestly i dont want to see my child have to live with or die because of my mistakes or something i contracted because of my past lifestyle. it would kill me to know that i did that to my own child knowing it could have been prevented. i respect and appreciate all of your input and i am very greatful for it but it offends me when i hear how some of you are disturbed by my decision as a mother to insure that my child dosent end up with something harmful to its health if i can prevent it. please dont leave me anymore comments about how sad my decision is or how careless im being by saying the risks dont bother me. of course ALL of the risks bother me but the ones of c-section do not bother me to the extent of those of vaginal delivery with an std. i dont go around judging you on your decisions as a mother or tell you how to raise your children and i would expect the same from you. i asked for advice and/or personal stories to help with my own decision making on what would be safer for my child, not criticism on my personal decision as a mother as to what i think would be best for my child.

Gail - posted on 01/17/2010

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It is better to go with the C-section, why risk any problems when a C-section will give a safer and healthier baby as well as a mother who can rest easier. It has been said if the baby goes through the birth canal and there is any type of flare up it can cause problems with eyesight and breathing, why take the chance.

[deleted account]

I have herpes and delivered both my children vaginally based on the advice I received from my midwives (2 different in 2 different states). I understand your concerns and, and know that feeling of wanting to do what is best. In this day and age, when we have so many choices and access to so much information, it is often hard to know what is best. And it doesn't stop here...you will be faced with many other decisions you find difficult such as circumcision, immunizations, medications, sleeping arrangements, discipline..etc. etc. etc. And you will have family, friends and strangers all offering you advice on what to do and opinions about what you have already done. In the end you have to decide what is right for you...and sometimes that means just stopping for a moment and figuring out what feels right.

Both of my childrens' births were beautiful natural deliveries, and I feel blessed to have have had that experience not only once, but twice. I wish every woman could experience it the way I did, but know that it does not always work out that way. Regardless...how it happens does not matter as much as the fact that it DOES happen. In the end, you will be blessed with your own beautiful child and that is what is really important. Don't let people make you feel guilty for the choices you make. Don't try to remove all the "risk" from your babies life, because you can't. Just do your best. That is what we are all doing.

Holly - posted on 09/18/2012

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I never knew I had HSV and I delivered my son and he was born with HSV. It was horrible. However! He is a thriving healthy very smart 11 year old now. I want women to know there is hope!

Nara - posted on 01/16/2010

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Have the C-section because of the herpes. there can be serious complications to your baby even though you have no active sores. your baby is to precious to risk. your ob should tell you all the risks, so don't be afraid to ask all of your questions ... even the ones you think are dumb lol

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Crystal - posted on 01/23/2010

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My friend is an OB doc. I asked her this question and the answer was your doctor should put you on an antiviral like acyclovir about 2 months before birth as long as you are not allergic to medications. the chances of something going wrong with an unnecessary c-section are higher than the baby getting herpes. If you have an active case of herpes then you should have the c-section.

Iysha - posted on 01/23/2010

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It won't happen if you let your doctor know. The first thing they tell you is "Yes, you can have a vaginal delivery." They WILL prescribe meds for a month before you're due when it really only takes about 10 days to clear up an outbreak. you will be taking the meds as if you have an outbreak so it won't be just suppressing, it will be stopping one if you have one and continue to supress it until you give birth.



You can start taking antiviral meds right now if you want to. They aren't harmful to babies at all. They also check right before you have the baby....well at least mine did. They will ask how long you've been on the antiviral meds and if you are having an outbreak and they check. If you need to have a c-section for your baby's safety, they will give you one. They aren't going to make you have a vaginal delivery if your baby can be harmed in any way. They are going to do what is best for you and your baby. Have faith in your delivery doctor.

Caitlin - posted on 01/23/2010

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ou i really appreciate your response, it was helpful unlike alot of others that just cut me down for wanting my baby to be safe. i have only had herpes for almost a year....by the time i have my baby about a year and a half ...but my first outbreak was in september. im afraid ill have another one soon and it just scares me to think it could be when i have my baby. im not 100% sure but recently it felt like i was getting another outbreak but i couldnt see and sores or blisters or anything it was just itchy and kinda stung for a few days but went away. my first outbreak was very painful and itchy and i could see the blisters. im afraid if i try to go for vaginal delivery ill not know if its an outbreak or not if its just a slight one and then possibly affect my baby. i mean if i didnt have herpes i would definitely want a vaginal delivery as my first choice, id reather not go through the hassle of a c section and all that comes along with it, but after knowing i have herpes and seeing photos of babies the have it all over their bodies from their mothers giving it to them during birth....it just breaks my heart and terrifies me that theres a chance it will happen to my baby.

Mary - posted on 01/21/2010

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C-sections are major surgery & can be very dangerous. Make sure if your not already on it get on suppressive therapy. As long as there is no active outbreak & no warning signs like: itching, tingling, or minor pain you can safely have a vaginal delivery. I have had it for almost 10 years & I gave birth to a girl vaginally 5 yrs ago no problems w/ her whatsoever. The longer you've had it the less likely you are to give it to a baby during delivery. Also, your body has anti-bodies against the herpes virus & the anti-bodies will go to baby in womb & if you breastfeed the baby will also get the anti-bodies. So baby has some natural immunities to the virus.

Anne - posted on 01/18/2010

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I bet I'm the only one who has herpes who's answering here. I worried about transmission too, and both my midwife and my OB/GYN said that suppression therapy with acyclovir would absolutely prevent herpes transmission to the baby.

YOU DON'T NEED TO HAVE A C-SECTION.

If you are on suppression therapy with Acyclovir, you're not going to have an outbreak during birth. Wouldn't you rather take a pill than have major surgery?

Seriously, think about what you're saying. 20% of the population has herpes and very few of them pass it onto their babies during birth - the ones that do are usually the ones who don't know they have it. You know, so you can take steps to prevent it, and that means taking acyclovir, not subjecting yourself and your baby to unnecessary major abdominal surgery. And the risk of complications from a c-section aren't just to you - there are major risks for your baby as well. A vaginal delivery is always healthier for mom and baby and that should be your first choice.

Iysha - posted on 01/18/2010

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I have Genital Herpes too.



You will get a month's prescription for a medication called Acyclovir, Famciclovir, or Valacyclovir to make sure you don't have a breakout and your child will not get it. It also depends where on the genitals the breakouts occur. In a very small amount of cases, ones that aren't treated, the virus does spread to the newborn.



I talked to my doctor about it. I wanted a C-section because all the information I found pointed to it. I also didn't want to be all "stretched out, " I have very low self esteem and that thought made me uneasy. The information is very general and does not speak for every case. I talked to my OB/GYN and she knew where it was that the breakouts occur and how long I have had the virus and all that played into whether or not I could have a vaginal delivery. I had it for less than a year bofore I got pregnant, It would be a year and 2 months before my baby was due. I do not get it inside the vagina. I was in the hospital for 2 weeks for preterm labor, took Acyclovir for those 2 weeks and when I delivered, I was able to have a vaginal birth. I didn't want to have a vaginal birth at first because of the "risk" but my doctor helped me to better understand my situation and I became more informed about the slight risk of passing it which was next to nothing in my case.



Talk to your OB/GYN about it.

Rashawnda - posted on 01/17/2010

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if you have a out break at that time of birth it is best to let the doctor know so you can have a c-section for the child sake of not getting herpes.

Anne - posted on 01/17/2010

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Yeah, so I just read all the replies and I am astonished that so many people would tell you to have unnecessary and potentially very dangerous major surgery. C-SECTIONS ARE MAJOR SURGERY. It is not something to be taken lightly, and it is required in very few circumstances - certainly not just for herpes, which nearly 20% of the population has.

If you want to find out more about how to have your best birth, watch this movie: http://www.thebusinessofbeingborn.com/

Anne - posted on 01/17/2010

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Absolutely not. A c-section is major surgery, and should be avoided unless absolutely necessary. A voluntary c-section subjects you to all sorts of serious complications. Although you can pass herpes to your baby during birth if you are having a breakout, the chances are slim and can be minimized by using Acyclovir suppression therapy. I have genital herpes as well, and my doctor put me on Acyclovir twice a day at 30 weeks in order to suppress breakouts. I had an all natural (no drugs) vaginal delivery and my baby girl is healthy and herpes-free.

Lena - posted on 01/16/2010

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Sonya, I agree wholeheartedly!. I think one of the reasons so many women think of C-sections as "not a big deal" (in fact, Caitlin herself said she was aware of the risks & they didn't bother her (!)) is that very few women have had a true informed consent. Just read Gina's educational post earlier with a long list of references. How many of us have received such information at our OB/GYNs' offices? I am a healthcare provider & well aware of the tactics that can be used to sway a patient one way or another. However, recommending C-section as an option to a healthy, low-risk woman is truly unethical. It makes me so sad...

Sonya - posted on 01/15/2010

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I find it astonishing that all these posts woulds recommend a caesarean birth when there is no problem. NO!!! you do not need a caesarean "just in case". Caesareans are MAJOR ABDOMINAL SURGERY". It is not something to do unless there is actual risk and if you are not experiencing a breakout then there is not a significant risk to your baby. I have been caring for pregnant women and babies for over12 years and never has this been recommended routine surgery. The surgery has more significant risks to you and your baby. If you think there is the possibility of an outbreak starting your midwife or doctor can assess that then. Herbs and enzymes from a naturopath can assist in keeping your body balanced to prevent a flare up. Make your decision with knowledge rather than hear say or fear.... Have a great birth!!!

Gina - posted on 01/15/2010

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Caitlin, I'm wondering why you would choose to put this in a public forum instead of asking second opinions from other care providers? The public's opinion about cesarean surgeries is skewed from the truth at best, but the research is very clear that cesarean surgeries hold real risks for both mothers and babies. The research is also clear that many cesareans are offered to women who, like you, are uncertain about possible risk factors and believe that surgery is safer than vaginal birth, and that many women who are not good candidates for elective cesarean are nudged toward it by care providers who prefer that all women give birth surgically.

Here is some information from ICAN that you might find interesting, and if you would like to get more information about the dangers of elective cesarean birth, please visit www.ican-online.org:

* These facts are presented by the International Cesarean Awareness Network with the hope that parents, childbirth educators, doulas, nurses, midwives and doctors together can effectively reduce the rate of unnecessary cesarean sections and their effects.
* A cesarean (si-‘zar-E-an) section is major abdominal surgery used for the delivery of an infant through an incision in the mother’s abdomen and uterus. The incision may be made across the bottom of the abdomen above the pubic area (transverse) or in rare instances, in a line from the belly button to the pubic area (vertical). Learn More: Cesarean section - what happens during delivery.
* When a cesarean is necessary, it can be a lifesaving procedure for both mother and baby.1 However, psychological outcomes such as negative feelings, fear, guilt, anger and postpartum depression are common consequences of both emergent and elective cesarean sections.2,3,4 A cesarean section is only indicated in the following situations:

* Complete placenta previa at term
* Transverse lie at complete dilation
* Prolapsed cord
* Abrupted placenta
* Eclampsia or HELLP with failed induction of labor
* Large uterine tumor that blocks the cervix at complete dilation (Most fibroids will move upwards as the cervix opens, moving it out of baby’s path.)
* True fetal distress confirmed with a fetal scalp sampling or biophysical profile
* True absolute cephalopelvic disproportion or CPD (baby too large for pelvis). This is extremely rare and only associated with a pelvic deformity (or an incorrectly healed pelvic break). Fetal positioning during labour and maternal positioning during second stage, most notably when women are in a semi-sitting position, cause most CPD diagnosed in current obstetrics.5
* Initial outbreak of active herpes at the onset of labor
* Uterine rupture

* Many reasons given for cesarean, especially prior to labour, can and should be questioned. This includes macrosomia (large baby),6,7,8 maternal age,9 and parity,10 assisted reproductive technology,11 CPD,12 dystocia, failure to progress, breech,13,14 fetal distress or even prolonged second stage.15 There are very few true indications for a cesarean section in which the risks of surgery will outweigh the risks of vaginal birth.16
* The cesarean section rate remains at an alarmingly higher rate in many industrialized countries than the 10-15% average recommended by the World Health Organization, causing unnecessary risk to both mother and baby.17 Healthy People 2010 recommends a reduction in cesarean births in the US to 15% by 2010.18
* A cesarean poses documented medical risks to the mother’s health. These risks include infection,19 blood loss and hemorrhage,20 hysterectomy,21,22 transfusions,23 bladder and bowel injury,24,25 incisional endometriosis,26,27 heart and lung complications,28 blood clots in the legs,29 anesthesia complications,30 and rehospitalization due to surgical complications,31 rate of establishment and ongoing breastfeeding is reduced,32 and psychological well-being compromised and increased rate emotional trauma.33 Potential chronic complications from scar tissue adhesions include pelvic pain, bowel problems, and pain during sexual intercourse.34 Scar tissue makes subsequent cesareans more difficult to perform, increasing the risk of injury to other organs and the risk of chronic problems from adhesions.35 One-half of all women who have undergone a cesarean section suffer complications, and the mortality rate is at least two to four times that of women with vaginal births. Approximately 180 women die annually in the United States from elective repeat cesareans alone.
* Each successive cesarean greatly increases the risk of developing placenta previa, placenta accreta and placental abruption in subsequent pregnancies.36,37,38 Both of these complications pose life-threatening risks to mother and baby. Cesareans also increase the odds of secondary infertility, miscarriage and ectopic pregnancy in subsequent pregnancies.39,40
* A cesarean poses documented medical risks to the baby’s health.41 These risks include respiratory distress syndrome (RDS),42,43,44,45 iatrogenic prematurity (when surgery is performed because of an error in determining the due date), 46,47 persistent pulmonary hypertension (PPH),48 and surgery-related fetal injuries such as lacerations.49,50 Preliminary studies also have found cesarean delivery significantly alters the capability of cord blood mononuclear cells (CBMC) to produce cytokines.51 An elective cesarean section significantly increases the risk to the infant of premature birth and respiratory distress syndrome, both of which are associated with multiple complications, intensive care and burdensome financial cost. Even with mature babies, the absence of labor increases the risk of breathing problems and other complications. Far from doing better, even premature and at risk babies born by cesarean fare worse than those born vaginally.
* Cesareans can delay the opportunity for early mother-newborn interaction, breastfeeding, and the establishment of family bonds.52,53,54
* Cesarean rates are influenced by nonmedical factors. These include: individual philosophy and training, convenience of doctor or patient, the patient’s socioeconomic status, peer pressure, fear of litigation, and financial gain.55,56,57
* In the United States, obstetricians offer defensive medicine as an excuse for the astronomical and sharply rising U.S. cesarean rate. Deliberately performing unnecessary surgery in the belief it avoids lawsuits is indefensible. That many obstetricians seem oblivious to the profound violation of ethical principles is shocking.58,59
* Vaginal Birth After Cesarean (VBAC) is safer for both mother and infant, in most cases, than is routine elective cesarean, which is major surgery.60,61,62,63,64,65,66 Learn More in our VBAC Section.
* The risk to your infant from the very low incidence of uterine rupture (less than 1%) after a prior cesarean is much less than the risk to your infant from respiratory distress as a result of a scheduled cesarean.67,68,69,70

The International Cesarean Awareness Network (ICAN) founded as Cesarean Prevention Movement in 1982, has chapters, individuals, an international newsletter (the Clarion), email line and website ready to give you support and information. For more information, please call 1-800-686-ICAN or visit http://www.ican-online.org/.


References:

1. Wagner M. Choosing Cesarean Section. Lancet 2000; 356: 1677-80.
2. Ryding, Elsa Lena, Wijma, Klaas & Wijma, Barbro. Experiences of Emergency Cesarean Section: A Phenomenological Study of 53 Women. Birth 1998; 25 (4), 246-251.
3. Soet, Johanna E., Brack, Gregory A. & DiIorio, Colleen. Prevalence and Predictors of Women’s Experience of Psychological Trauma During Childbirth. Birth 2003; 30 (1), 36-46.
4. Koo, Vincent, Lynch, Janine & Cooper, Stephen. Risk of postnatal depression after emergency delivery. The Journal of Obstetrics and Gynaecology Research 2003; 29 (4), 246-250.
5. Gupta J, Glanville J, Johnson N, et al. The effect of squatting on pelvic dimensions. Eur J Obstet Gynecol Reprod Biol 1991;42: 19-22.
6. Parry S, Severs CP, Sehdev HM, Macones GA, White LM, Morgan MA. Ultrasonographic Prediction of Fetal Macrosomia: Association with Cesarean Delivery. J Reprod Med 2000;45:17-22.
7. Haram, Kjell, Pirohonen; Jouko, Bergsjo. Suspected big baby: a difficult clinical problem in obstetrics. Acta Obstetricia et Gynecologica Scandinavica 2002; 81 (3), 185-194.
8. Sandmire, Herbert F. & Woolley, Robert J. IN THE LITERATURE Macrosomia: Can We Prevent Big Problems with Big Babies? Birth 25 1998; (4), 263-267.
9. Kozinszky, Zoltán, Orvos, Hajnalka, Zoboki, Tünde, Katona, Márta, Wayda, Kornelia, Pál, Attilla, Kovács, László. Risk factors for cesarean section of primiparous women aged over 35 years. Acta Obstetricia et Gynecologica Scandinavica 2002; 81 (4), 313-316.
10. Qublan, Hussein, Alghoweri, Ahmad, Al-Taani, Mohammad, Abu-Khait, Sami, Abu-Salem, Areej & Merhej, Ahmad. Cesarean section rate: The effect of age and parity. J Obstet Gynaecol Res 2002; 28 (1), 22-25.
11. Kozinszky, Zoltán, Zádori, János, Orvos, Hajnalka, Katona, Márta, Pál, Attila & Kovács, László. Obstetric and neonatal risk of pregnancies after assisted reproductive technology: a matched control study. Acta Obstetricia et Gynecologica Scandinavica 2003; 82 (9), 850-856.
12. Brabin, Loretta, Verhoeff, Francine, Brabin, Bernard. Maternal height, birthweight and cephalo pelvic disproportion in urban Nigeria and rural Malawi. Acta Obstetricia et Gynecologica Scandinavica 2002; 81 (6), 502-507.
13. Usta, Ihab M., Nassar, Anwar H., Khabbaz, Antoun Y. & Abu Musa, Antoine A. Undiagnosed term breech: Impact on mode of delivery and neonatal outcome. Acta Obstetricia et Gynecologica Scandinavica 2003; 82 (9), 841-844.
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Caitlin - posted on 01/15/2010

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well im not afraid to have a c-section, i know the risks of it and it dosent bother me. i did talk to my doctor about my herpes and she said she would give me valtrex before i deliver to make sure i dont have a break out if i wanted to have the baby vaginally (i have only had one breakout since i got it) but she also said c-section was an option. i just wanted to hear other opinions from mothers with similar experiences. and thank you all for your input, i think im going to go with the c-section, my mother had a c-section with me and my brother just because we were big babies and i have a few friends that had c-sections as well because of std issues but they were told they didnt have a choice, it HAD to be a c-section. so i appreciate all of your advice. thank you all :)

Megan - posted on 01/15/2010

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I believe it would be both safer and better to have a C-section just to be safe, don't take any unnecessary risks with the birth of your baby. Recovery with take a little longer but its better than you spreading that to your innocent baby...Congrats and good luck

Lena - posted on 01/15/2010

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Your chance of HSV (herpes virus) transmission to your baby is < 1% if you don't have an active HSV breakout during delivery. C-section, although so commonly done & trivialized in the US, is a surgical procedure with some serious possible complications including would infection, increased risk of hysterectomy, post-partum hemorrhage, blood clot formation resulting in a heart attack, pulmonary embolism (clot in a lung) or stroke. The list of complications goes on & on... I would say avoid C-section at all costs. Don't forget about your subsequent pregnancies. C-section scar makes you more likely to get placenta previa (placenta covers cervical opening) & placenta accreta (placenta implants on or near C-section scar), both of which are high-risk conditions. Most providers would put you on daily antiviral therapy a few weeks before your due date to prevent HSV outbreak during delivery. Here is the reputable source of this information - the CDC: http://www.cdc.gov/std/treatment/2-2002T...

Mary - posted on 01/14/2010

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You really need to talk to your doc about this, but I can tell you that most OB's will put you some type of HSV suppressent, like Valtrex, by 36 weeks. Unless you are actively having a breakout, there is no reason that you cannot have a vaginal delivery. Not only will you be asked about this when you come in laboring, but they will do an inspection as well. Good luck!

Tara - posted on 01/14/2010

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I always say, better safe than sorry. Your doc is the expert & it is YOUR decision, but could you ever stop thinking it was your fault if your child was blind or something worse? These things are many times a part of life, but as parents if we have the opportunity to protect our children from something - that is exactly what we do. C-sections sound bad, but I was not in labor for less than two days with any of my children... so none of it is too much fun. :)

Remember that even without an outbreak you can pass genital warts to your partner, during birth there is much more vigorous skin on skin contact - so that would worry me.

Krista - posted on 01/14/2010

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Talk to your doctor, but my instinct would be to not take any chances and have a c-section instead.

Rosie - posted on 01/14/2010

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i would also like to add that i just look on the cdc's website it it said that they do not routinely perform c-sections on women infected with herpes unless they are experiencing an outbreak at the time of labor. i also went to wikipedia and found this out


The risk of transmission to the newborn is 30-57% in cases where the mother acquired a primary infection in the third trimester of pregnancy. Risk of transmission by a mother with existing antibodies for both HSV-1 and HSV-2 has a much lower (1-3%) transmission rate. This in part is due to the transfer of significant titer of protective maternal antibodies to the fetus from about the seventh month of pregnancy.

i'm not a hundrend percent positive, but i believe the risk of dying during surgery is higher than that. but like i said before have a good long talk with your dr. and make your decision then.

Abba - posted on 01/14/2010

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Hi Caitlin,
I caught genital herpes back in 2005. I've only ever had the one flare up.
Providing you have not flared up during your pregnancy or at the time of the birth, you're baby will be perfectly safe. The baby cannot catch it as long as like I said you DO NOT have a flare up.
I had my baby vaginally and she is perfectly healthy. Your midwives and doctors should be monitoring you through your pregnancy as you have herpes.
Hope this helps xxx

Meghan - posted on 01/14/2010

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i guess its just who you talk to, my friend had her wee girl yesterday vaginally, and has herpes, but wernt active. she got told she was aloud.

Denise - posted on 01/14/2010

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Hey Caitlin... I personally think it's better not to risk passing it to you baby. I think the doctor would agree... but he/she may not... I'm sure in the end the decision is up to you... Good luck...

Sara - posted on 01/14/2010

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Yes. It can be passed even without an active breakout during the time of birth. Your OB should really discuss this with you.

Dana - posted on 01/14/2010

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Yes. What does your doctor say? I really don't know much about genital herpes but from what I've heard, you should not deliver vaginally and no doctor should even suggest that.

Julie - posted on 01/14/2010

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I would say that it is best to do a c-section so there is NO chance that you transfer it to your child.

Sarah - posted on 01/14/2010

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It would be safer to have a C-section even if you do not have a breakout during birth. The virus can spread to the baby during a vaginal delivery, and cause very serious problems like brain damage. It is better to be safe than sorry. C-sections aren't so bad. The recovery is a little harder, but nothing a few pain killers can't fix!

Rosie - posted on 01/14/2010

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my best friend has herpes and she delivered both of her babies vaginally. i also have another close friend who has herpes who delivered all 4 of her children vaginally. it all depends on you and the info you have gotten from your dr. definintely talk about the pros and cons and make your decision then.

Tara - posted on 01/14/2010

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From what I understand, you can pass genital herpes on to the baby even if you are not on a breakout during the birth (primarily because of micro-tears in the vaginal wall caused by birth), so most OBs will recommend a c-section. I would definitely ask your OB though.

Krista - posted on 01/14/2010

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Yes. Hormones apparently cause genital warts to flare up. However, your OB would be best to answer this question.

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