For women who do not have an active herpes lesion during their labour, it is usually recommended that they aim to have a vaginal birth. This is because most babies will have good immunity to the virus. Some women will choose to have a vaginal birth anyway, because they believe the risk is low. (If there is an active sore or
prodromal symptoms, the risk of the baby getting neonatal herpes is about 0.25% - 5%). Be aware that there have been many documented incidents of lesions being discovered soon after the birth, with the baby remaining well and healthy.
If you have an active lesion that can be seen on the skin, some women will cover the lesion with a plastic backed bandaid or dressing during the birth, to increase protection for their baby. If the waters break before the labour starts, it may be advisable to
induce the labour. Prolonged rupture of the membranes can increase the chances of the baby developing neonatal herpes. Some caregivers advocate a Caesarean within 4 to 6 hours of the waters breaking. This may depend on whether you have an active outbreak at the time.
Deciding to have a caesarean
Some women feel uncomfortable with having a vaginal birth, even if the chances of their baby becoming infected are only very small. Your body's ability to progress well in the labour can depend on how anxious you are feeling. If you are overly concerned about the small risk, then your progress in labour may be hindered. You will have to weigh up your fears, and whether you will be able to relax enough to labour for a vaginal birth (even though it is viewed that the risks of Caesarean would outweigh the risks to the baby). You may wish to read more about Caesarean in
Class 9.
If you do decide to have a Caesarean (or one is recommended) you may wish to consider the reasoning you will give for the operation to family and friends. Many women feel self-conscious, or embarrassed, about having genital herpes.