Re: I don't want to have surgery
As of yet, Valtrex and acyclovir have not proven to be safe during pregnancy yet. BUT...that doesn't mean it's NOT safe! It just means that studies haven't been done on it yet. So it hasn't been proven to be harmful either.
I have two babies who contracted neonatal herpes. Honestly, if I were pregnant again, I would definately take the suppressants! Without hesitation! Especially if I was already having problems with herpes throughout my pregnancy. Many many doctors are prescribing suppressive therapy during pregnancy now. And really, it seems any ill effects of the meds (if any at all) are not as severe as the disease itself.
You can deliver vaginally if you are healthy at the time of delivery. That means if you have no active outbreak and no prodromal symptoms. Most babies with neonatal hsv contract it from mothers who either contracted herpes during the late stages of pregnancy and/or didn't know they had the virus. The chance of you passing this infection to your baby at delivery is as low as 1% even during a vaginal birth as long as you do not have an outbreak. Even if you were shedding or had an outbreak, the risk is still as low as 5%, which relatively is very low! That's because your baby has already been exposed to your antibodies for all these months and any shedding will be less severe and of shorter duration.
If you do have a vaginal birth, there are certain precautions to keep in mind. Discuss with your physician internal monitors, vacuum/suction, forceps, and artificial rupturing of the membranes. These things can increase the risk slightly. With the membranes, the concern is how long the membranes are ruptured before delivery. Six hours or less is ideal...after that higher times are associated with higher risk. So if your physician wants to break your water, find out what her plan is if you haven't delivered within 6 hrs. With the other procedures, the concern is breaks in the skin. Breaks in the skin allow the virus an easy place to infect. In my oldest son, the pricks left in his scalp from the monitors were the first sites to develop lesions. My second son (twins) was delivered with forceps.
This is definatley something for you to discuss very candidly with your physician very soon. Together you should be able to come up with a plan that offers you what you want from your birth experience (but remember, emergencies arise even for moms without herpes that require csections) and offers the highest level of safety and protection to your baby. But in general, as long as you are not having any type of symptoms, a vaginal delivery is recommended (by the ACOG) and safe.
Mom to two HSV-1 survivors!