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Frynd1 03-09-2005 04:23 PM

I don't want to have surgery
I'm looking for encouragement from women who have herpes and have delivered vaginally.

I am 20 years old and contracted GH when I was 16. I always had a hard time dealing with and accepting it because I got it without even having sex. It took a toll on my relationship with my mother because she never believed my story and still doesn't. Now, I am 7.5 months pregnant and am worried about having a C-section. Having GH has already tortured me in several ways and the last thing I wanted out of it was a major surgery. My pregnancy has brought on constant reoccuring outbreaks and I am yet to take Valtrex for them. I have been trying to stay natural throughout these nine months. If I chose to have a C-section, will they make me start taking it anyway? I'd rather not have one though and am wondering how possible it is since I've had problems with them all through this pregnancy. Anyone deliver vaginally with no problems? Anyone have a c-section and still have to take medication? Has Valtrex been proven safe for unborn babies? TY

hsvmom 03-09-2005 05:06 PM

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.

Good luck!

Frynd1 03-09-2005 08:50 PM

Re: I don't want to have surgery
Is it okay that I've been having outbreaks while pregnant? I'm always worried they'll hurt my baby.

I really want a vaginally delivery. I don't want to be stripped of the whole child-birthing experience just because of this horrible virus. If they tell me I have to take the medication, then I will, but I'm very worried that it will hurt my baby. I hate having to go through this. Sometimes I believe herpes has ruined everything... :nono:

hsvmom 03-10-2005 02:46 AM

Re: I don't want to have surgery
outbreaks don't pose a risk to your baby until you deliver. if you have an outbreak at that time, then you really must deliver surgically. as for being stripped of the experience, you are going to experience your child birth regardless of how you deliver. And honestly, childbirth is going to be what you make out of it. even without herpes, any number of situations could arise that required a surgical birth or a delivery totally different from what you anticipated, and that's okay! The whole goal is to have a healthy baby, and I am quite confident that if it took a csection to get you there that you would feel no less amazed by your accomplishment than if you had delivered vaginally. I won't tell you how my delivery went, it's one of those horror stories people like to volunteer when you are pregnant that drives women nuts! Why do people share that stuff? But anyway, it did NOT go as any mom would have liked! But, even with all the complications and scares, I honestly don't feel like i missed out on a thing! The only thing I regret was that I was so ill when I delivered...the meds they had to give me made it hard for me to understand what was happening at the time. But i understand it now and I couldn't have possibly asked for anything better!

as for the meds, your doctor will help you to balance the risk. yes, there MAY be a risk to the baby with the meds even though there aren't any documented yet. But there definately IS an very real risk to the baby if you have an outbreak near delivery. Trust me, neonatal herpes is an awful awful disease! I personally would have done anything to prevent it in my boys had we known about it. If your doctor recommends suppresive therapy, then I would highly suggest you follow his/her treatment plan. After all, you chose your doctor b/c you had trust in her to protect your little one, so let him/her do it!

I am sorry that you are dealing with this. Please remember that the risks are very low as long as you don't have an outbreak. Remember, stress is one of the best ways to bring on an outbreak! So please try and relax! When it's all said and done, what matters most is a healthy baby, no matter how it meets the world. You can do this!

Ornament 03-10-2005 10:21 AM

Re: I don't want to have surgery
Search this board for posts from "backpacker", she has experience in this area.

backpacker 03-15-2005 05:57 PM

Re: I don't want to have surgery
Lynn--sorry, I've been too busy to go on the computer lately. I've had 4 boys. The first two I had naturally at home with midwives. When I was at 8 1/2 months with my 3rd, I had my primary ob. I went into labor as the sore was almost healed, so I had to have a Caesarean. The fourth I had again naturally at home. The home births were the most wonderful, incredible experiences I ever had. That is not to say they were easy, though! The Caesarean was a major operation that hurt a lot and took forever to heal, but I got through it, and all my boys have always been exceptionally healthy. I was depressed and crying on the way home from the hospital 3 days later (and the sore was completely healed by then), feeling that I hadn't been able to give my baby the best, healthiest birth, but now, years later, it doesn't matter at all. The important thing is having your baby in your arms.

I don't know anything about taking Valtrex. I didn't have more ob's while
pregnant--maybe because I slept a lot and had a lot of help and support with the other kids.

I do know that the Bradley method of childbirth tends to be more successful than Lamaze.

outinthesticks 04-05-2005 08:51 AM

Re: I don't want to have surgery
I took suppressives during the last months of both of my pregnancies and had vaginal births. My children are both very healthy.

nadyjo 04-05-2005 09:28 AM

Re: I don't want to have surgery
I have had 6 childern vag. They were all normal deliv. No outbreaks at the time of birth. Homeopathy for the outbreaks. They are NO risks to your baby. Katie Childbirth ed.&Doula

navysab 04-05-2005 11:52 AM

Re: I don't want to have surgery
LynnDewald1, I am in the exact same boat as you. I have herpes also, and I am only 3 weeks from my due date, and I have been worrying about a C section as well. I really, really don't want a C section. My doctor has told me to start taking Valtrex every day until I deliver for suppressive therapy. I agreed to do it, since for some reason I have been getting more outbreaks during my prenancy, then I did before I became pregnant. I am not a big fan of taking an RX, but it this will allow me to have a vaginal delivery then I am willing to do it. My only fear is that they will find a lesion down there when I deliver, but if they do, at least I did everything that I could do to try to prevent it. Some times I just get itchy down there, but there is no auctual blister, and I am wondering if you can still deliver vaginally if you are itchy, but no blisters, or will they only do a c section if you have a visible blister? Anyway, I guess I will know soon enough.

hsvmom 04-05-2005 03:49 PM

Re: I don't want to have surgery
if you are itchy you definately need to talk to your doctor. The ACOG and the UK recommendations call for a surgical delivery if you have prodrome (sp?) sypmtoms. BUT...since you acquired herpes [i]before[/i] your pregnancy, even if you were shedding without an actual outbreak your changes are REALLY good for a healthy vaginal delivery. But definately talk to your doc about it.

And don't forget, in the most ideal pregnancies moms feel all kinds of weird things. When you add to it that you are worried about an outbreak, you may feel a lot of stuff that you otherwise wouldn't have even noticed.

Make sure you actually physically show your doc where you have outbreaks by pointing so he can check thoroughly. Hope to hear a GREAT update in a few weeks!

littlebo 04-08-2005 10:33 AM

Re: I don't want to have surgery
I'm not pregnant and have yet to experience the joy of having a child. I really really do look forward to being able to have a baby. I've had HSV-2 going on 5 years now. Once I was diagnosed, I knew immediately that I would [U]want[/U] a C-section if and when I had a baby.

Yes, I did hate the thought of missing out on a vaginal delivery. But, my biggest desire would be that my innocent baby not be exposed to this virus!

I know it is felt safe to deliver vaginally as long as there is no active ob/lesion, but my concern has always been what if I have a lesion internally(on the vagina or cervix) that I'm not aware of. My obs have just about always been on my perineum (maybe one near my clitoris; but, I'm not totally convinced it was a herpes lesion). I assume the doctor can examine all these areas during labor and before the delivery, but what if they miss something? The baby comes through the birth canal and is exposed then, right?

My feeling has always been to err on the side of caution. If my ob/gyn is really certain that I could deliver safely, I'd probably go along with it. But, I imagine when I am able to have a baby (hopefully in the near future!) I'll be asking for a C-section.

hsvmom 04-08-2005 06:52 PM

Re: I don't want to have surgery
really, the risks that come with a surgical birth would outweigh the any herpes related risks. Since you already have an established infection, your risk of transmission is as low as 0.4%! That is REALLY low! Acyclovir, Famvir, and Valtrex are all Category B drugs for pregnancy. To put it in perspective, so is Tylenol. So they are considered safe. Most (but not all) ob/gyns will prescribe suppressive therapy. Even IF you had an outbreak at delivery, the highest risk (IF you deliver vaginally, IF you have internal scalp monitors, and IF your membranes are ruptured for more than 6hrs) is around 5%. That sounds bad, but it means there's a 95% chance that you wouldn't pass on the virus. And usually they can see lesions inside your vagina and on your cervix. They use a very high powered light and get very up close and personal!

I can definately understand the concern and wanting to be as absolutely careful as you can. Believe me! But even after having not one but two babies who both fought neonatal herpes (twins, by the way...not two pregnancies), I still prefer to deliver vaginally if and when we have another as long as the conditions are appropriate.

Oh yeah...and you have to consider that only about 2000 babies are infected each year in the US. That is a really small incidence rate. Of those 2000, only about 600 are infected with hsv-1 (which is useful to know if you have genital hsv-1). And of those 2000, [b]70%[/b] are born to moms who do not know they have herpes. About the same percentage are born to moms who have a primary infection during pregnancy. Of the remaining 30% or so (sorry, I forget the statistic right now), many are born to moms who have a first non-primary outbreak, meaning they have already acquired the virus in the past but experience their first real outbreak during pregnancy. So, the risk is really greatest to women who contract it during pregnancy, not women with an established infection. certainly may already know all of that. If you do, great...knowledge is such a big step towards protecting yourself and your loved ones. But I say all that just to say this...if your ob/gyn feels confident that you can/should deliver vaginally one day, try to relax and trust that your baby-to-be will be beautiful. if you take a look, you will find a LOT of stories of happy endings when it comes to pregnancy and herpes. You will find very few stories about neonatal me! I've looked!

Good luck to you and all of those who want to grow their families one day!

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