Treatments for STDs during pregnancy have seen significant and welcome advances in recent years, especially when combined with proactive screening. While these infections can still be a cause for concern, screenings for sexually transmitted infections (STIs) can give mothers the means to protect their health and the health of their baby.
Most treatments for STDs during pregnancy are fairly routine. But not all STIs manifest symptoms, so if you think you?re at risk for a sexually transmitted disease you should talk to your OBGYN or midwife about your screening and treatment options.
What is a Sexually Transmitted Infection?
STD stands for Sexually Transmitted Disease, a class of illness that usually begins with a sexually transmitted infection (or STI). Colloquially, the terms are often used interchangeably.
Medically, however, an infection usually precedes and causes the presentation of disease. An STI can begin with a virus or bacteria spread through bodily fluids or sexual intercourse. The disease manifests as the infection spreads and you begin to show symptoms.
For pregnant women, the primary concern is the spread of an STI from mother to baby. The specifics of how this might occur depends on the particular infection. Some infections can be transmitted during gestation. Others are transmitted more often during vaginal birth. Knowing the vector of an infection can help your OBGYN or midwife take steps to minimize or prevent the transmission of an STI from mother to child. That?s why STI screenings are routinely performed throughout your pregnancy.
How Do You Get an STI?
There is a great deal of misinformation about how sexually transmitted infections are spread from person to person. Sexual activity does indeed play a role in infection, but it?s not the only pathway for disease transmission.
In general, you could get an STI from the following activities:
- Engaging in unprotected sex (vaginal, anal, and oral sex can all be vectors for STIs)
- In general, saliva does not carry most STIs. However, other bodily fluids, such as blood, may be a vector for some infections. As a result, sharing needles or syringes, for example, can transmit some STIs.
- Most STIs can also be transmitted from mother to child, often through childbirth.
- Some infections can also be passed via breast milk to nursing infants.
It?s possible to become infected either before or after your pregnancy begins. Depending on your lifestyle and risk factors, you may wish to screen more or less often. All sexually active adults should be screened regularly.
Types of STIs and STDs
Public awareness of STDs and STIs during pregnancy is often limited to knowledge of one or two specific infections. However, there are several types of sexually transmitted infections, each of which can be mitigated or managed by the right treatment or therapeutic approach. The most common types of STIs include:
- Bacterial: STDs caused by a bacterial infection are often successfully treated with antibiotics. Bacterial STDs include chlamydia, gonorrhea, and syphilis, all of which are usually treated in pregnant women with antibacterial medication.
- Viral: In general, viral infections are more challenging to treat than their bacterial counterparts. Viral STDs include HPV, HIV, HSV or Hepatitis. These infections are usually managed by a variety of therapeutics, including anti-virals.
- Parasitic: In some cases, infections can be spread via infectious parasites. That?s the case with trichomoniasis. Treatments for parasites vary, depending on the specific type of infection. Often, antibiotic therapeutics can have the desired result and clear the infection.
It?s possible to have multiple STIs of various types. If you think you might have an STI, you will want to consult with your doctor to determine the best treatment method available to you.
The type of STI or STD will have several important implications. In general, the type of STD can tell you what to expect in terms of the longevity of the infection or the possible transmission vectors you may need to avoid. This information is incredibly valuable and can help keep you and your baby healthy and happy.
Risks of STIs
When tested and screened, every mother hopes for a clean bill of health. Positive results on an STD screening are not a reflection on your character or values. What?s more, screenings give you an opportunity to effectively evaluate risk that may be present for both you and your child. Once those risks are identified, your OBGYN can take steps to minimize and mitigate those risks.
You can think of risks created by STIs in two different ways. The first is a risk of transmission of infection. When it comes to diseases such as Hepatitis B or HIV, transmission could leave your child with a chronic and serious condition that requires significant therapies to treat.
The second risk concerns complications. Some infections can cause unwanted outcomes in pregnancies and development, especially if no therapies have been deployed to safeguard the health of mother and child. These complications could include:
- Miscarriage or Premature birth: Some STIs, such as gonorrhea, syphilis, and Hepatitis C, have been linked to an increased risk of preterm birth.
- Stillbirth: Some infections, such as syphilis, have been linked to a higher risk of stillbirth. It?s possible for infants born with syphilis to have serious complications impacting several organs.
- Blood infections
- Blindness and deafness
- Chronic liver disease
- Brain damage
The specific risks to you and your baby will depend most significantly on the nature of your infection. Syphilis, for example, may present one set of risks while HIV might present other challenges. Screening is usually employed to make sure the most serious complications from STDs during pregnancy can be avoided.
Treatments for STIs
Because the risks associated with having an STD during pregnancy can be so serious, it?s important that your doctor know about and treat any STIs you may have. Doctors have many tools designed to help prevent the spread of an STD from mother to child or eliminate the infection altogether.
In general, treatments for STIs may include:
- Antibiotics: Diseases such as syphilis, gonorrhea, and chlamydia can all be effectively treated and eliminated using antibiotics. Once the infection has been mitigated by the medication, there is usually no further risk to your child.
- Antivirals: While they are not quite as universally effective as antibiotics, antiviral medication can still reduce your viral load. And that can help keep your child from becoming infected from certain viral diseases, such as HIV.
- Therapies and treatments: In cases of particularly dangerous viral infections, such as HIV, special therapies may be used that are designed to prevent the spread of the illness from mother to child. These therapies are usually quite effective, leading to healthy deliveries.
- C-section: Because transmission of some STIs occurs only during vaginal birth, delivery via cesarean section is sometimes used in order to help protect the health of the baby as much as possible. The decision to undergo a C-section will depend on your own unique risk factors, so this option is something you?ll discuss with your OBGYN.
Your OBGYN or midwife will be able to tell you specifically which treatments will be warranted by which STI. It?s also important to note that mothers may be screened often for STIs–and other infections–as the sooner you?re able to treat any infection, the healthier your child will likely be.
Your health is personal, and STDs and STIs can feel even more private than usual. But it?s important to know that, in many ways, STIs are not all that different from any other infection: you can?t always control every vector of transmission, and treatment can help save you and your baby from unnecessary complications. With the right treatment, you?ll be able to spend your energies focused on your healthy and beautiful new baby.
If you have questions about screenings or treatment options, or want to talk to an OBGYN or midwife, contact our Wilmette or Glenview offices to schedule an appointment today.