You do. But while the thought of that conversation probably makes you cringe, you have every right to feel no shame about sharing this information. According to the Centers for Disease Control (CDC), there were 2,457,118 reported cases of STDs in the United States in 2018 — and many go unreported. That’s a lot of people. And I can guarantee all those folks aren’t irresponsible miscreants. People contract STDs. It happens. It’s something that should obviously be avoided as much as possible through safe sex practices, but despite our best efforts they still occur all the time. This is especially true when we’re teens and more prone to in-the-moment “I can’t find a condom, but whatever” behavior. And if we contract something like herpes — an STD that can never be erased from the body — we have to deal with those super-normal, yet unfortunate, teen-decisions forever.
Note: Most care providers recommend testing for human immuno- deficiency virus (HIV), hepatitis B, chlamydia, and syphilis during the first prenatal visit.
Although your care provider will provide the most up-to-date in- formation on how your STD could impact pregnancy and what the best course of action will be, here’s the lowdown on STD risk factors and the STDs that pose the greatest threat during pregnancy:
- Can pass to the fetus during delivery: Without certain medications, chlamydia, gonorrhea, genital herpes, and cytomegalovirus (CMV) can be passed from mother to infant as baby moves through the birth canal.
- Can infect the fetus during pregnancy: Syphilis, HIV, and CMV can pass to the fetus.
- Pregnancy loss: Syphilis, gonorrhea, HIV, and herpes can all increase the chance of pregnancy loss if left untreated.
- Chlamydia: This STD can increase the risk of preterm labor, and eye infections or pneumonia in the baby.
- Gonorrhea: Eye infections, pneumonia, or infections of the joints or blood in the baby can be caused by gonorrhea.
- Syphilis. Syphilis can cause a slew of serious issues for mother and baby, which is why it’s often treated with antibiotics during pregnancy.
- Genital herpes: Herpes exposure during delivery could lead to problems in baby, like brain damage. Women who have been diagnosed with herpes but don’t have active sores will be given medication to prevent an outbreak during delivery. Those with active sores will receive a C-section.
- Hepatitis B: As hepatitis can cause serious liver complications, the baby of a woman with this STD will receive the hepatitis B vaccine within twelve hours of birth, in addition to a treatment, called immune globulin, that helps prevent a chronic hepatitis infection. Some women might also receive antiviral therapy during the third trimester.
- CMV: Cytomegalovirus is a common virus (related to herpes) that often goes undetected. Serious illness could occur if it’s passed on to the baby. It’s usually managed by giving the mother antiviral medications.
- HIV/AIDS: This STD is often managed by giving the baby the medication zidovudine for four to six weeks after birth. In addition, the mother will likely be advised to continue her standard medication regime during pregnancy. A C-section is often recommended if there’s an elevated amount of HIV present in the body in the third trimester.
While these risks sound scary, many can be prevented if your care provider knows about your STD as soon as possible and gets you the necessary care.
What to do
Remind yourself that you’re not the first pregnant woman to tell her care provider she has an STD. Many women have come before you. Then re- mind yourself that your care provider is legally obligated to zip it when it comes to everything you tell them — no one else (beyond members of their staff with the clearance to see your chart) will find out, unless you tell them. And because preparation often does wonders for minimizing nerves, think through how you’ll tell them the news. As you do this, your head might be filled with visions of your care provider looking at you in horror, or shaking their head in disappointment while making that annoying “tsk tsk” sound. I can almost guarantee they’ll do none of the above.
Something else to consider is that you might have omitted this information in numerous prior visits. For example, I’ve worked with women who have seen their OB-GYN for years, and because of (undeserved!) shame, never told them about their STD. In all cases, the women received treatment for their STDs at a Planned Parenthood. Fast forward to their pregnancies — now they not only had to tell a person they saw as an authority figure that they had an STD, but also had to let it slip that they had been holding back key medical info for quite some time.
If you’re in the same predicament, you might feel the amplified anxiety and embarrassment these women all reported. However, it’s important to know that — just like the millions of people who also have STDs — there are likely also hundreds of thousands of other humans who have felt too embarrassed to share this info with their primary care physician. In addition to knowing that you’re not alone, know that if your care provider is worth their salt, they won’t bring up the fact that you’ve been keeping this from them. They’ll simply mark the info in your chart and discuss how it will be managed. Just another special circumstance. No biggie.