STDs During Pregnancy: What Every Expecting Mom Needs to Know

Somewhere between the first ultrasound and the nursery paint samples, a nurse hands you a lab slip with a list of tests on it. Some of them are for infections you’ve never worried about. And a small, anxious voice asks: why are they testing me for that?

Here’s the reassuring truth about STDs during pregnancy. You’re being tested not because anyone suspects anything about you, but because these infections are screened for in everyone — and because catching them early is one of the most effective things modern prenatal care does.

Jump to a sectionIn this article8 sections

1. Why Screening Happens at All
2. STDs During Pregnancy: What Gets Screened, and When
3. What Each Infection Can Mean for a Baby
4. A Few Situations Worth Understanding
5. If You Test Positive
6. 💡 Actionable Tips for Expecting Moms
7. ⚠️ Call Your Provider Right Away If You Have
8. You Are Doing the Right Thing By Reading This

Why Screening Happens at All

Pregnancy changes the stakes. An infection that might cause a woman mild symptoms — or none at all — can affect a developing baby differently.

Some infections can cross the placenta during pregnancy. Others pass to the baby during delivery. A few can be transmitted through breastfeeding. Each pathway has different risks, and each has different ways of being interrupted.

That’s the entire logic of prenatal screening: find it, treat it, and cut off the pathway before it matters.

Does being tested mean your provider suspects something? No. It means you’re pregnant. That’s the whole criterion.

STDs During Pregnancy: What Gets Screened, and When

At your first prenatal visit, you’ll typically be tested for HIV, syphilis, and hepatitis B. These are standard nearly everywhere, and many states legally require syphilis testing at the first visit.

Chlamydia screening is recommended for pregnant women under 25 and for those with certain risk factors. Gonorrhea screening follows similar logic. Hepatitis C screening is now recommended during each pregnancy.

The Syphilis Question — And an Honest Answer

This is where you should know that experts don’t fully agree, and that’s worth understanding rather than glossing over.

Syphilis rates in the United States have climbed sharply, and cases of congenital syphilis — syphilis passed to a baby — have surged along with them. In response, the American College of Obstetricians and Gynecologists now recommends that all pregnant patients be screened three times: at the first prenatal visit, in the third trimester, and again at birth.

The CDC, meanwhile, recommends the first-visit screening universally, and additional third-trimester and delivery screening based on risk factors and local rates.

What does that mean for you? It means your provider may follow either approach, and both are defensible. If you want the additional screening, you can ask for it. That’s a completely reasonable conversation to have.

Here’s the number that matters most: public health officials estimate that the large majority of congenital syphilis cases — around nine in ten — could have been prevented with timely testing and treatment. This is a solvable problem. Testing solves it.

What Each Infection Can Mean for a Baby

Take this table as information, not alarm. Notice the last column.

Infection	Possible Risk to Baby	With Prenatal Care
Syphilis	Miscarriage, stillbirth, congenital syphilis, lasting bone/nerve/hearing problems	✅ Treatable with antibiotics; prevention is highly effective
HIV	Transmission during pregnancy, birth, or breastfeeding	✅ Treatment lowers transmission risk to under 1%
Hepatitis B	Chronic infection in the baby	✅ Newborns receive protective treatment at birth
Chlamydia	Preterm birth, low birth weight, eye and lung infection in newborn	✅ Curable with antibiotics safe in pregnancy
Gonorrhea	Preterm birth, serious newborn eye infection	✅ Curable; newborns routinely receive eye ointment
Genital herpes	Neonatal herpes — rare, but serious	✅ Managed with medication and delivery planning
Trichomoniasis	Preterm birth, low birth weight	✅ Curable with medication
HPV	Very rarely affects the baby	✅ Usually no impact on pregnancy

Look down that right-hand column again. Every single row has a path forward. That’s not spin — that’s what prenatal care is for.

A Few Situations Worth Understanding

Herpes and Delivery

If you’ve had genital herpes for years before pregnancy, your body has built antibodies, and those antibodies cross to the baby. The risk of neonatal herpes in this situation is low.

The higher-risk scenario is contracting herpes for the first time late in pregnancy, when there’s been no time to build that protection.

Providers manage this in two ways: medication in the final weeks, and — if there are active sores at the time of labor — a cesarean delivery to avoid contact during birth. Millions of women with herpes have delivered healthy babies. Tell your provider. That’s the whole action item.

HIV and the Number That Changed Everything

Without treatment, roughly a quarter to a third of babies born to mothers with HIV would acquire the virus.

With modern treatment during pregnancy, delivery, and infant care, that number falls to 1% or less.

That’s one of the great success stories in medicine, and it depends entirely on one thing: knowing the diagnosis early enough to act on it. Which brings us back to testing.

What About Group B Strep?

This one confuses everyone, so let’s clear it up. 💡

Group B strep is not a sexually transmitted infection. It’s a common bacteria that lives harmlessly in the digestive tract and vagina of many healthy women. You’ll be swabbed for it late in pregnancy, and if it’s present, you’ll receive antibiotics during labor to protect the baby.

Same with bacterial vaginosis — an imbalance of normal vaginal bacteria, not an STI.

Being screened for these does not mean anyone thinks anything about your sex life. It means you’re pregnant, and pregnancy comes with a checklist.

If You Test Positive

First: breathe. Then read this twice.

A positive result during pregnancy is not a catastrophe. It’s information arriving in time.

The most damaging thing a woman can do with a positive result is hide from it. The infections in the table above become dangerous when they go untreated — not when they’re found.

What Happens Next

Treatment starts. Nearly all of these are safely treated during pregnancy. Your provider will choose an approach appropriate to your specific infection and stage of pregnancy.

Your partner needs treatment too. Otherwise you’ll be reinfected, and you’ll be back where you started. This is not optional.

Follow-up testing happens. Confirming that treatment worked is part of the process.

Your baby may be monitored or treated after birth. Depending on the infection, this can range from a simple eye ointment to a more involved plan.

Will anyone judge you? Your care team has seen this many times. It is a Tuesday for them. Their entire focus will be on protecting you and your baby.

💡 Actionable Tips for Expecting Moms

1. Go to prenatal visits — all of them. A meaningful share of congenital syphilis cases occur in pregnancies without adequate prenatal care.
2. Ask which tests you’re getting. “What am I being screened for today?” is a perfectly normal question.
3. Ask about third-trimester syphilis screening specifically, given the guidance differences.
4. Disclose your history. Herpes, past infections, partner risk factors. It changes the plan, and the plan protects your baby.
5. Get your partner tested. Their result affects your pregnancy.
6. Ask about hepatitis B vaccination if you’re not immune.
7. Report any new symptoms — sores, unusual discharge, pelvic pain, fever — without waiting for your next appointment.
8. Don’t stop treatment early because you feel fine. Feeling fine is the default state of most STIs.
9. If you missed early prenatal care, start now. Later is enormously better than never.

⚠️ Call Your Provider Right Away If You Have

• 🚩 New genital sores or blisters, especially in the third trimester
• 🚩 Unusual discharge, pelvic pain, or burning with urination
• 🚩 Fever during pregnancy
• 🚩 A partner who has tested positive for any STI
• 🚩 Any bleeding or fluid leakage
• 🚩 Reduced fetal movement

These aren’t wait-and-see symptoms. Pick up the phone.

You Are Doing the Right Thing By Reading This

There’s a particular kind of shame that attaches itself to STDs during pregnancy — the sense that a positive result says something about the kind of mother you’ll be.

It doesn’t. It says you’re a person who has had sex, which describes essentially every pregnant woman on earth. What actually predicts outcomes is not whether you’ve ever had an infection. It’s whether it was found and treated in time.

You’re already doing the thing that matters. You’re informed, you’re asking questions, and you’re showing up. Go to your appointments. Ask what you’re being tested for. Tell your provider the truth about your history, even the parts that feel uncomfortable.

Nearly every serious outcome in this article is preventable, and the prevention is straightforward. A test. A conversation. A course of treatment. Then a healthy baby, and a mother who did exactly what she needed to do.

That’s within your reach. It probably always was.

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Screening recommendations and treatment during pregnancy depend on individual circumstances and are actively evolving. Always follow the guidance of your obstetric care provider.

Keep going: this article is part of my natural healing and healthy living guide. For every guide, free tool, and honest review, organized by where you are stuck, visit the Hormone Health Hub.