STD Testing During Pregnancy

Many sexually transmitted infections have no symptoms, so you can have one without knowing, and prenatal care includes screening for that reason. Here is what is routine, what isn’t, and where herpes fits.

Do they test for herpes when pregnant?

Not routinely by blood test. CDC’s guidelines say routine HSV-2 blood screening of pregnant people is not recommended. Instead, CDC says to tell your provider if you have ever had a genital herpes diagnosis or symptoms, and at the time of delivery your provider should check you for herpes sores.

This matters because herpes can pass to a baby, more commonly during delivery than before birth, and neonatal herpes can be serious. CDC says to tell your provider if you’ve ever had a genital herpes diagnosis or symptoms.

If you have a history of herpes, or a partner does, ask your prenatal provider about a plan. CDC’s guidelines describe suppressive antiviral treatment late in pregnancy to reduce recurrences near term. They also say that people with recurrent genital herpes lesions at the onset of labor should have a cesarean delivery to reduce the risk of neonatal herpes. Your provider decides what fits you.

Which STD tests are routine in pregnancy?

CDC recommends that all pregnant people get tested for HIV, syphilis, hepatitis B and hepatitis C. Chlamydia and gonorrhea tests are recommended for people under 25, and for older people at increased risk. CDC defines increased risk to include having a partner who had an STI, or having new or multiple partners. The USPSTF also recommends chlamydia and gonorrhea screening for sexually active women 24 or younger, including pregnant people.

Trichomoniasis is different. CDC says pregnant people with symptoms should be tested and treated, and that the benefit of routine screening without symptoms hasn’t been established.

When in pregnancy are the tests done?

Most are done at the first prenatal visit. Some people are tested again later:

• Third trimester. CDC lists syphilis at 28 weeks and HIV before 36 weeks for certain groups, plus repeat chlamydia testing for people under 25 or at continued high risk, and gonorrhea for ongoing risk.
• At delivery. People who weren’t screened earlier for HIV and hepatitis B are tested.

Why does testing matter for the baby?

CDC says you can give chlamydia and gonorrhea to your baby during delivery, and treating them as soon as possible makes health problems for your baby less likely. For syphilis, CDC says that if the baby doesn’t get treatment right away, serious problems may develop within a few weeks, which is why testing at the first prenatal visit matters.

CDC says HIV testing should be performed during each pregnancy.

What if I test positive or have symptoms?

Call your prenatal provider. Chlamydia, gonorrhea and syphilis can be treated, and your provider will choose medicine suited to pregnancy. For chlamydia, CDC advises a follow-up test about 4 weeks after treatment during pregnancy, and another about 3 months after.

If your partner was told they tested positive, or you notice new sores, discharge or pain, don’t wait for your next scheduled visit. See our page on the window period if you’re unsure when a test would be reliable.

Can I get these tests without going through my prenatal provider?

You can, but a separate test doesn’t replace prenatal care. Your provider orders the screening that fits your pregnancy and follows up on results with treatment and delivery planning.

What about hepatitis B and C?

CDC recommends hepatitis B and hepatitis C testing for all pregnant people during each pregnancy. CDC also recommends hepatitis B vaccination for all infants, and lists infants born to mothers with hepatitis B among those who should be tested.