Sexual Health in Pregnancy

As part of #SexualHealthAwarenessWeek 2020, Hey Girls have collaborated with sex educators from across the UK to promote empowering conversations about sexual health. This blog post was written by Social Enterprise, RISE, a Digital Platform for Women’s Wellbeing.

Pregnancy is very often the product of sex and yet it is something we do not talk openly about enough. Sexual health is always important and pregnancy is no exception. When you book your pregnancy test with your midwife or GP, you will be given information about screening for infectious diseases. This is a blood test which screens for Hepatitis B, HIV and Syphilis which are blood borne infectious diseases, transmitted through unprotected sex (without a condom), through needles, either injecting drugs or tattoos and piercings, if they are not sterilised or at birth. If you are in an at risk group due to your age, have any symptoms or live in an area with high incidence you may be offered screening for Chlamydia and Gonorrhoea too. Screening for genital warts and herpes is not routine but treatment in pregnancy is possible. As with all screening tests and decisions in pregnancy it is your choice whether you wish to have them. Finding out whether you have one or more of these infections is important, as there are potential side effects for you and your baby and effective treatments to prevent these once they are identified.

Hepatitis B
Hepatitis B is an infection of the liver caused by the virus. 9 out of 10 adults with a positive Hepatitis B test will recover fully, with 1 in 10 becoming life-long carriers. If you are a carrier of Hepatitis B in pregnancy, your baby has a chance of being infected at birth. An infected baby has a risk of being a lifelong carrier of Hepatitis B and a 1 in 4 chance of developing a serious liver disease. There is a very effective vaccination which your baby can receive after birth to reduce these risks and prevent them becoming a lifelong carrier.

HIV
HIV (Human Immunodeficiency Virus) is the virus which causes AIDS (Acquired Immune Deficiency Syndrome) and gradually weakens the immune system making it harder to fight infections. All blood donations in the UK are screened for HIV and needles are never reused in healthcare settings. The test screens for HIV antibodies which can take up to 3 months to develop, if you think you are at risk for developing HIV please speak to a healthcare professional. If you have HIV this can be passed to your baby during pregnancy, birth and breastfeeding. There are medications for use in pregnancy which greatly reduce the chance of your baby becoming infected from 1 in 4 (25% to less than 1 in 200 (0.5%). Breastfeeding is not recommended if you are positive for HIV due to transmission risk to your baby, however you can get breastmilk donations if you choose.

Syphilis
Syphilis is the last and least common of the blood borne viruses routinely screened for in pregnancy. Symptoms include small ulcers, sores or growths around the genitals or mouth, a blotchy red rash on the soles of the feet and palms of the hands and general flu signs. If left untreated for a long time (years) syphilis can travel to your brain and cause damage and so is important to get treated quickly. If left untreated in pregnancy it can be passed to the baby, and may cause miscarriage, stillbirth or premature labour. It can be cured with a simple course of antibiotics (typically Penicillin) which will also treat your baby if you are pregnant. Your baby will also be offered a course of treatment after they are born to ensure they are clear of the infection.

Chlamydia and Gonorrhoea
Chlamydia and Gonorrhoea are the two most common sexually transmitted bacterial infections in the UK. They are transmitted through unprotected sex without a condom, contact with another persons genitals, vaginal or seminal fluids or sharing sex toys which are not washed between users. They are not routinely screened for in pregnancy in the UK, but if you are under the age of 25, have had any unusual discharge or bleeding in pregnancy you will be offered screening as part of your care.
Symptoms may include painful urination, bleeding or spotting from the vagina between periods or a change in discharge, but some people will experience no symptoms. All of these symptoms can also be caused by other infections or side effects of pregnancy, it is always important to get them checked out by a healthcare professional. If left untreated the infection can spread to other parts of your body and lead to pelvic inflammatory disease (PID), for men inflammation of the testicles and infertility for women and men. In pregnancy both Chlamydia and Gonorrhoea infections can be passed to your baby in pregnancy and during birth and can cause miscarriage, premature birth, low birth weight and eye and lung infections after they are born. Treatment is very simple and involves antibiotics, tablets for Chlamydia and injection for Gonorrhoea, so don’t worry just get checked.

Genital Warts and Herpes
Genital warts look like little raised painless bumps, herpes look like small sores, both appear on or around your genitals and are transmitted through skin to skin contact with someone who has them. They are not routinely screened for in pregnancy but if you have symptoms or are concerned you have them speak to your midwife. If you have had either of these infections before they can happen again in pregnancy as your immune system changes. Towards the end of your pregnancy it is important to know if you have an active infection as it can change recommendations for your birth. Treatment is safe in pregnancy and can prevent a recurrence close to the birth.

If you are concerned that you may have these or possibly other sexually transmitted infections, it is important to tell your healthcare provider so that you can be tested and get treatment on board if necessary. It is also important to inform people that you have had sexual contact with, so that they can get screening and treatment too.

Unless you are advised by your health team sex is safe in pregnancy and will not affect your baby. Some people find they want to have sex more in pregnancy, some less – however you feel its normal and important to listen to your body. And remember to always practice safe sex!

RESOURCES
To find your nearest sexual health clinic for information, advice and treatment click here.

Post written by Charlie Pace, Founder of RISE HQ, Digital Platform for Women’s Wellbeing. Find them on social media and at www.risehq.co.uk.