Vaginal birth and herpes

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A: It mostly depends on the state of your herpes. The American College of Obstetricians and Gynecologists ACOG currently recommends that only women with active herpes lesions or symptoms that a lesion is about ready to erupt should undergo a cesarean section to prevent the virus from infecting the baby during a vaginal delivery. In addition, as discussed later in this article, there are ways to reduce the amount of viral shedding associated with active herpes. It is this shedding that increases the risk of transmission. Some simply ask the patient about her symptoms or do a visual check for the presence of an active lesion which, as you probably know, looks like a cold sore and can range from slightly uncomfortable to very painful.
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Birth-Acquired Herpes

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Herpes & Pregnancy | American Sexual Health Association

I have genital herpes. There, I said it. No use in beating around the bush, right? For a couple of reasons. The first being that there is still so much stupid stigma attached to STDs, including herpes, and so I think it's important to talk about it. Herpes is incredibly common — it is estimated that 1 in 4 women and 1 in 5 men have it, and up to 85 percent of those infected do not know they have it because they never show any symptoms. So here's this thing that a lot of people have and yet no one talks about, and when they do, it's with shame and embarrassment.
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Genital Herpes - CDC Fact Sheet

Newborn infants can become infected with herpes virus during pregnancy, during labor or delivery, or after birth. If the mother has an active outbreak of genital herpes at the time of delivery, the baby is more likely to become infected during birth. Some mothers may not know they have herpes sores inside the vagina. Some women have had herpes infections in the past, but are not aware of it, and may pass the virus to their baby. Herpes type 2 genital herpes is the most common cause of herpes infection in newborn babies.
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It can be stressful to know that you have to think about genital herpes during pregnancy. It's possible for there to be severe consequences if a child becomes infected with the herpes virus during labor or shortly after being born. In rare cases, neonatal herpes can even be deadly. Because of this, women with genital herpes are often counseled toward a very conservative management of their pregnancy and delivery options.
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