What are STIs and STDs? 

Sexually Transmitted Infections (STIs) and Sexually Transmitted Diseases (STDs) happen when bacteria, a virus or even a parasite enter your body from one person to another during sexual contact and your immune system tries to fight it. If that infection multiplies and disrupts normal body function it turns into a disease. Often when people are talking about STIs and STDs they mean the same thing. STI is considered the more “up to date” term though, as most infections don’t make it to the disease stage. However, the term “STDs” have been used and around longer so most people still use this term. In this article, I’ll be using them interchangeably.  

Curious about signs and symptoms, check out the video below. 

Do I Have to Get Tested for STDs During My Pregnancy?

Yes, you should be tested for Sexually Transmitted Infection (STI) and Sexually Transmitted Disease (STD) while you are pregnant. As STIs can cause serious harm and health complications to a pregnant woman and unborn baby. The sooner you begin testing and even receiving treatment, the better the health outcomes will be for you and baby.  

I do want to add that even if you have been in a monogamous relationship, you will still need STD tests. As some STIs can lie dormant for years, it is always better to be safe than sorry. I know that may surprise some women, and it caught me off guard as well. I was a little shocked when they mentioned what the blood draw would be testing. I anticipated they would test for my blood type and rh factor, but std testing is standard practice for all pregnant women often in early pregnancy.

If you are curious about some of those additional tests see are article about Group B Step and Understanding Rh Factor.  

Why Do We Routinely Test for STIs During Pregnancy?

The reason a health care provider will routinely test pregnant women for STDs is because you can still get them while pregnant. Unfortunately pregnancy does not make you immune to STIs. Often STIs can be silent with no symptoms, but they could still be passed to your baby either in utero, in the birth canal, or even through breastmilk.

 If you are thinking of starting a family, or are pregnant, you should be tested for STIs. Like I mentioned above, STDs can seriously affect you and baby, even becoming life threatening if you become affected while pregnant.  If you are diagnosed with an STD while pregnant you and your sexual partner(s) should also be tested and treated. 

If you think you are ready to start your family we have an article about tuning into your body to know if it’s ready. 

How can STIs Affect Me and My Unborn Baby?

According to the U.S. Centers for Disease Control (CDC), STDs can complicate your pregnancy and may have serious effects on both you and your developing baby. Some of these problems may be seen at birth; others may not be discovered until months or years later including: 

• Easier to become infected with Human Immunodeficiency Virus (HIV)
• Premature or preterm birth
• Babies with low birth weight
• Preterm labor
• Premature rupture of membranes
• Eye infections
• Blindness
• Birth defects
• Liver infection
• Congenital syphilis
• Still birth
• Miscarriage

Some STDs can cause one or multiple of these adverse effects. Depending on which STD a pregnant Mom has, a baby can become infected as they pass through the birth canal. Some STDs can cross the blood placenta barrier separating your blood from your baby. Others can even be transferred through breastfeeding. I know that some of these are very serious, hence why your healthcare provider will check for them. We want to make sure that Mom and Baby are as healthy as they can be. 

While there may be some stigma still attached to STIs or STDs, there is no shame in knowing what they are, and receiving treatment if needed. It is better to know how and what you can do to help your body and your baby, than to wish you would have known. 

What STDs Do They Test For While Pregnant?

Below are the CDC screening recommendations for STDs during pregnancy. I’ve only included a very brief overview of what each infection is. If you want to know more, feel free to click on the links below, and you will be taken directly to the CDC’s web page. 

• Human Immunodeficiency Virus or HIV (the virus that causes AIDS. It attacks cells that are needed to fight off diseases, your white blood cells. This virus can pass to babies during pregnancy, childbirth, and breastmilk. There are antiviral medications available, but no cure)
• Hepatitis B virus or HBV (liver infection that can be passed during pregnancy. The greatest risk happens when mothers become infected close to the time of delivery. By screening pregnant patients for the infection and providing treatment to at-risk infants shortly after birth, healthcare providers can prevent mother-to-child transmission of HBV)
• Hepatitis C virus or HCV (another type of liver infection that can also be passed to baby during pregnancy) 
• Chlamydia (Chlamydia is the most common sexually-transmitted bacterium in the United States. Most do not have symptoms. The infection can be passed to baby as it goes through the birth canal)
• Gonorrhea (Gonorrhea is caused by infection with a bacteria. The bacteria infects the mucous membranes and can be asymptomatic. It can be passed to baby during birth through the vaginal canal)
• Syphilis (Syphilis is caused by bacteria through direct contact with a syphilitic sore, known as a chancre. Chancres can occur in, on, or around the penis, vagina, anus, rectum, and lips or mouth. Syphilis can spread during vaginal, anal, or oral sex. Pregnant people with syphilis also can transmit the infection to their unborn child.)

Other common STIs include bacterial vaginosis( a common cause of vaginal discharge caused by bacteria, while not technically an STD it does have serious pregnancy complications); herpes simplex virus or HPV (two distinct virus types that can infect the human genital tract, HSV-1 and HSV-2 that leave lesions sores and genital warts. There are complications linked to infection of the newborn. Transmission can happen in pregnancy and after delivery, the risk of transmission is high among women who acquire genital herpes near the time of delivery), and lastly trichomoniasis (Vaginal infection due to a sexually-transmitted parasite that leads to pregnancy complications, and in very rare cases can be passed directly to female newborns).

The good news is that generally when your healthcare provider orders a blood draw they will check multiple things at once. If you do test positive for an STI then you may be tested a few times over the course of pregnancy and delivery to ensure that the baby will be alright.     

When Will You be Tested?

Generally pregnant women will have blood drawn at their first prenatal visit to test for potential STIs and perform other standard screening tests.

Depending on age, health history, sexual history, and results of testing, your healthcare provider may do further testing in your pregnancy to ensure that appropriate prenatal care is given. If further testing is needed, often you will see it happen in the third trimester and again at delivery. This way you have the most up to date references on bacteria colonies and virus status in your body.

Testing is also subject to what bacteria or virus you may have and your sexual partners. For example for syphilis, a woman will be tested at her first prenatal visit and then she will likely be re-screened during the third trimester and/or delivery. Especially if factors have changed from her first appointment. 

You can see this in the fact sheet by the CDC to know when STD screening would happen during pregnancy. 

This is another great fact sheet from the American College of Obstetrics and Gynecologists that answers many questions regarding when and what you can be tested for while pregnant. 

Can I Get Treated for an STD During Pregnancy?

Good news! Yes, you can be treated for certain STDs during pregnancy. Chlamydia, gonorrhea, syphilis, and trichomoniasis can all be treated and cured with pregnant safe antibiotics. Unfortunately viral STDs like genital herpes, hepatitis B, hepatitis C, and HIV cannot be cured. However, in some cases these infections can be treated with antiviral medications or other preventive measures to reduce the risk of passing the infection to the baby. While this may change a few things about your birth plan, it will be helpful to know so that you will be able to work with your birthing team to find what will work best for you and baby in the long run. 

An important note is to be sure to finish all of the antibiotics or medicine you may be given. Often people will stop because they start feeling better, without realizing they may still have the bacteria. And please don’t share your medication, as you need all of it. If you and your sexual partner(s) have an STD you will want to avoid having sex until you finish all of your treatment so you don’t reinfect each other.

How can I Reduce the Risk of Getting an STI While Pregnant?

The very best and reliable way to avoid STDs while pregnant is to abstain from oral, vaginal, and anal sex.  Or to be in a long-term, mutually monogamous relationship with a partner known to be uninfected. If that isn’t possible, receiving treatment is a key while also abstaining from sexual intercourse until completion of the entire course of medication is crucial. 

Also latex condoms, when used consistently and correctly, can reduce the risk of transmitting or acquiring STDs and HIV.

Final Thoughts

While it may be surprising that regardless of your relationship status you should be tested for STDs in your prenatal care, I’m glad you know understand why it’s so important. As so many sexually transmitted infections can be cured, it allows you and your baby to avoid potential high risk situations. Especially if the STD has been dormant. I hope that this has been helpful as you are planning for baby, destigmatizing STIs/STDs, and allowing you to know that your healthcare team is there for you.