It is generally safe to get pregnant if you have the human papillomavirus (HPV). For most, an HPV diagnosis does not lead to significant complications during pregnancy, nor does it typically affect the developing baby. This article provides information on navigating pregnancy with HPV, detailing considerations and management approaches.
Understanding HPV During Pregnancy
The human papillomavirus is a common viral infection that transmits through skin-to-skin contact during sexual activity. Many with HPV experience no symptoms, and the infection resolves on its own. During pregnancy, HPV can involve different types, each with distinct implications.
Low-risk HPV types cause genital warts, which are benign growths on the vulva, vagina, cervix, or anus. Conversely, high-risk HPV types cause changes in cervical cells, which can lead to cervical cancer if unmanaged for many years. HPV infection is widespread; many pregnant individuals may already have HPV or acquire it during pregnancy without awareness.
Potential Effects on Mother and Baby
For the pregnant individual, HPV typically does not pose immediate health threats during pregnancy. If genital warts are present, hormonal changes and increased blood flow during pregnancy may grow larger or more numerous. These warts may bleed more easily, but they do not generally cause pain or interfere with the pregnancy itself. Monitoring of cervical cell changes caused by high-risk HPV types is common, though active treatment for these changes is deferred until after delivery.
The transmission of HPV from mother to baby during pregnancy is rare, and the virus does not cause birth defects or miscarriage. However, during a vaginal birth, there is a low risk of the baby acquiring HPV if the mother has an active infection in the birth canal. In rare instances, this transmission can lead to juvenile onset recurrent respiratory papillomatosis (JORRP) in the child. JORRP causes benign growths (papillomas) in the larynx and respiratory tract, which can lead to hoarseness or breathing difficulties.
Managing HPV Throughout Pregnancy
Managing HPV during pregnancy involves a watchful waiting approach, especially for changes in cervical cells. Routine Pap tests continue as part of prenatal care, and if an abnormal result indicates high-risk HPV, a colposcopy may be performed to examine the cervix. This procedure allows assessment of cellular changes without harming the pregnancy. However, biopsies or treatments for cervical changes are postponed until after the baby is born.
When genital warts are present, treatment is delayed until the postpartum period unless they are large, bothersome, or obstructing the birth canal. Certain topical wart medications are not safe during pregnancy. If treatment becomes necessary due to significant discomfort or obstruction, healthcare providers may opt for methods like cryotherapy, which freezes the warts, or surgical removal, both generally considered safe during pregnancy. Pregnant individuals should openly discuss any history of HPV or current symptoms with their healthcare provider to ensure appropriate monitoring and management throughout their pregnancy.
Delivery and Postpartum Considerations
Decisions regarding the method of delivery for individuals with HPV are made on a case-by-case basis. A cesarean section (C-section) is not recommended solely for an HPV diagnosis or the presence of genital warts. Vaginal delivery is safe, and the risk of transmitting HPV to the baby is low. A C-section might only be considered if large genital warts are obstructing the birth canal, or if they are causing significant bleeding complicating vaginal delivery.
After birth, most babies born to mothers with HPV do not require special immediate medical care and appear healthy. In the rare event that a baby develops symptoms of JORRP, such as persistent hoarseness or unusual breathing sounds, these appear later in infancy or childhood and warrant medical evaluation. For the mother, once the postpartum period is complete, discussions about receiving the HPV vaccine can occur if she has not been vaccinated and is eligible, as it protects against future HPV infections.