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STIs in TTC, Pregnancy, and/or Breastfeeding- What You Need To Know.

There is a lot of fear mongering and misinformation about sexual transmitted infections (STI) so for the second week of April we are celebrating STI Awareness week. Each year we are given the opportunity to raise awareness, advocate for comprehensive sex education, reduce fear, discrimination and stigma. For those navigating reproduction (at any stage) it is important to understand the implications of an STI.  

There are two categories of STIs: Bacterial and Viral. Bacterial infections like chlamydia, gonorrhea, syphilis, and ​​trichomoniasis can be treated with antibiotics and Penicillin. Viral infections like HIV, HPV, HSV, and hepatitis B are lifelong but symptoms can be managed with medical care.

The CDC suggests that STI testing is a critical component of appropriate prenatal care; this is especially important because many STI are asymptomatic and if left untreated can lead to more serious consequences. If your doctor hasn’t yet talked to you about STI screening take this opportunity to advocate for yourself. 

“I am trying to conceive, what might I want to know?”

First step is to get tested! You can still get pregnant with most STIs and many can be treated before pregnancy and/or throughout pregnancy. Whereas lifelong STIs can be managed with medications to reduce risk of complications.

If an asymptomatic STI like chlamydia or gonorrhea is left untreated the infection can spread and impact fertility. If the fallopian tubes have been damaged by extreme inflammation IVF is still an option. 

“I am pregnant, what might I want to know?”

First step is to get tested! Many STIs can be treated or managed before and during pregnancy. One of the most common effects of STIs on pregnancy is an increased risk of preterm delivery but with testing and treatment risks can be reduced. 

When untreated chlamydia and gonorrhea have been linked to preterm labor, low birth weight, premature rupture of membranes, and infections in both the pregnant person and the baby. These bacterial STIs can be treated with antibiotics during pregnancy. If the baby was exposed to infection during delivery they may be treated to reduce risk of infection. Syphilis has been linked to preterm birth, stillbirth, developmental delays, as well as vision and hearing difficulties but syphilis can be easily treated with Penicillin which is why regular testing is crucial. 

Viral infections like HSV-1 and HSV-2 are incredibly common but can have more severe implications on a newborn. If a pregnant person has HSV-1 or HSV-2 symptoms can be managed with medication which reduces risk of transmitting infection to the baby. If the pregnant person has an outbreak around expected delivery a doctor might recommend a C-section to reduce risks.

Newborn babies can contract HIV during pregnancy, birth and chest feeding as well but with early detection and treatment the risk can be reduced to only 2%. In these cases a C-section might be recommended if viral levels are high around time of birth. 

Hepatitis B can be contracted during pregnancy and birth and lead to liver disease in newborns. This sounds scary and treatment during pregnancy substantially lowers the risk of transmission to the fetus which is why regular testing is so important.

“I am breast/chest feeding, what might I want to know?”

STIs can also have an impact on the breast milk of infected individuals. While many STIs are not transmitted through breast feeding, some infections can be passed to the baby through breast milk. HIV can be passed through breastmilk, it is recommended that those with HIV do not breast feed. HSV can not be passed through breast milk but can be passed through the act of breastfeeding; parents can continue to chest feed as long as the baby and equipment are not in contact with sores. Many antibiotics that are used to treat or manage these STIs are safe during breastfeeding.

In addition to the physical effects of STIs on conception, pregnancy, and breastfeeding, there can also be emotional and psychological effects. In part due to the stigma around STIs a diagnosis can be a source of stress and anxiety for parents, and may also have an impact on their relationships and families.

The effects of an STI on conception, pregnancy, and breastfeeding can be significant but with early detection and proper treatment many of these complications can be avoided. It is crucial for all of us to prioritize our sexual health, get tested frequently, and be informed. 

If this post doesn’t apply to you, one way you can support reducing STI stigma is by replacing the language of “clean” which implies there is such a thing as “dirty” with “positive” or “negative” when referring to STI testing.

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