I'm curious. For those pregnant clients who are negative for HSV-2 and are poly or have a HSV-2 positive primary partner, do you discuss the risks or acquiring HSV-2 during pregnancy, especially the third trimester?
yes, I do. I actually discuss this as part of my initial counseling with diagnosis. I try to realistically address in a NON-fear based, NON judgement based, factual manner what impact the diagnosis will have on her life (my patients are all women) so I discuss safer sex, communication with present and future partners, and the ramification for childbirth. (I usually discuss this BOTH with those intending and not intending to have children because there are times when women who have previously decided not to have children change their minds, in my [professional] experience.)
The issue of primary outbreaks in pregnancy has come up several times recently in the last 6 months because the practice has had a few women who were known HSV negative (through serum testing) whose partners were positive. Because of the risks associated with neonatal HSV, they were counseled that it probably was a good idea to either abstain from sex or use a barrier method and be veryvery careful, AND to have their partners be on supression therapy for the remainder of the pregnancy. Part of that counseling is CERTAINLY because of how devastating neonatal herpes is, but in OB these days there is a huge dose of (?over)caution because of the concern for litigation.
probably more information than you were looking for, but sexuality, safer sex and women's health are topics near and dear to me!
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aroraborealis) wrote2011-02-16 03:31 pm
Re: my $0.02
I'm curious. For those pregnant clients who are negative for HSV-2 and are poly or have a HSV-2 positive primary partner, do you discuss the risks or acquiring HSV-2 during pregnancy, especially the third trimester?
Re: my $0.02
I actually discuss this as part of my initial counseling with diagnosis. I try to realistically address in a NON-fear based, NON judgement based, factual manner what impact the diagnosis will have on her life (my patients are all women) so I discuss safer sex, communication with present and future partners, and the ramification for childbirth. (I usually discuss this BOTH with those intending and not intending to have children because there are times when women who have previously decided not to have children change their minds, in my [professional] experience.)
The issue of primary outbreaks in pregnancy has come up several times recently in the last 6 months because the practice has had a few women who were known HSV negative (through serum testing) whose partners were positive. Because of the risks associated with neonatal HSV, they were counseled that it probably was a good idea to either abstain from sex or use a barrier method and be veryvery careful, AND to have their partners be on supression therapy for the remainder of the pregnancy. Part of that counseling is CERTAINLY because of how devastating neonatal herpes is, but in OB these days there is a huge dose of (?over)caution because of the concern for litigation.
probably more information than you were looking for,
but sexuality, safer sex and women's health are topics near and dear to me!