HPV and pregnancy can feel worrying, especially when a test result appears during a prenatal visit. Many pregnant women first hear about HPV after a Pap test, HPV test, or exam for genital warts. The good news is that HPV usually does not stop someone from having a healthy pregnancy or a healthy baby.
Human papillomavirus, or HPV, is a common virus that spreads through intimate skin-to-skin contact. Some HPV types can cause genital warts, while high-risk types can lead to abnormal cervical cell changes over time. Pregnant women with HPV may develop genital warts or cervical changes, and routine cervical cancer screening can help detect those changes during pregnancy.
What Is HPV?
HPV is a group of viruses that can affect the skin and moist areas of the body, including the cervix, vagina, vulva, anus, throat, and genital region. Many people with HPV never notice symptoms, so they may not know they have it.
There are different types of HPV. Low-risk HPV types can cause genital warts. High-risk HPV types can cause cervical cell changes that may need monitoring. These cell changes do not mean someone has cancer, but doctors track them because some changes can become serious if left unchecked.
Can HPV Affect Pregnancy?
In most cases, HPV does not directly harm the pregnancy. Many people with HPV go through pregnancy without major complications. However, pregnancy can sometimes make existing genital warts grow larger, become more noticeable, or bleed more easily because of normal body changes.
HPV can also be found during cervical screening. If a Pap test shows abnormal cells, the doctor may recommend follow-up testing. Screening during pregnancy can help identify abnormal cervical changes early, and cervical cancer screening can be performed during pregnancy when needed.
HPV Symptoms During Pregnancy
Many pregnant women with HPV have no symptoms. When symptoms appear, they may include small bumps, flat lesions, or cauliflower-like growths around the genital area. These are usually genital warts.
Some women may also learn about HPV only after an abnormal Pap smear. High-risk HPV usually does not cause visible symptoms, so screening plays an important role. If you notice bleeding after sex, unusual growths, pelvic discomfort, or changes near the genital area, speak with your healthcare provider.
Can HPV Pass To The Baby?
HPV transmission from mother to baby can happen, but it is rare. The CDC notes that in rare cases, a pregnant woman can transmit HPV to an infant during delivery.
Most babies do not develop health problems from HPV exposure. Rarely, certain HPV types may be linked with growths in a child’s airway, called respiratory papillomatosis. This condition is uncommon, and the exact route of transmission is not fully understood.
Does HPV Mean You Need A C-Section?
HPV alone usually does not mean a cesarean delivery is needed. The CDC states that cesarean delivery should not be done only to prevent HPV transmission to the newborn.
A doctor may consider a C-section if very large genital warts block the birth canal or create a delivery concern. This decision depends on the size, location, symptoms, and overall pregnancy situation. Most people with HPV can still have a vaginal delivery.
HPV Testing And Pap Smears During Pregnancy
Prenatal care may include a review of cervical screening history. If you are due for a Pap smear, your healthcare provider may perform it during pregnancy. A Pap smear checks cervical cells for abnormal changes, while an HPV test checks for high-risk HPV types.
If results show mild changes, your provider may monitor them. If results show higher-risk changes, the doctor may recommend colposcopy. During colposcopy, a specialist uses a magnifying device to examine the cervix more closely.
ASCCP guidance states that colposcopy with biopsy during pregnancy is safe when clinically needed, but expedited treatment is not recommended during pregnancy. Excision is only recommended if cancer is suspected.
Treatment For HPV During Pregnancy
There is no treatment that removes HPV itself from the body. Treatment focuses on the conditions HPV may cause, such as genital warts or abnormal cervical cells. Many HPV infections clear or become inactive over time, but follow-up care remains important.
Some genital wart treatments are not recommended during pregnancy. CDC guidance says podofilox, podophyllin, and sinecatechins should not be used during pregnancy, and imiquimod should be avoided until more safety data is available.
Doctors may remove warts if they cause pain, bleeding, rapid growth, or delivery concerns. However, treatment may not fully clear warts until after pregnancy. Never use over-the-counter wart removers on genital warts, especially during pregnancy, unless a clinician specifically approves it.
HPV Vaccine And Pregnancy
The HPV vaccine helps protect against HPV types linked with cervical cancer and genital warts. However, HPV vaccination is not recommended during pregnancy. If someone receives a vaccine dose before realizing they are pregnant, routine pregnancy testing before vaccination is not recommended.
Vaccination can be continued after pregnancy if the person is still eligible. ACOG notes that the HPV vaccine can be given to breastfeeding women age 26 years and younger who have not previously been vaccinated.
How To Manage HPV Safely During Pregnancy?
The best step is to keep all prenatal appointments and follow your doctor’s screening plan. Tell your provider if you have a history of HPV, genital warts, abnormal Pap results, LEEP, cone biopsy, or cervical treatment.
You should also avoid picking, shaving over, or trying to burn off genital warts at home. Use condoms if your provider recommends them, although condoms do not fully prevent HPV because the virus can affect areas not covered by a condom. Mayo Clinic notes that condoms reduce risk but do not fully protect against genital warts.
When Should You See A Doctor?
Speak with a healthcare provider if you notice genital bumps, bleeding, pain, itching, or unusual discharge. You should also ask questions if you receive an abnormal Pap result or positive HPV test during pregnancy.
Seek prompt care if you have heavy bleeding, strong pelvic pain, signs of infection, or rapidly growing genital lesions. These symptoms do not always mean something serious, but pregnancy is not the time to guess.
Final Thoughts
HPV and pregnancy can sound stressful, but HPV usually does not prevent a safe pregnancy or healthy delivery. The main goal is careful monitoring. Keep your prenatal visits, follow cervical screening advice, and speak with your provider before using any wart treatment.
If you have a positive HPV test, abnormal Pap smear, or genital warts during pregnancy, your doctor can guide you with safe options based on your results, symptoms, and stage of pregnancy.
FAQs
Yes, most women with HPV can have healthy pregnancies and healthy babies. HPV rarely passes to the baby, but regular prenatal care remains important.
HPV usually does not cause miscarriage. If you have cervical changes, genital warts, or past cervical treatment, your doctor may monitor you more closely.
Genital warts may grow faster or become more irritated during pregnancy. Hormonal and immune changes can make existing warts more noticeable.
Yes, cervical screening can be done during pregnancy when needed. Your provider may recommend a Pap smear if you are due for routine screening.
Some treatments are unsafe during pregnancy. Your doctor may use pregnancy-safe options or delay treatment until after delivery, depending on symptoms.
References
Centers for Disease Control and Prevention
About Genital HPV Infection
https://www.cdc.gov/sti/about/about-genital-hpv-infection.html
CDC STI Treatment Guidelines
Human Papillomavirus Infection
https://www.cdc.gov/std/treatment-guidelines/anogenital-warts.htm
American College of Obstetricians and Gynecologists
Human Papillomavirus Vaccination
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination