The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA
An interactive resource for moms on easy steps they can take to reduce exposure to chemical toxins during pregnancy.
Other excellent resources about avoiding toxins during pregnancy
These are easy to read and understand and are beautifully presented.
USPSTF: Do Not Screen for Genital Herpes [8/5/16] by Veronica Hackethal, MD - The US Preventive Services Task Force (USPSTF) has released new recommendations advising against screening for genital herpes simplex virus (HSV) in asymptomatic adolescents and adults, including pregnant women.
The report was released August 2 and updates the 2005 USPSTF recommendations, drawing on "substantial" new evidence about the accuracy of screening tests for HSV-2 infection and "limited" new evidence about its harms and benefits.
Guidelines for Neonates Exposed to HSV During Delivery
Guidance on Management of Asymptomatic Neonates Born to Women With Active Genital Herpes Lesions. [full text]
Kimberlin DW, Baley J; COMMITTEE ON INFECTIOUS DISEASES; COMMITTEE ON FETUS AND NEWBORN.
Pediatrics. 2013 Jan 28. [Epub ahead of print]
Herpes simplex virus (HSV) infection of the neonate is uncommon, but genital herpes infections in adults are very common. Thus, although treating an infant with neonatal herpes is a relatively rare occurrence, managing infants potentially exposed to HSV at the time of delivery occurs more frequently. The risk of transmitting HSV to an infant during delivery is determined in part by the mother's previous immunity to HSV. Women with primary genital HSV infections who are shedding HSV at delivery are 10 to 30 times more likely to transmit the virus to their newborn infants than are women with recurrent HSV infection who are shedding virus at delivery. With the availability of commercial serological tests that reliably can distinguish type-specific HSV antibodies, it is now possible to determine the type of maternal infection and, thus, further refine management of infants delivered to women who have active genital HSV lesions. The management algorithm presented herein uses both serological and virological studies to determine the risk of HSV transmission to the neonate who is delivered to a mother with active herpetic genital lesions and tailors management accordingly. The algorithm does not address the approach to asymptomatic neonates delivered to women with a history of genital herpes but no active lesions at delivery.
and Pregnancy: Preventing Neonatal Transmission (Archived Web
Conference) CME/CE [Medscape registration is free]
Release Date: February 16, 2005; Valid for credit through February 16, 2006
Cesarean Section Appropriate in Women With Active Genital HSV [Medscape registration is free]
"Other risk factors for neonatal HSV were first-episode infection, isolation of HSV from the cervix, HSV-1 vs. HSV-2 isolation, invasive monitoring, delivery before 38 weeks, and maternal age younger than 21 years."
This means that women with a long-standing HSV infection not
cultured from the cervix who carry to term are at lowest risk for
passing on neonatal herpes to their baby, even with an active
lesion. However, it seems clear that suppression therapy is
a big win for women with a history of herpes.
of neonatal herpes require prompt treatment
Antiviral treatment curtails virus and enhances normalcy at 1 year.
of herpes simplex virus during pregnancy.
Brown ZA, Selke S, Zeh J, Kopelman J, Maslow A, Ashley RL, Watts DH, Berry S, Herd M, Corey L
N Engl J Med 1997 Aug 21;337(8):509-15
OBGYN.net - The Female Patient Article (Understanding Herpes Simplex Virus - Diagnosis, Transmission, Management)
The chance of asymptomatic shedding at any one time is about 2%, half of which occurs within 7 days of an outbreak. Young age and recent acquisition of genital herpes were identified as risk factors for asymptomatic shedding of HSV during pregnancy.
Neonates delivered vaginally during a recurrent episode have an
infection risk of only 1% to 4%. So the risk of infection
for an asymptomatic woman is less than 0.02% to 0.08% on average,
and even less than that for older women who did not acquire herpes
HERPES AND PREGNANCY from herpes.com
double-blind, randomized, placebo-controlled trial of acyclovir
in late pregnancy for the reduction of herpes simplex virus
shedding and cesarean delivery.
Watts DH, Brown ZA, Money D, Selke S, Huang ML, Sacks SL, Corey L.
Am J Obstet Gynecol. 2003 Mar;188(3):836-43.
CONCLUSION: Acyclovir significantly reduced, but did not eliminate, herpes simplex virus lesions and detection in late pregnancy.
Articles for most recent studies]
Hale, T. (1996) Medications and Mother's Milk, 5th ed.:
Approved by the AAP for use in breastfeeding mothers.....Percutaneous absorption following topical application indicates poor systemic absorption, with undetectable plasma levels....Acyclovir levels in breastmilk are reported to be 0.6 to 4.1 times the maternal plasma levels, Maximum ingested dose was calculated to be 1500 mcg/day assuming 750ml milk intake. This level produced no overt side effects in one infant. In another study, doses of 800 mg five times a day produced milk levels from 4.16 to 5.81 mg/L (total infant ingestion per day=0.73 mg/kg/day). .......Toxicities associated with acyclovir are few and usually minor.......Acyclovir therapy in neonates is common and produces few toxicities. Calculated intake by infant would be less than 1 mg/day.
The medication recommended here (zovirax) I need to tell all of
you about. It works ok when taken orally in pill form but not in
the cream form that you rub on a herpes outbreak. I was pretty
shocked about this myself but my son works at a drug co. and this
is the information they got. It was hush, hush like don't tell to
many people ( hah like no one will be looking) but it truly
doesn't work in that form and they keep making lots of money off
of it. So for what it is worth don't use the cream!
I beg to differ. The study that I was in was with the cream only.
I have used the cream and find it works really well. I don't know
what source the pharmacists had but I have been using it for 15
years and think the cream is great.
Complete Holistic Treatment Protocol for Herpes Viruses
Our local chiropractor/nutritionist says she's had great results
in her practice using an herb from the Amazon called tayuya.
It will shorten outbreaks from a week to 2-3 days. Many
patients say if they take it at the first tingle it prevents the
outbreak completely. She carries it under the name DermH3.
Our local naturopath recommends:
* acupuncture to increase immunity (working to support remission
with the liver divergent meridian; can also use carrot oil on
Liver DM points)
* tinctures of echinacea, siberian ginseng and reishi mushroom combined 1-2 droppersful every 2 hours; vitamin C and zinc to body's tolerance; lots of fluids to flush the system
* frequent topical application of melissa essential oil (it is not cheap and not so easy to find, but very effective); diluted manuka or tea tree oil as a less ideal substitute.
* lemon balm (melissa) tea, also chamomile tea, hops, passionflower, st. john's wort...tension tamer. teas that calm the nerves. I've heard some people using chamomile tea bags topically too.
* taking a warm bath in any of the above herbs; also baking soda. essential oils are good in the bath for calmative and therapeutic effects.
* abstaining entirely from sugar, chocolate, caffeine, dairy, alcohol, hot/spicy food, anything processed
* avoiding sex, biking, and other topical irritants and avoiding all forms of stress which further antagonizes the nervous system
* lots of sleep and rest
I would recommend L-lysine 1500mg per day until symptoms are gone
and then maintain 500mg per day.
The CNM who was my preceptor has shared the following guidelines
re herpes with me: 1000 mg lysine every 2 hours plus 1000 mg vit C
on day one of the outbreak, then 1000 mg twice a day till the
sores are gone.
What about weaning from the acyclovir onto a maintenance dose of
Lysine though? I have a friend that gets severe oral herpes that
was pretty chronic with worsening during any stress. She now takes
about 500 mg a day regularly and has had no further outbreaks in
the past two years.
There is an excellent write up in Christine Northrup's book
"Womens Bodies, Womens Wisdom". Lots of alternatives to acyclovir:
1) Garlic - 12 tabs @ outbreak onset then 4 tabs q 4-6 hours; 4
tabs a day for prophylaxis 2) Vitamin C (1000mg) &
Bioflavinoids QD 3) L Lysine 500mg TID.
activity of extracts from the medicinal plant Geranium
Serkedjieva J, Ivancheva S.
J Ethnopharmacol. 1999 Jan;64(1):59-68.
It can therefore be concluded that quantitative proof exists in vivo that H-Away effectively and safely inhibits HSV2 (genital herpes).
anti-herpetic activity of antisense phosphorothioate
oligonucleotides 5' end modified with geraniol.
Shoji Y, Ishige H, Tamura N, Iwatani W, Norimatsu M, Shimada J, Mizushima Y.
J Drug Target. 1998;5(4):261-73.
Conclusion: the anti-viral constituent geraniol in H-Away is able
to penetrate into cell membranes to safely inactivate HSV1 (cold
sores, fever blisters).
Relief™ (Formerly Herpilyn®) from Enzymatic Therapy contains lemon
balm leaf extract.
These products contain glycyrrhizinic acid, which has
anti-ulcerous, anti-viral and anti-inflammatory induction,
stopping viral growth (barrier effect).
What happened to the research a few years ago that showed that
infants of women with long term herpes were immune to herpes and
that vaginal birth was safe, period?
Article in the Summer '95 Birth Gazette about the active herpes
mode of delivery debate? It's in Medical Media Watch, on page 35
(Vol 11 No 3).
The US docs vetoed vag births. Here is an article from the Family
Physicians Continue to Disagree About Vaginal Delivery and Herpes
I've met midwives who've done stuff with spray-on bandage
coverings for the lesions. Worked fine.
In addition to the spray-on bandage, I've heard of nail polish
used successfully to cover lesions.
The problem with nail polish/spray on bandage to cover herpes lesion is that there is frequently cervical shed of the virus in addition to the local lesion.
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