Pregnancy changes how the body responds to sexually transmitted infections, and an untreated STI during pregnancy can affect the developing pregnancy in ways an STI outside pregnancy would not. Most prenatal care includes routine STI screening for this reason. Anyone who is not yet in prenatal care, or who has reason to think a recent exposure happened, should consider testing sooner rather than later. Here is the short version of what to know, what to test for, and where to go in the Merrimack Valley.
Why STIs matter more during pregnancy
Several STIs can be passed from a pregnant person to the developing pregnancy or to the infant at birth. Others can increase the risk of preterm delivery or miscarriage. Some are easier to treat in pregnancy than others. The common thread is that all of them are easier to manage when caught early.
The infections most commonly screened for in pregnancy:
- Chlamydia and gonorrhea. Both can cause neonatal eye infection at delivery and increase the risk of preterm birth. Both are bacterial and treatable with antibiotics safe in pregnancy.
- Syphilis. Untreated syphilis in pregnancy can cause serious complications including stillbirth. Treatment with penicillin is safe and effective. Rates of syphilis in pregnancy have been rising nationally, and Massachusetts public health has expanded testing recommendations as a result.
- HIV. With early diagnosis and treatment, the risk of transmitting HIV to the infant drops to under one percent. Without treatment, the transmission rate is much higher. Testing in early pregnancy is standard.
- Hepatitis B. Untreated infection can be passed at delivery. Newborns can receive a vaccine and an immune globulin shot at birth to prevent infection if the pregnant person tests positive.
- Trichomoniasis. Can increase the risk of preterm birth. Treatable in pregnancy.
- Herpes. Cannot be cured, but active outbreaks can be managed. A cesarean delivery is often recommended if an active outbreak is present at the time of labor.
When to test
If you are receiving prenatal care, testing is part of the standard first-visit panel. If you have not started prenatal care yet, two situations warrant testing sooner:
- You suspect an exposure. Symptoms vary widely. Many STIs have no symptoms at all in early stages. If you know or suspect a partner has an infection, or if you have had an unprotected encounter you are concerned about, schedule a test.
- You are weighing options for the pregnancy. An untreated STI can complicate an abortion procedure, particularly the risk of pelvic inflammatory disease afterward. Testing and treatment before the procedure reduces those risks.
What testing actually involves
Most STI testing uses a urine sample, a vaginal swab, or a blood draw. The samples are sent to a lab and results return in a few days. Some clinics offer rapid testing for HIV and syphilis with results in under an hour.
Massachusetts has expanded access to free or low-cost STI testing through Department of Public Health partner clinics. Tests are often free to anyone, regardless of insurance or immigration status. The state’s STI clinic directory covers locations across the Merrimack Valley.
Where to go in the Merrimack Valley
We do not perform STI testing at our centers. We provide referrals to licensed providers in Haverhill, Lawrence, Lowell, and surrounding towns, including:
- Local community health centers that offer free or sliding-scale testing.
- The Massachusetts Department of Public Health partner clinics.
- Family planning providers who include STI testing in their visits.
Our role is to help you find an option that fits, whether that is the lowest-cost route, the fastest result turnaround, or a provider with bilingual staff. A free phone call to any of our three locations is enough to start.
If you test positive
Most STIs are highly treatable. Bacterial infections (chlamydia, gonorrhea, syphilis, trichomoniasis) are cured with antibiotics. Viral infections (HIV, hepatitis B, herpes) are managed with ongoing medication that keeps them suppressed.
A positive result during pregnancy is not a crisis. It is information that lets your provider make the right calls about your care and the care of the pregnancy. Treatment in pregnancy is well understood. The medications used are safe.
Testing is the lever. Everything else follows from it.