What is gonorrhea?
Gonorrhea is a bacterial infection that can be transmitted through genital, oral, or anal sex. It can also spread from an infected woman to her baby during delivery. The incubation period (the time it takes for an infection to develop) is usually two to 10 days after exposure.
Gonorrhea is highly contagious, so if you have unprotected sex with an infected partner, it's likely you'll be infected. More than 583,000 cases of gonorrhea were reported in the United States in 2018, an increase of 63 percent since 2014.
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How can gonorrhea in pregnancy affect my baby?
If you have gonorrhea during pregnancy, you may have a greater risk of:
Prompt treatment reduces the risk of these problems.
An untreated gonorrhea infection makes you more susceptible to HIV and some other sexually transmitted infections (STIs), if you're exposed to them, and raises your risk of a uterine infection after you have your baby.
If you have a gonorrhea infection when you go into labor, you can pass the bacteria to your baby. Gonorrhea in newborns most commonly affects the eyes. As a preventive measure, the American Academy of Pediatrics and the U.S. Preventive Services Task Force strongly recommend (and most states require by law) that all babies be treated with medicated eye drops or ointments soon after birth.
Some parents will decline this eye ointment due to concerns about eye irritation or interference with bonding due to blurry vision. The risk of irritation is miniscule, and a newborn’s vision is notoriously limited to start with, so be assured the ointment is safe and important.
If you know you have a gonorrhea infection when you deliver, or if your baby is diagnosed with a gonorrheal eye infection at birth, he'll be treated with systemic antibiotics as well.
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If left untreated, a gonorrhea infection in an infant can cause blindness or spread to other parts of a baby's body, causing such problems as blood or joint infections and meningitis.
Gonorrhea symptoms in pregnancy
Gonorrhea doesn't always cause symptoms, so you may not be able to tell you've been infected.
If you do have symptoms, they may vary depending on which part of your body is infected.
If your cervix, vagina, or urethra are involved, your symptoms may include abnormal vaginal discharge, burning or pain during urination, spotting, and pain during intercourse.
With an anal infection, you might have discharge, itching, or pain when you move your bowels.
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If you have oral sex with an infected partner, you can develop a gonorrhea infection in your throat or mouth, which can become red and sore.
If your eyes come in contact with the bacteria (for example, by touching infected genitals and then rubbing your eyes), you can develop an eye infection with discharge and itchy, red eyes.
Will my partner have symptoms of gonorrhea?
Women may not have any sign of infection, but most men infected with gonorrhea have symptoms, which may include burning or pain while urinating, discharge from the penis, and tender or swollen testicles.
If your male partner has any of these symptoms, you both need to see a healthcare provider as soon as possible for testing and treatment, if necessary.
In the meantime, do not have sex. If either or both of you test positive, wait seven days after your treatment is complete before having sex again.
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Will I be tested for gonorrhea in pregnancy?
Maybe. The CDC recommends that all pregnant women age 25 and younger – plus pregnant women 25 and older who are considered at high risk for gonorrhea – be tested at their first prenatal visit. Risk factors include:
- Having a prior gonorrhea infection or another STI
- Becoming sexually active at a young age
- Having new or multiple sex partners
- Using condoms inconsistently
You may be tested again after treatment for a gonorrhea infection, and again in your third trimester if you're still considered at high risk.
If you think there's any possibility you might have gonorrhea or another STI, tell your provider so you can be tested. You also should be tested (or retested) at any time during pregnancy if you or your partner develops symptoms of gonorrhea, or if you contract another STI because they're often found together.
To test for gonorrhea, your provider will collect a urine sample or swab your cervix then send the sample to a lab for analysis. If you've had anal or oral sex, your provider may also take swabs from your throat and rectum.
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If your test is positive, you'll start treatment immediately.
Gonorrhea treatment during pregnancy
Gonorrhea can be treated with antibiotics that are safe to take during pregnancy. If you have more than one STI, your provider will treat you for them at the same time. (It's common to have chlamydia at the same time as a gonorrhea infection.)
Your partner also should be treated. To avoid reinfection, you should not have sex until you've both completed treatment.
What are the risks if gonorrhea isn't treated?
Left untreated, gonorrhea can spread to other areas of your body and cause serious problems. Before and after pregnancy, gonorrhea can spread to your uterus and fallopian tubes and cause pelvic inflammatory disease (PID).
In rare cases, the bacteria can enter the bloodstream and cause a serious condition called disseminated gonococcal infection. If that happens, you may have a fever and chills, sores, and painful, infected joints. Disseminated gonococcal infection can occur in anyone with an untreated gonorrhea infection, but it's more common in women and seems to occur more often during pregnancy.
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Gonorrhea prevention: ways to lower your risk
Have sex only with a long-term partner who does not have gonorrhea and who has sex only with you. Otherwise, use latex condoms for vaginal or anal intercourse and a dental dam for oral sex to lower your risk of getting gonorrhea (and certain other STIs). (Note that birth control pills, shots, implants, and diaphragms do not protect you from gonorrhea or other STIs.)
There are a number of illnesses - sexually transmitted and not - that might be worrisome during pregnancy. Check out our article on infections to watch out for in pregnancy.
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