Case History: Herpes Simplex Virus-2 In Pregnancy

Caroline is a 38-year-old mother of two children born by cesarean section because of history of recurrent herpes genitalis outbreaks, including at the time of delivery in both previous pregnancies. Currently 22 weeks pregnant with her third child, she is already being told by her obstetrician that she has almost no chance of a vaginal birth given the likelihood that she will again experience an outbreak close to labor given her frequently recurring outbreaks, sometimes as often because every 2 to 3 weeks. She is very discouraged by this, because she found the recovery from the c-sections challenging, and she would prefer to have a vaginal birth. She has been told by a birthing center that if she can remain free of herpes for several weeks prior to and at the time of labor, they will support her desire for a vaginal birth barring other problems. At the time, Caroline was working as a nurse, doing many night shifts to bring in extra money for her family and to have time available in the daylight hours for her daughter. She was chronically stressed and exhausted, and the anxiety about the potentially impending cesarean was exacerbating her stress level. She was eating a lot of fast foods, especially in the evening at the hospital, and drinking coffee regularly to combat fatigue. Her marriage and home life were otherwise good, and she was committed to making personal and dietary changes to see if she could prevent herpes outbreaks.

Caroline immediately went on a high-lysine and low-arginine diet, cut back her night hours, switching to weekends with the plan to phase out working by the middle of her third trimester (she had planned to stop working then anyway), committed to stop drinking coffee, and began the following herbal protocol:

• • Infusion of equal parts of echinacea and burdock roots, two cups daily, prepared 28 g herb (1 oz) / 1 L of boiling water and steep 2 hours
• • Nervine tea, two cups daily consisting of chamomile, lemon balm, and lavender
• • 2000 mg daily vitamin C
• • Alternating applications of vitamin E and antiviral tincture (lemon balm, licorice, thyme, and St. John’s wort in a witch hazel extract base) should tingling or lesions become apparent

Caroline had an outbreak 1 week after our initial visit, at 23 weeks pregnancy. This was not surprising, given that she had been under prolonged stress and had worked an especially long weekend, and had only just started the herbal protocol. This was the last outbreak she experienced during the pregnancy, and cultures at 38 and 40 weeks yielded negative results. Caroline gave birth vaginally, at the birthing center, after 3 days of difficult labor and antibiotics for prolonged rupture of membranes. She experienced a vaginal yeast infection after the birth but felt this was a mild inconvenience compared with the recovery she previously experienced postcesarean.