Pregnant woman having an antenatal blood test

STI Testing in Pregnancy: What's Offered and What Isn't

Yes, STI testing is part of pregnancy care in the UK, but only for some infections. On the NHS you’ll be offered a blood test for HIV, hepatitis B and syphilis. Other infections, like chlamydia and gonorrhoea, aren’t routinely screened for in every pregnancy, so if you’re worried, you need to ask.

Let’s be real: it can feel awkward to bring this up with a midwife when you’re already juggling scans, appointments and a long list of things to think about. You shouldn’t feel that way. Sexual health is a normal part of looking after you and your baby, and this guide walks you through what happens, what doesn’t, and what your options are.

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TL;DR

  • Every pregnant woman in the UK is offered a blood test for HIV, hepatitis B and syphilis, ideally by 10 weeks.
  • Chlamydia, gonorrhoea and herpes aren’t part of routine antenatal screening, so ask your midwife, GP or a sexual health clinic if you’ve had a new partner, symptoms or a possible exposure.
  • STI tests are safe in pregnancy, but treatment choices are narrower, so never self-treat with leftover antibiotics.
  • Home tests can help you decide what to do next, but a positive result in pregnancy should always go to a clinician for confirmation and a safe treatment plan.

Table of Contents

What the NHS tests for in every pregnancy

During pregnancy you’ll be offered a blood test for three infections: hepatitis B, HIV and syphilis. The NHS describes this as routine antenatal screening recommended for every pregnancy. It’s usually done at your booking appointment, alongside your other first blood tests.

Three infections included in routine pregnancy screening

Why those three? Because early treatment makes a huge difference. The NHS explains that the test should be done as early as possible, ideally by 10 weeks, so treatment can start early if you need it. For HIV, treatment in pregnancy can cut the chance of passing the virus to your baby from about 1 in 4 to less than 4 in 1,000.

The screening pathway is also designed to catch infections early so that vertical transmission (mother to baby) is significantly reduced. It is an offer, not an obligation: you can say no. But if you decline at one point, you can change your mind later. Clinicians are used to these conversations and they’re confidential.

If you’re in another part of the UK

The details of how appointments are run can vary between NHS trusts and the four nations, so check your own maternity service’s leaflet. The three-infection core panel is the same idea throughout.

The gap: STIs that aren’t routinely checked

Here’s where people fall through the cracks. Many other infections, including chlamydia and gonorrhoea, aren’t screened for in every pregnancy. They’re usually tested for if you have symptoms, are considered higher risk, or ask for a test.

That matters because the most common STIs often cause no symptoms at all. You can feel completely fine and still carry an infection.

Chlamydia

The UK National Screening Committee does not currently recommend a national screening programme for chlamydia in pregnancy. That’s a population-level decision, not a statement that chlamydia is harmless for you. The same document notes that infants born vaginally to mothers with untreated genital chlamydia face a 15 to 50% risk of neonatal conjunctivitis, an eye infection.

It also points out that treatment options in pregnancy are limited because fewer antibiotics can be used safely. That’s a good reason to find out early rather than wait.

If you do test positive and are treated, guidance for clinicians says a test of cure should always be done in pregnancy. That’s the follow-up test a few weeks later to confirm the infection has cleared. It’s easy to forget, so put it in your diary.

Chlamydia — overview diagram

Gonorrhoea

Untreated gonorrhoea and chlamydia in pregnancy have been linked with problems such as preterm birth and low birth weight, and can pass to your baby during birth. The West of Scotland pregnancy and STI guideline sets out how common STIs affect the pregnant woman and her child, and which management recommendations differ in pregnancy.

Genital herpes

Herpes isn’t part of routine screening either. The good news from the RCOG is that genital herpes can be safely treated in pregnancy and during breastfeeding.

Timing is what matters most. Neonatal herpes is rare in the UK, affecting up to 7 in every 100,000 newborns. The risk is higher if your first-ever episode comes in the third trimester, especially within six weeks of delivery, because you haven’t yet built antibodies to pass on to your baby. In that situation a planned caesarean is typically recommended. If you’ve had herpes before, your body has likely made protective antibodies, and the risk is much lower.

For women who may have caught it close to delivery, RCOG clinical guidance says type-specific HSV antibody testing is advisable to work out the right advice on delivery.

Is STI testing safe while pregnant?

Yes. Blood tests, urine samples and swabs don’t harm you or your baby. For chlamydia and gonorrhoea, the test is typically a urine sample or a painless vaginal swab, which you can often take yourself if you prefer.

The real difference in pregnancy isn’t the test. It’s the treatment. Some standard antibiotics aren’t suitable, and some work less well. Your clinical team may need to coordinate between sexual health, obstetric and paediatric specialists, especially for syphilis, where BASHH guidance on syphilis in pregnancy stresses specialist, joined-up care.

So please don’t take leftover or online-bought antibiotics “just in case”. Get a diagnosis first and let a clinician choose a treatment that’s safe for both of you.

Signs worth mentioning to your midwife

A lot of pregnancy symptoms look a bit like infection symptoms, which makes this confusing. Ask for a check if you notice:

  • unusual vaginal discharge, or a change in smell or colour
  • pain or burning when you pee
  • sores, blisters, ulcers or unusual lumps around the genitals or anus
  • pain during sex or bleeding that isn’t normal for you
  • itching or irritation that won’t settle

Also ask for a test, even with no symptoms, if:

  • you’ve had a new partner since you got pregnant, or before you knew you were pregnant
  • your partner has had other partners, or has been diagnosed with an STI
  • you had unprotected sex and haven’t tested since
  • you’re under 25 and haven’t been tested for chlamydia recently

Pregnancy doesn’t protect you or your baby from STIs. Expecting a baby is a good moment to get a clear picture.

Where to get tested during pregnancy

You’ve got a few routes, and none of them are wrong.

  1. Your midwife or GP. Tell them you’d like an STI check. They can arrange tests or refer you on.
  2. A sexual health (GUM) clinic. You can usually self-refer without a GP letter, and the service is free and confidential. Many offer same-week or walk-in slots, though availability varies by area.
  3. A home test. Useful if you want a quick, private first answer before deciding what to do next, or if you can’t get an appointment soon.

If you’re already thinking about other aspects of pregnancy care, like staying comfortable or managing back pain safely, it’s worth reading up on questions such as safety checks for chiropractic during pregnancy before you book anything, and it’s the same principle as sexual health: tell every professional you see that you’re pregnant.

Can a home rapid test help during pregnancy?

It can help you get clarity quickly, with one big caveat. A rapid screening kit tells you whether it’s worth taking the next step. It doesn’t replace your midwife, GP or a sexual health clinic, and it doesn’t give you a treatment plan.

Here’s a sensible way to use one:

  1. Check the instructions for the specific kit and ask your midwife or pharmacist if you’re unsure it suits you in pregnancy.
  2. Take the test in a calm moment, following the instructions exactly.
  3. If you get a negative result but have symptoms or a recent high-risk exposure, still speak to a clinician. Timing matters, as infections may not show up straight away. Our guide on how soon after exposure you should test for chlamydia explains why.
  4. If you get a positive or unclear result, contact your midwife, GP or a sexual health clinic promptly. They will confirm it and choose safe treatment.
  5. If you’re treated, book the test of cure your clinician recommends.

A positive result is not a verdict on you. STIs are common, treatable, and the whole point of testing is to protect you and your baby.

Our perspective

We built Rapidtest because we think proactive health care should be affordable and not embarrassing. We hear from people who put off testing because of queues, awkward conversations or just a lack of time. Pregnancy makes all of that harder, not easier.

Here’s what we believe. Routine NHS antenatal screening is excellent at what it covers, and you should take it up. But it covers a specific, narrow panel. If you’re wondering about anything outside it, you shouldn’t have to sit with that worry until your next appointment.

A home kit gives you a first, private step, with results in 15 minutes. It’s not a substitute for clinical care, and we’d never suggest it was. If you’re pregnant, the right move after any positive or worrying result is to speak to your midwife, GP or a sexual health clinic, because treatment choices in pregnancy are more limited and need a professional’s judgement.

Our kits are CE-certified, arrive in discreet packaging, and come with full instructions, free UK shipping, customer support and a 60-day refund guarantee if the kit doesn’t work. That’s the kind of low-friction option we’d want ourselves.

— Jack

Planning a pregnancy? Test before you conceive

The easiest time to deal with an STI is before you’re pregnant, when more treatments are open to you. NHS Healthier Together says most STIs can be treated, but some treatments aren’t suitable in pregnancy, so it’s a good idea to get checked before trying for a baby.

That applies to both partners. If you’re trying as a couple, test together, so nobody is re-infecting the other.

Check your options at Rapidtest

If you’d like a private first step, our at-home STI and STD test kits start from £21.95. They screen for infections including chlamydia, gonorrhoea, syphilis, HIV, hepatitis B and C, HSV-2 and HPV, with results in around 15 minutes and no lab returns.

Trying to conceive? Our fertility insight kits cover hormone and sperm concentration testing, and you can browse everything on rapidtest.co.

What to say to your midwife

Not sure how to start? Try one of these:

  • “I’d like to talk about sexual health testing. Can you tell me what’s included in my routine bloods?”
  • “I’ve had a new partner since getting pregnant. Can I be tested for chlamydia and gonorrhoea?”
  • “I think I might have been exposed to herpes. What should I do?”

You don’t need a big reason. As the RCOG’s patient information puts it, you should contact your doctor or a sexual health clinic if you think you may have an infection, and you may be offered testing for more than one STI because it’s possible to have several at once.

FAQ

Do they do STI testing during pregnancy?

Yes, but only partly. Everyone is offered blood tests for HIV, hepatitis B and syphilis. Tests for chlamydia, gonorrhoea, herpes and others are usually done if you have symptoms, are at higher risk or ask for them.

How do you know if you have an STI while pregnant?

Often you don’t, because many STIs cause no symptoms. Warning signs include unusual discharge, pain when peeing, sores or blisters, and pelvic pain, but the only way to know is a test. If you’ve had a new partner or possible exposure, ask for one.

What happens if you give birth while having an STI?

Some infections can pass to the baby during birth. Untreated chlamydia can cause an eye infection in newborns, and a first herpes episode close to delivery carries a higher risk, which is why a caesarean may be advised. Finding and treating infections in pregnancy is the best way to lower these risks.

Can I use a home STI test while pregnant?

A home test can be a quick private first step, but it’s no replacement for clinical care. Follow the kit instructions, and if the result is positive, unclear, or you have symptoms despite a negative, speak to your midwife, GP or a sexual health clinic. Treatment in pregnancy needs to be chosen by a clinician.

Sources

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