Having HPV during pregnancy rarely harms the baby. The most common change is that genital warts grow faster than usual because of pregnancy hormones and increased blood flow. Transmission to the newborn is uncommon and the dangerous outcome — warts in the baby's airway — is rare. Most people deliver vaginally without trouble.
of HPV-attributable cancers
| Item | Value |
|---|---|
| Currently infected | ~42 million |
| New infections / yr | ~13 million |
| Clear within 2 years | ~90% |
| Vaccine prevents | >90% — of HPV-attributable cancers |
Why HPV matters in pregnancy
HPV is the most common sexually transmitted infection, so many people are carrying it before they ever conceive CDC. Most infections cause no symptoms and clear on their own — in most cases the virus goes away within two years without health problems. Low-risk types (6 and 11) cause genital warts, while high-risk types (16, 18 and others) are the ones linked to cancer. Importantly, the types that cause warts don't cause cancer, and the types that cause cancer rarely cause anything you can see or feel.
Pregnancy doesn't make HPV more dangerous to you, but it can change how warts behave. The hormonal surge and richer blood supply to the genital tissue can make existing warts enlarge, multiply, or become more fragile and prone to bleeding. Some people notice warts for the first time in pregnancy simply because they're growing faster than the immune system can keep them in check. After delivery, these warts often shrink on their own as hormone levels fall.
If you want the full picture of how the virus is detected and what a positive result means, our guide to hpv testing walks through the science. Warts in male partners are covered separately in our piece on genital warts in men.
Risks to the baby
For nearly all babies, a parent's HPV causes no problem at all. The virus isn't known to cause miscarriage, birth defects, or developmental issues. The concern that worries most parents — passing warts to the baby during birth — is real but uncommon, and the serious version of it is rare.
Recurrent respiratory papillomatosis (RRP)
The rare neonatal risk is recurrent respiratory papillomatosis, a condition where HPV types 6 or 11 — the same low-risk types behind genital warts — settle in the baby's voice box or airway and grow as wart-like lesions. RRP can cause a hoarse cry, noisy breathing, or, in severe cases, airway obstruction, and it often needs repeated surgeries through childhood to keep the airway clear. It's uncommon even when a parent has active warts, which is one reason a cesarean is not routinely recommended just to prevent it (more on that below).
Genital and high-risk HPV
High-risk HPV doesn't behave the same way. It's typically asymptomatic and doesn't form lesions a baby could acquire, and the slow process by which persistent infection can progress toward cervical, vulvar, vaginal, penile, anal, or throat cancer plays out over years — not over a pregnancy. There's no evidence that being pregnant accelerates that progression in a way that changes management during the nine months.
Screening for HPV in pregnancy
Pregnancy is often a person's entry point into regular care, so it's a natural time to make sure cervical screening is up to date. The schedule itself doesn't change because you're pregnant — clinicians follow the same age-based guidance and simply fit it into prenatal visits when you're due.
Under the USPSTF 2018 recommendation (Grade A), people ages 21–29 get cytology (a Pap) every three years, and people ages 30–65 can choose cytology every three years, high-risk HPV testing alone every five years, or co-testing every five years USPSTF, 2018. More recent guidance favors starting at age 25 with a primary HPV test every five years rather than a yearly Pap ACS — because most HPV clears on its own within two years, and HPV testing catches more true precancer with fewer visits.
A few practical points specific to pregnancy: a Pap or HPV test is safe to perform, and a routine prenatal speculum exam already gives the clinician a look at the cervix and vaginal walls. If a screening result is abnormal, colposcopy (a magnified exam of the cervix) can be done in pregnancy, but biopsy and treatment of precancer are usually deferred until after delivery unless there's a strong concern for invasive disease — because cervical precancer is slow-moving and most of it doesn't need urgent action. If you're newly worried about a recent exposure, see our explainer on when to test after exposure, and you can also get tested for the broader panel that's standard in early pregnancy.
Safe treatment of warts in pregnancy
Whether to treat genital warts during pregnancy is a judgment call. Many clinicians watch and wait, since warts often regress after birth and treatment doesn't remove the virus. When warts are large, symptomatic, or bleeding, removing them can make delivery more comfortable and reduce bleeding — though no treatment is proven to lower the already-low chance of passing HPV to the baby.
The catch is that several standard wart treatments are not used in pregnancy. The patient-applied options — imiquimod cream, podofilox solution or gel, and sinecatechins ointment — are generally avoided because their safety in pregnancy isn't established CDC STI Tx Guidelines. Pregnancy-safe care leans on provider-administered methods instead.
| Treatment | How it's done | Use in pregnancy |
|---|---|---|
| Cryotherapy | Clinician freezes warts with liquid nitrogen or a cryoprobe | Commonly used |
| TCA or BCA (80%–90%) | Clinician applies an acid solution to the warts | Commonly used |
| Surgical removal | Excision, curettage, laser, or electrosurgery | Reserved for large or extensive warts |
| Imiquimod / podofilox / sinecatechins | Creams or solutions you apply at home | Avoided |
What treatment actually feels like: a clinic freeze or acid application takes minutes and stings or burns for a while afterward, and warts usually need several sessions over weeks before they're gone. None of these methods is clearly best, and because treatment removes the warts but not the virus, they can recur — sometimes during the same pregnancy. Don't reach for a leftover home wart cream from before pregnancy; podofilox and imiquimod aren't for self-use now.
Reducing transmission at delivery
The big question many parents have is whether they need a cesarean. For most, the answer is no. A C-section is not routinely recommended solely to prevent HPV transmission, because the risk to the baby is low, RRP is rare, and surgery carries its own risks. The main reason to consider a cesarean is mechanical — if warts are so large or numerous that they block the birth canal or are likely to bleed heavily during a vaginal delivery.
It's worth knowing that even a cesarean doesn't fully eliminate the chance of the baby acquiring HPV, which is part of why surgery isn't used as a preventive measure on its own. Your obstetric team will weigh the size and location of any warts against the usual considerations for delivery and talk through the plan with you.
When to see a clinician
- You notice a new bump or cluster of bumps in the genital area — genital warts usually look like a small bump or group of bumps.
- Existing warts grow quickly, bleed, or become uncomfortable during pregnancy.
- You're due for cervical screening or have never been screened — bring it up at a prenatal visit.
- You've had an abnormal Pap or HPV result and want to know whether follow-up should happen during or after pregnancy.
- You want to plan delivery and aren't sure whether warts will affect it.
After pregnancy, talk with your clinician about the hpv vaccine for adults if you haven't completed the series. The vaccine is prevention, not treatment — Gardasil 9 protects against future infection but won't clear an infection or warts you already have, and given at the recommended ages it can prevent more than 90% of HPV-caused cancers American Cancer Society. Vaccinated or not, keep up with cervical screening on schedule.