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Your guide to strep throat during pregnancy

This infection is unpleasant, but luckily there are treatments that are safe for expectant moms

Dealing with a case of strep throat while pregnant is no fun at all. If you develop strep throat symptoms, such as a sore throat and pain while swallowing—or if you’ve recently tested positive for strep—you are probably wondering what happens next. Is strep throat dangerous for pregnant women? Will it harm the pregnancy? And what treatment options are effective and pregnancy-safe?

The good news is that strep throat is not generally more serious for pregnant people than those who aren’t, and there are many treatment options available when you’re expecting. Let’s take a look at everything to know about strep throat and pregnancy, from risks to treatments and prevention.

RELATED: Strep throat vs. sore throat

Symptoms of strep throat during pregnancy

The symptoms of strep throat in pregnant people aren’t really any different than symptoms in non-pregnant people, says James Miller, MD, an OB-GYN in Wooster, Ohio. These symptoms usually include sore throat, tender lymph nodes, tonsillar swelling and drainage, and fever. However, says Dr. Miller, sometimes pregnant people may notice an uptick in Braxton Hicks contractions (false labor pains) while having strep throat. “These faulty contractions will occur more frequently when febrile and/or overall ill,” Dr. Miller says. Luckily, Braxton Hicks contractions won’t cause any complications in your pregnancy.

In both pregnant and non-pregnant people, strep throat usually starts with a sudden and intense sore throat. A sore throat when you also have symptoms of a cold such as cough, runny nose, and nasal congestion is not strep. But, common symptoms of strep may develop, including:

  • Pain and soreness while swallowing
  • Swollen tonsils that may look red and have white, patchy areas
  • Small red spots or white spots on the roof of your mouth called petechiae
  • Swollen lymph nodes in the neck area
  • Fever 100.4 F or greater
  • Headache
  • Digestive symptoms like stomachaches, nausea, vomiting (more common in children), or loss of appetite
  • Sandpaper-like rash (scarlet fever)

Strep throat has several symptoms that resemble the common cold. But strep throat is caused by a bacterial infection (group A Streptococcus, specifically) and not a virus. You can’t tell for sure if you have a streptococcal pharyngitis infection or another respiratory illness without seeing a medical provider who may obtain a strep throat swab (a rapid strep test or throat culture). 

Risks of strep throat while pregnant

Strep infection is very contagious and is passed from person to person via respiratory droplets, but it is quite uncommon in those older than 15 years. These droplets can be exchanged through close contact when someone talks or sneezes, or by touching a surface that an infected person has touched and then touching your mouth or nose. Strep can also be contracted by using utensils or cups that a sick person has used or touched.

Thankfully, if you catch it, strep throat isn’t usually any more harmful to pregnant people than non-pregnant people, says Mitchell S. Kramer, MD, the chairman of the department of obstetrics and gynecology at Huntington Hospital in New York. “There are no specific risks from strep throat unless it is neglected and goes untreated or treated improperly,” he explains. “If left untreated, the infection could theoretically progress and become systemic, which could affect the baby by causing sepsis, high fever, etc., although this is unlikely as most people are diagnosed and treated properly.” Untreated strep throat can also lead to rheumatic fever. 

That’s why it’s important that if you have any signs or symptoms of strep throat, you should visit your healthcare provider for a diagnosis and treatment plan, including any necessary medication. 

Strep throat (Group A) vs. Group B

During your pregnancy, you’ve probably heard of a type of infection called Group B strep, and may be wondering if there is any relationship between this and strep throat. These are two different pathogens, says Dr. Miller. “There is no clinical connection between Group B strep and strep throat (Group A strep),” he explains.

Strep throat is usually caused by Group A streptococcus, whereas Group B streptococcus is a bacterium that colonizes the vagina and can cause health issues for infants. “Group B strep is tested for at 36 weeks of pregnancy via vaginal culture,” Dr. Miller says. “Group B strep is a natural vaginal bacterium for 20%-30% of women.”

Group B strep can be passed to your baby during childbirth, explains Dr. Miller. “Patients positive for Group B strep need antibiotics during their labor to prevent this transmission,” he says. Babies who contract Group B strep during childbirth are at risk for serious complications like pneumonia, sepsis, seizures, or meningitis.

Strep throat can be passed to your baby after it’s born, but not while your fetus is in utero, says Dr. Kramer. If you have strep after your baby is born, you can take precautions to prevent transmission to your infant. “Prevention of giving strep throat to the newborn is by using the usual precautions: avoid direct respiratory or oral contact, wear a mask, [employ] careful handwashing and sanitizing, and avoid sharing utensils and towels,” Dr. Kramer advises. It’s okay to breastfeed while you’re sick, but be sure to use respiratory precautions as your infant will be near your face.

Again, it’s also important that if you contract strep throat before or after pregnancy, you receive proper medical care. It’s not always possible to distinguish strep throat from other illnesses. Common cold viruses, allergies, and even the effects of smoke inhalation can also cause a sore throat. That’s why it’s best to see a medical provider for diagnosis and treatment. Proper treatment will also lessen the risk of passing along strep throat to your baby. 

How to get rid of strep throat while pregnant

If you have strep throat, you might be wondering: How do I get rid of strep throat while pregnant? Moreover, you might want to know what you can safely take for strep while pregnant.

There are two aspects to consider here: soothing your symptoms and getting rid of your infection. Symptom soothers may include pain relievers and at-home treatments. The best way to clear your body of a strep throat infection is to take antibiotics, but it’s not essential to take meds when you’re 15-44 years old as your body can clear it on its own. In general, treatments will be the same for pregnant and non-pregnant individuals.

Antibiotics

Strep throat is usually treated with antibiotics. Most of the common antibiotics used to treat strep throat are safe during pregnancy as well as breastfeeding and have minimal side effects, says Dr. Kramer. Pregnancy-safe strep throat antibiotics include penicillins or cephalosporins, such as amoxicillin or cephalexin. It should be fine to take these if you are not allergic to them. Dr. Kramer notes. A small amount of antibiotics may pass into your breast milk if you are breastfeeding, but there is no evidence of negative side effects for the baby. If you are diagnosed with strep throat while pregnant, your physician will discuss antibiotic options with you.

Most people need antibiotics to clear the infection, decrease the chances of spreading it to others, and to lower the risk of complications. However, the U.S. Centers for Disease Control and Prevention (CDC) say that people without symptoms but who test positive for strep throat may not need antibiotics. Talk to your physician about the best course of action for you.

At-home treatments 

There are several ways you can soothe your strep throat symptoms during your treatment. Sore throat home remedies include:

  • Drinking warm drinks (such as hot water or herbal teas) or cold liquids (whichever feels best)
  • Pregnancy-safe over-the-counter pain medications like Tylenol
  • Gargling with warm salt water
  • Using a humidifier
  • Taking a steamy bath or shower
  • Making sure to get as much rest as possible 

Preventing strep throat while pregnant

Although pregnant people usually have the same set of symptoms as non-pregnant people, they have a somewhat increased chance of getting sick. “Pregnant patients have a weaker immune system and may contract common infections more frequently,” explains Dr. Miller.

It makes sense to take common precautions to decrease the risk of infection with strep throat or any contagious disease. These precautions include frequent handwashing and wearing a mask in high-risk settings. Dr. Kramer says that practicing good oral hygiene, such as thoroughly brushing your teeth and using an antiseptic mouthwash daily, can help reduce the risk of catching strep. 

It’s also important to avoid contact with anyone who you know to be infected with strep or showing signs of it. People with symptoms are more likely to spread the virus to others, and it can take two to five days for you to develop symptoms once exposed. According to the CDC, people are usually cleared to mingle with others once their fever clears or within 12 hours of starting an antibiotic.