Gonorrhea and Pregnancy: Risks and What to Do

Untreated gonorrhea during pregnancy raises the risk of premature birth, low birth weight, and can be passed to the baby during delivery, potentially causing serious eye infections or, rarely, blindness. Ceftriaxone — the standard treatment — is considered safe throughout pregnancy, and treating early prevents nearly all of these complications.

In my practice, this is one of the questions I take most seriously, because the stakes involve both the mother and the baby. The reassuring news is that gonorrhea in pregnancy is very treatable, and the risks I describe below are almost entirely preventable with timely screening and treatment.

How Common Is Gonorrhea in Pregnancy?

Gonorrhea during pregnancy is not rare, and because it's frequently asymptomatic in women, routine screening — not symptoms — is how most cases are caught. The CDC recommends screening all pregnant people at increased risk (including anyone under 25 or with new or multiple partners) at the first prenatal visit, with repeat testing in the third trimester if risk factors persist.

What Are the Risks to the Pregnancy?

Untreated gonorrhea during pregnancy is associated with several complications:

• Preterm birth — delivery before 37 weeks

• Premature rupture of membranes — water breaking early

• Low birth weight

• Chorioamnionitis — infection of the membranes surrounding the fetus

• Postpartum infection in the mother

What Happens If the Baby Is Exposed During Delivery?

If gonorrhea is present in the birth canal at delivery, the baby can develop ophthalmia neonatorum — a gonococcal eye infection that, left untreated, can progress to corneal scarring and blindness. This is why most U.S. hospitals apply antibiotic eye ointment to all newborns shortly after birth as a preventive measure, regardless of the mother's known infection status.

Is Treatment Safe During Pregnancy?

Yes. Ceftriaxone, the standard single-dose treatment for gonorrhea, is considered safe throughout pregnancy and is the same recommended regimen used in non-pregnant adults. If chlamydia co-infection is also present, azithromycin (rather than doxycycline, which is avoided in pregnancy after the first trimester) is typically used instead.

When to Seek Urgent Care

• Go to the ER or labor and delivery immediately if you have vaginal bleeding, fluid leakage, or contractions before 37 weeks

• Call your OB within 24 hours for any new discharge, burning, or pelvic pain during pregnancy

• Call your OB immediately if you have a known gonorrhea exposure and haven't yet been tested

• Notify your delivery team if you have a confirmed but recently treated infection, so the newborn can be monitored appropriately

Frequently Asked Questions

Can gonorrhea cause miscarriage?

While the strongest documented risks are preterm birth and neonatal transmission, untreated infections and the inflammation they cause can contribute to broader pregnancy complications, which is why early testing and treatment matter.

Will I need a C-section if I have gonorrhea?

Not necessarily. If treated before delivery, vaginal delivery is generally still appropriate. Delivery method is a decision made with your OB based on your overall clinical picture, not gonorrhea status alone.

Can I pass gonorrhea to my baby through breastfeeding?

Gonorrhea is not known to transmit through breast milk. The primary transmission route to a newborn is contact during vaginal delivery.

How soon after treatment can I be retested to confirm it's gone?

Your provider will determine the appropriate retesting schedule, but a test of cure is often done given the added importance of confirming clearance before delivery.

Should my partner be tested during my pregnancy?

Yes. Partner testing and treatment reduce the risk of reinfection before delivery, which is especially important given the risks to the newborn.

Learn more about gonorrhea testing and treatment or find STD testing near you.

Related reading: How STDs Affect Pregnancy · Gonorrhea Treatment: The Complete Guide · Gonorrhea Symptoms in Women