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HPV testing during pregnancy follows the same age-based guidelines as outside of pregnancy, there is no separate pregnancy-specific HPV screening protocol. Whether you get tested for HPV while pregnant depends on your age, your last screening date, and the results of any previous Pap tests, not on the pregnancy itself.
If you’re asking because you’re newly pregnant and worried about what an HPV diagnosis means for your baby, that’s a fair concern, and this article addresses it directly.
Key Takeaways
- Routine HPV testing in pregnancy follows standard cervical screening guidelines, not a separate pregnancy protocol.
- If you’re between 30 and 65, co-testing (Pap plus HPV test) or primary HPV testing may be performed at your first prenatal visit if you’re due for screening.
- Cervical swabs are safe during pregnancy; there is no blood test for HPV.
- Most HPV infections, including high-risk types, do not cause complications in pregnancy, though persistent HPV-16/18 has been associated with a modestly increased risk of preterm birth in some studies.
- The HPV vaccine is not recommended during pregnancy, any remaining doses in a series should be delayed until after delivery.
What Cervical Screening Actually Happens at Your First Prenatal Visit
Your first prenatal appointment typically includes a cervical exam. If you’re due for a Pap test or HPV screen based on your age and last screening date, your provider will collect one at that visit.
For people aged 21-29, current ACOG and ASCCP guidelines recommend a Pap test (cervical cytology) alone, every three years. HPV co-testing is not part of routine screening for this age group, pregnant or not.
For people aged 30-65, guidelines support either co-testing (Pap plus HPV test) every five years, or primary HPV testing every five years. If you fall into this group and you’re due for screening, your provider may test for HPV at your prenatal visit as part of that standard protocol, not because of the pregnancy, but because the interval is up.
What providers are not doing is ordering a separate HPV test specifically triggered by pregnancy. The pregnancy doesn’t change the schedule. If you were screened 18 months ago with normal results, your provider will note that and move on.
For more detail on how cervical screening works and how results are interpreted, the cervical smear HPV test guide covers the process step by step.
Is HPV Testing Safe During Pregnancy?
Yes. Collecting cervical cells with a swab, spatula, or cytobrush is considered safe during pregnancy. The procedure is the same as outside of pregnancy. Light spotting afterward is common and not a sign of a problem.
There is no blood test for HPV. HPV is identified through cervical cell samples, either by looking at the cells under a microscope (cytology) or by detecting HPV DNA directly in the sample. Both methods can be performed during pregnancy without meaningful risk to the fetus.
A 2025 study comparing HPV test results in pregnant women versus the same women postpartum found no statistically significant difference in positivity rates, around 89% during pregnancy versus 81% after delivery. This supports that pregnancy itself does not substantially alter HPV’s behavior or make test results unreliable.
What Happens If Your HPV or Pap Result Is Abnormal During Pregnancy
An abnormal result during pregnancy is managed differently than outside of pregnancy, not because the result is less significant, but because most treatment is safely deferred until after delivery.
If your Pap shows low-grade changes (LSIL or ASC-US with high-risk HPV), your provider will typically recommend a repeat screen around 6-12 weeks postpartum rather than immediate colposcopy. Cell changes at this level rarely progress quickly enough to require action before delivery.
If the result suggests high-grade changes (HSIL), colposcopy, a closer examination of the cervix, is recommended during pregnancy, usually between weeks 13 and 26. The goal is to rule out invasive cancer, not to treat the lesion. Biopsy may be done if the colposcopy findings are concerning. Treatment of cervical intraepithelial neoplasia (CIN) is almost always postponed until after delivery unless cancer is confirmed.
The broader picture of HPV in women, including cervical risk and pregnancy implications, is worth reading if you’ve received an abnormal result and want to understand what the grading system actually means.
How Common Is HPV During Pregnancy?
More common than most people expect. A 2023 cohort study published in JAMA Pediatrics found vaginal HPV DNA in about 40% of pregnant participants at recruitment. HPV DNA was also detected in 10% of placentas.
That number is not a reason for alarm. Having HPV during pregnancy does not mean your baby will be infected, and it does not automatically mean your pregnancy is at higher risk.
What the evidence does show is a more specific concern: persistent infection with HPV-16 or HPV-18 during pregnancy has been associated with a modestly increased risk of preterm birth in some multicenter cohort studies. This association doesn’t mean HPV causes preterm birth in most cases, it means it’s a factor researchers are actively studying, and it’s one reason careful cervical monitoring during pregnancy matters.
Vertical transmission, passing HPV to the newborn, does occur, but appears to be transient. In the JAMA Pediatrics cohort, HPV was detected in 7% of newborns at birth, and no infections persisted at the 6-month follow-up. The clinical significance of transient neonatal HPV appears to be low based on current data.
If you’ve been wondering whether HPV could affect your ability to conceive or carry a pregnancy, the article on whether HPV can prevent pregnancy addresses that question directly.
Who Is at Higher Risk for HPV-Related Complications During Pregnancy
Certain groups face a higher likelihood of persistent HPV infection or more complex management during pregnancy:
- Immunocompromised pregnant people, including those living with HIV or on immunosuppressive therapy after an organ transplant, have higher rates of HPV persistence and are more likely to develop high-grade cervical lesions. Screening may be recommended more frequently in this group.
- People with a history of abnormal Pap results, prior HSIL, CIN2, or CIN3 means closer monitoring is warranted during pregnancy, regardless of current HPV status.
- Unvaccinated people, those who have not received the HPV vaccine (Gardasil 9) before pregnancy have no protection against the high-risk types most associated with cervical dysplasia, including HPV-16 and HPV-18.
Genital Warts in Pregnancy: A Separate Situation
Genital warts are caused by low-risk HPV types, primarily HPV-6 and HPV-11. They do not cause cervical cancer and are not detected by HPV co-testing, which screens for high-risk types only.
If genital warts appear or grow during pregnancy, your provider will assess them visually. Warts can enlarge during pregnancy due to hormonal and immune changes, and in rare cases, large warts near the birth canal may influence delivery planning.
Treatment options during pregnancy are limited. Some topical treatments used outside of pregnancy are not safe during it. Your provider will discuss options based on the size, location, and gestational age. For a full overview of treatment approaches, the genital warts treatment guide outlines what’s available and how each method works.
The HPV Vaccine and Pregnancy
The HPV vaccine is not recommended during pregnancy. This applies to all three approved HPV vaccines, including Gardasil 9. If you discover you’re pregnant after receiving a dose, there’s no evidence it causes harm, but remaining doses should be paused and completed after delivery.
If you haven’t started the vaccine series and are planning a pregnancy, the evidence supports completing vaccination before conception rather than waiting. Postpartum vaccination is also appropriate for those who are eligible and haven’t been vaccinated.
Pregnancy itself is not a reason to delay vaccination indefinitely, it’s a reason to time it correctly.
If you’ve been considering supplements like AHCC alongside standard care, the article on whether AHCC is safe during pregnancy covers what the current evidence does and doesn’t support.
Vertical Transmission and Newborn Risk
The question most pregnant people with HPV actually want answered is: will my baby be affected?
Based on current data, the risk of lasting harm to the newborn is low. Transient HPV detection in newborns is documented, but it clears without intervention in the vast majority of cases. A rare condition called recurrent respiratory papillomatosis (RRP), caused by HPV-6 or HPV-11, can develop in children exposed during delivery, but it is uncommon. Cesarean delivery is not routinely recommended solely to prevent HPV transmission.
The evidence does not support panic. It does support making sure your cervical screening is current, your provider knows your HPV history, and any abnormal results are followed up appropriately.
Frequently Asked Questions
Will my midwife or OB automatically test me for HPV at my first prenatal appointment?
Not automatically. HPV testing at a prenatal visit depends on your age and when you were last screened. If you’re 30 or older and due for cervical screening, your provider may include an HPV test as part of co-testing or primary HPV screening. If you were recently screened with normal results, no additional testing is needed.
Can HPV cause a miscarriage?
Current evidence does not establish that HPV causes miscarriage in most cases. Some research has explored a possible association between high-risk HPV and early pregnancy loss, but the data is not strong enough to draw firm conclusions. If you’ve had a miscarriage and also have HPV, the two are not necessarily connected.
Does having HPV mean I need a C-section?
No. HPV infection alone is not an indication for cesarean delivery. The exception sometimes considered is very large genital warts that obstruct the birth canal, but this is a clinical decision made case by case, not a blanket rule.
If I had HPV before pregnancy and it cleared, can it come back during pregnancy?
HPV that has cleared, meaning it’s no longer detectable, doesn’t typically reactivate during pregnancy in the same way that herpes simplex does. However, a previously undetected persistent infection can become detectable if immune function shifts. If a new positive result appears during pregnancy, it more likely reflects a persistent low-level infection rather than a brand-new one.
Should I tell my partner I tested positive for HPV during pregnancy?
HPV is extremely common, and the timing of any infection is often impossible to determine. A positive result during pregnancy doesn’t indicate when the infection was acquired. Sharing your result with a partner is a personal decision, but medically, there is no treatment for HPV in people without symptoms, and routine HPV testing is not available for people with penises in most clinical settings. The HPV testing category has more on how screening works across different situations.
What to Do Next
If you’re pregnant and have questions about HPV screening, the clearest next step is to confirm with your provider when you were last screened and what those results showed. Bring that information to your first prenatal appointment.
If you have a history of abnormal Pap results or a known HPV diagnosis, tell your OB or midwife at the start of care. They will schedule appropriate follow-up, usually a repeat screen or colposcopy between weeks 13 and 26 if indicated.
Cell changes are easiest to monitor and treat before they progress, that’s exactly what prenatal cervical screening is designed to catch. You don’t need to do anything differently than you would outside of pregnancy. You just need to make sure the screening happens on schedule.
