This sheet is about having mpox in a pregnancy or while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is mpox (monkeypox)?
Mpox is an illness caused by a virus. The virus belongs to a group of viruses called orthopoxviruses.
Symptoms of mpox can begin 5 to 21 days after being exposed to the virus, but most people start having symptoms in 7 to 14 days. The first symptoms to appear can be: fever, headache, muscle aches, backache, swollen lymph nodes (“glands”), chills, and exhaustion (being very tired). Within a few days, a skin rash appears on the body, often starting near the genitals or on the face. The rash causes bumps and sores that can be itchy and painful and that gradually turn into scabs that fall off. In most people, the illness lasts 2 to 4 weeks before clearing up on its own. In some people, mpox can cause more severe illness and even death. There is no cure for mpox, but certain medications (called antivirals) can help manage symptoms.
Two kinds of monkeypox/smallpox vaccines are available for people who have been exposed to an orthopoxvirus, or for certain people at higher risk of exposure. You can read more about these vaccines on the MotherToBaby fact sheets at https://mothertobaby.org/fact-sheets/monkeypox-smallpox-vaccine-jynneos/ and https://mothertobaby.org/fact-sheets/monkeypox-smallpox-vaccine-acam2000/.
How does the virus that causes mpox spread?
The virus spreads from person to person through body fluids, including direct contact with the skin sores or scabs of an infected person, from the fluids that come from these sores (such as on clothing or bedding), or through saliva and respiratory droplets (such as kissing or being in close contact with someone with mpox when they breathe, talk, cough, or sneeze). The virus can also pass from a person who is pregnant to their developing baby. It is not known at this time if the virus that causes mpox can spread through semen or vaginal fluids, but close contact during sex can spread the virus.
I have mpox. Can it make it harder for me to become pregnant?
It is not known if having mpox can make it harder to get pregnant.
Does having mpox increase the chance for miscarriage?
Miscarriage is common and can occur in any pregnancy for many reasons. Based on the available information, it is not known if having mpox increases the chance for miscarriage. Miscarriage has been reported in some case reports of confirmed mpox infection during pregnancy. Infection during pregnancy with other viruses related to mpox (such as smallpox) has been found to increase the chance of miscarriage.
Does having mpox increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Based on the available information, it is not known if having mpox increases the chance of birth defects.
Fever is a possible symptom of mpox. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen is usually recommended to reduce fever in pregnancy. If you have a fever, talk with your healthcare provider about how to treat it during pregnancy. For more information about fever and pregnancy, see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/.
Does having mpox increase the chance of other pregnancy related problems?
Mpox infection has not been well-studied in pregnancy. There is one case report of a stillbirth and one case report of a preterm delivery (birth before week 37) after infection with mpox during pregnancy. In both of these cases, the babies also had signs of mpox infection. Infection during pregnancy with other viruses related to mpox (such as smallpox) has been found to increase the chance of stillbirth and preterm delivery. It is not known if mpox infection can cause other pregnancy-related problems, such as low birth weight (weighing less than 5 pounds, 8 ounces (2500 grams) at birth).
Can the virus that causes mpox pass to the baby during pregnancy or at the time of delivery?
In the two case reports described above, the virus that causes mpox passed to the babies during pregnancy and caused symptoms that included skin sores. It is not known how often this virus might pass to a baby during pregnancy or at the time of delivery, or how likely it is to cause problems for the baby.
Does having mpox in pregnancy affect future behavior or learning for the child?
Studies have not been done to learn if having mpox in pregnancy increases the chance for behavior or learning issues.
Breastfeeding with mpox:
It is not known if the virus that causes mpox can pass to a baby through the breast milk. However, the virus can pass to an uninfected infant through close contact with a person who is infected (such as holding the baby to breastfeed). If a person has mpox, the Centers for Disease Control and Prevention (CDC) recommend that they not breastfeed until all of their lesions are healed, the scabs have fallen off, and a fresh layer of skin has formed. They also recommend that any breast milk that is pumped during that time be discarded (thrown away). If you have mpox, talk with your baby’s healthcare provider about the best way for a healthy caregiver to feed your baby until you recover. Be sure to talk to your healthcare provider about all of your breastfeeding questions.
If a male has mpox, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?
Studies have not been done in males to see if having mpox could affect fertility or increase the chance of birth defects above the background risk. It is not known if the virus that causes mpox can spread to a partner through semen. However, the virus can pass to a partner during close contact (including oral, anal, and vaginal sex). CDC recommends that anyone with mpox avoid having close contact with a pregnant partner until their lesions have healed, the scabs have fallen off, and a fresh layer of skin has formed
For more information about paternal exposures, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
Please click here to view references.
OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.
