This page is general health information, not medical advice. It cannot tell you whether you have an infection. A clinician can, and the testing options on this site are a good place to start.

STD testing during pregnancy is a routine part of prenatal care in Texas. State law and CDC guidance both call for tests at more than one point, because some infections can pass to a baby and most can be treated when found early. These answers are written for people in San Antonio and Bexar County.

The basics

Why are STDs tested for during pregnancy?

Some infections can be passed to a baby during pregnancy or birth, and many cause no symptoms in the parent. Testing lets a clinician find an infection and prescribe treatment before it affects the baby. The CDC STI Treatment Guidelines (2021) build screening into routine prenatal care for this reason.

Which infections does the CDC say to screen for?

The CDC recommends screening for syphilis, HIV and hepatitis B at the first prenatal visit. It also recommends screening for hepatitis C during each pregnancy. Chlamydia and gonorrhea screening is recommended for pregnant people under 25 and for older people at increased risk, according to the CDC guidelines.

Is prenatal STD testing only for people who think they are at risk?

No. Prenatal STD testing is offered as standard care, and it applies to every pregnant person regardless of gender, orientation or relationship status. Being offered a test is not a judgment. Infections often have no symptoms, so a test is the only way a clinician can know.

Will my results stay private?

Results go into your medical record, which your care team protects. Texas DSHS lists chlamydia, gonorrhea, syphilis and HIV as notifiable conditions, so labs and clinicians report positive results to public health. Ask your clinic how it handles your information if you have concerns.

What Texas requires

What does Texas law say about prenatal syphilis testing?

Texas Health and Safety Code Sec. 81.090 requires a syphilis test at the first prenatal examination and visit. It also requires a syphilis test in the third trimester, not earlier than the 28th week. A test is required again when a person is admitted for delivery.

Does the law cover HIV and hepatitis B too?

Yes. The same statute calls for HIV and hepatitis B tests at the first prenatal visit and an HIV test in the third trimester. A hepatitis B test is also done on admission for delivery. The statute lets the pregnant person object to the HIV tests, but not to the syphilis tests.

What happens if I did not have testing late in pregnancy?

Under the same Texas statute, if there is no third-trimester syphilis or HIV result in the record, syphilis and expedited HIV testing happen at delivery. The law gives the HIV result in under 6 hours. If it was not done before delivery, the newborn is tested within 2 hours of birth.

Can a teen get prenatal STD care without a parent?

Texas Family Code Sec. 32.003 lets a minor of any age consent to diagnosis and treatment of reportable infectious diseases, which covers reportable STIs and HIV. A parent's consent is not needed. The statute does allow a physician to tell a parent or guardian, so ask the clinician about privacy before the visit.

Syphilis and congenital syphilis

What is syphilis in pregnancy?

Syphilis is a bacterial infection that can be cured with treatment from a clinician. It often causes no symptoms for long stretches, so a blood test is how it is usually found. During pregnancy, it can pass to the baby, which is why screening is repeated.

What is congenital syphilis?

Congenital syphilis happens when a baby is infected with syphilis before or during birth. The CDC says it can cause serious health problems, but it is preventable when the pregnant person is tested and treated on time. Testing at each point the law and CDC describe is the main safeguard.

How common is congenital syphilis in Texas?

The CDC's 2023 surveillance state ranking tables report 930 congenital syphilis cases in Texas, a rate of 238.6 per 100,000 live births. Cases are rising nationally, which is one reason repeat testing matters. This is a public-health trend, not a reason for anyone to feel blame.

How common is syphilis in San Antonio?

The Texas DSHS 2022 STD Surveillance Report counts 500 primary and secondary syphilis cases in Bexar County, a rate of 24.3 per 100,000. The Texas rate that year was 15.5 per 100,000. The same report counts 2,602 syphilis cases of all stages in the county. For more local numbers, see what the latest data shows about STD rates in San Antonio.

Can syphilis be treated during pregnancy?

Yes. A clinician prescribes treatment, and CDC guidelines recommend penicillin for syphilis in pregnancy. Your clinician decides the details and follows up with later blood tests to check that treatment worked. Ask your care team about any partner who may also need testing.

Other infections

What about HIV during pregnancy?

HIV is not curable, but it is treatable. The CDC says HIV medicine prescribed by a clinician during pregnancy greatly lowers the chance of passing HIV to the baby. Knowing your status early gives your care team the most options.

Why are hepatitis B and hepatitis C tested?

Both can pass to a baby at birth. The CDC recommends hepatitis B screening at the first prenatal visit and hepatitis C screening in each pregnancy. If a test is positive, clinicians can plan care for you and your newborn.

Can chlamydia or gonorrhea affect a pregnancy?

Both are bacterial infections that are curable with treatment from a clinician. The CDC says they can be passed to a baby during birth. Screening is recommended for people under 25 and for older people at increased risk, and clinicians may retest later in pregnancy.

Getting tested in San Antonio

Where can I get tested in San Antonio?

Start with your prenatal provider, who orders these tests as part of your visits. For other options, the local testing list shows clinics in the city. You can also read where to get tested for STDs in San Antonio.

Does Metro Health test pregnant people?

The San Antonio Metropolitan Health District says syphilis testing for pregnant women is available at its Walk-In and Mobile Clinics. The STI Walk-In Clinic is at 512 E. Highland, Suite 150, phone 210-207-8830. Metro Health lists a $15 office visit administrative fee, and other fees vary by service. A photo ID is required, and testing is not anonymous. Check hours with the clinic before you go.

Are there free or low-cost options?

The San Antonio AIDS Foundation, 818 E. Grayson Street, lists free HIV, syphilis, gonorrhea and chlamydia testing. The Alamo Area Resource Center, 303 N. Frio, lists free testing for HIV, hepatitis C, syphilis, gonorrhea and chlamydia. CommuniCare and CentroMed list sliding fee scales. Call ahead to confirm services, since each clinic sets its own.

Is there a way to find more testing sites?

Yes. The CDC runs a locator at gettested.cdc.gov for HIV, STI and hepatitis testing sites. Texas DSHS also offers free mailed kits through Test for Texas for people 13 and older. A kit does not replace prenatal care, so tell your prenatal provider about any result.

STD Testing During Pregnancy in Texas