I'm married.  My wife is pregnant. My anxiety, though is through the roof.

Roughly 6-7 days after that encounter, my wife and I have unprotected sex.  [The first time in months]  At the time I did notice slight white substance from her on me, but didn't think anything of it.   The following week she develops itchiness inside and outside her vagina... and also has to frequently urinate.  She starts taking internal cream [monistat] for a yeast infection and is then given antibiotics (Ammoxicillin) for a UTI, over 7 days.  The UTI seems to have gone away, but the itch persists for some time, over the following few weeks.  She is in her 3rd trimester, and I understand these can be quite common, but the timing freaks me out

Then, the UTI, returns.  She goes in again and her urine shows high levels of glucose and a little protein. She's now being tested for gestational diabetes. She's back on Ammoxicillan with good result.  She's doing fine at the moment.

Meanwhile, I'm an anxiety riddled mess.  For two months I've had no symptoms, but now I'm experiencing frequent urination, and even when i'm finished it feels like I still need to go.  There is no pain, no discharge.  I can't tell if it is my nerves or not.  Wondering if I should just tell my wife, so we can go through further testing.  It's psychologically taxing, and I deserve this anguish. My question, I suppose is, given my previous exposure and the timeline... What is the likelihood I may have given her an STI [and myself without knowing it?]. I deeply regret my actions.   Just want to make sure she, and the baby are safe.

Your extramarital encounter was safe, since oral sex is low risk for all STDs (zero risk for some) and vaginal (or anal?) sex was condom protected. A bit of condom slippage makes little if any difference. Equally important, most "escorts" -- expensive female sex workers by appointment, as opposed to brothel workers, bar pickups, etc -- are knowledgeable about STD risks and prevention, are tested frequenctly, and most of their clients are low risk, i.e. men like you. So all things considered, the chance you caught anything is extremely low.

Perhaps more to the point of your question, your wife has had nothing that suggest an STD acquired from you. Your reaction about "slight white substance from her" was exactly right, i.e. something to be ignored. But it sounds like she went on to develop symptoms typical of both a UTI and a yeast infection. Both are "normal" in women -- i.e. every woman has a genital yeast infection and UTIs from time to time. Neither is the result of an STD and neither is acquired from sex partners. Further, it sounds like she the two most common predisposing factors for both problems:  pregnancy and elevelated blood glucose due to diabetes (or pre-diabetes). And UTI and vaginal yeast infections are easy, everyday diagnoses; her doctor is unlikely to have mistaken an STD for either problem.

As for the coincidence in timing with your escort adventure, that's all it is -- coincidence. Look at it this way:  every month there must be millions of extramarital sexual encounters by American men; and every month thousands (tens of thousands?) of their pregnant wives develop yeast infection and/or UTI. (I'm guessing at the numbers, but you get the idea.) The chance of such a random association is far higher than the likelihood of STD transmission, plus misdiagnosis of her yeast and UTI. Further, two courses of amoxicillin would have cleared up chlamydia and probably gonorrhea, if she happened to have either one -- so testing her at this point wouldn't be likely to change anything. Anyway, many Obs routinely test their pregnant patients for STDs, so she might have already had (or will have) such testing anyway.

Finally, your own symptoms:  As you seem to suspect yourself, frequent or urgent urination, sense of incomplete bladder emptying, and generally increased awareness of genital and urinary feelings are typical for genitally focused anxiety that often follows regretted sexual decisions. Also, these sympotms are not typical for STDs that affect the lower urinary tract (gonorrhea, chlamydia, nongoncoccal urethritis, etc). For additional reassurance about it, you could consider professional examination and testing for common STDs, especially a urine test for gonorrhea and chlamydia. I would expect them to be negative, in which case you couldn't have infected her.

For all those reasons, I have no doubt your wife and the baby are safe, which would be confirmed if you are tested and negative. As for discussing things with your wife, that is a relationship issue -- if it would ease your guilt and in the long run strengthen your relationship, by all means consider it. But from a medical or safety standpoint, I see no need.

I hope these comments have been helpful. Let me know if anything isn't clear. Best wishes to you and your wife for your growing family!

HHH, MD