Group B Strep

GBS (group b strep) is a scary sounding thing, not to be taken lightly, as it is potentially life threatening.  But, as with most things, deciding what to do about it is not clear cut. It is about the balance of probabilities. You will need to weigh up the pros and cons, to work out what is right for you. You may like to have several plans depending on what happens.

About 30% of the adult population in the UK is a carrier of GBS at any one time, usually without symptoms. It is a bacteria carried in the gut, and can be present in the urethra and vagina. It can be passed to the baby during childbirth. It may be discovered before or during pregnancy, or during a previous pregnancy. It is not routinely tested for in the UK as so many people are carriers it would result in a lot of people receiving antibiotics when only a small proportion will actually pass that infection on to their baby. There are negative effects of giving newborn babies antibiotics, which is one of the reasons for balancing the different factors. Read the Cochrane review.

The following information is for women/pregnant people who find themselves being offered treatment for GBS, either because it has been found that they are a carrier in this pregnancy or at a previous time. 

It is worth bearing in mind that some women are in a situation which increases the chance of their baby picking up GBS, and this will be a factor in your decision making. It could be that at the moment you don't have any of these higher risk factors, so you might have a plan A, but if any of the higher risk factors happen, then you can go to plan B, or plan C. Babies are at higher risk of contracting GBS if you had GBS in a previous pregnancy, especially if that baby contracted GBS; if they are premature, if the waters brake before labour (the longer broken, the greater the chance, as the bag of waters protects the baby). 

There are some things that you can do that reduce the chance of your baby picking it up: don't let anyone break your waters, that includes avoiding sweeps, especially if 2cm or more dilated (baby will only pick up gbs from your vagina if waters have gone); having a water birth (this reduces the contamination by washing the baby); having long time skin to skin after baby is born as skin to skin has been shown to decolonise the baby's skin of bad bacteria.

Recommended care is to have intravenous antibiotics during labour, every four hours. Having antibiotics in labour will only be effective if you get in two doses, four hours apart, so that means being in hospital in labour for at least five hours. If you are on baby number two or more then that might not happen. The advantage of antibiotics in labour is that it doesn't need to be given to the baby after the birth. 

Also if you are having a second or subsequent baby and waters don't go till pushing, as the average pushing stage for second plus babies is 20 mins or less, that means babies are exposed to the bacteria for a very limited amount of time.

Here's an article listing other natural treatments by world renown Canadian midwife Gloria Lemay.

You might like to read the GBStrep support website. Their FAQs are interesting.  If you read the site you will be aware that they are very pro antibiotics in labour, as you would expect from parents of babies who've been so affected. They do say that it could be there isn't time for two lots of antibiotics .

 

There is the possibility of giving antibiotics to the baby after the birth. Many hospitals no longer gives antibiotics to the baby if woman is GBS positive, even if she didn't have the recommended antibiotics in labour. They just monitor babies and treat them if poorly, due to the downsides to giving babies antibiotics unnecessarily.

 

If you are planning a home birth.

You can have a plan A to give birth at home, if you are low risk of passing it on, and a plan B if that changes (such as waters breaking and no contractions). Having a home birth reduces the chance of having your waters broken, and increases the chance of having a water birth and having skin to skin.

Some areas do give antibiotics at home but not many.

 

You can choose to go into hospital after the birth for 12-24 hours for monitoring or opt for monitoring at home. This is a useful guide about monitoring your baby for neonatal infection. 

More information: 

Midwife, researcher and lecturer Sara Wickham has lots of useful information and has written a book

AIMS (Association for the Improvement of Maternity Services) also has a book on the topic. 

Disclaimer: I am not a medical professional. This is information I have gleaned from reading the sources provided. Please do your own reading. Nothing on here constitutes medical advice. 

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