You have options when it comes to Group B Streptococcus
Toward the end of your pregnancy, between 35 and 37 weeks, your midwife or doctor will let you know about GBS screening.
We can perform this type of screening at The Retreat. The screening process itself is simple, with a quick swab of the vagina and rectum, but the treatment of GBS for women who test positive is a complex issue.
At The Retreat, we are passionate about presenting each woman with a comprehensive view of every test and treatment as it comes up, and letting her make the best decision for her body and baby.
Here are the facts and options you need to be aware of regarding GBS screening and treatment.
GBS in pregnant women
Group B Streptococcus itself is a bacteria that doesn’t often cause problems for women who carry it. In fact, it’s estimated that 10-30% of pregnant women would test positive for carrying GBS — with only a very few ever presenting any symptoms of illness or infection.
Most infants develop their own healthy colonizations of a variety of bacteria (possibly including GBS) as a result of contact with the mother’s various vaginal flora as they pass through the birth canal.
So both the GBS bacteria and the process of the baby contacting and benefiting from vaginal bacteria are normal and typically healthy processes.
GBS in newborns
The potential problems come in when the GBS not only colonizes the new baby, but subsequently causes an infection.
The reason the CDC recommends testing women who are nearing the end pregnancy is that, although it poses little risk to the mother, GBS is one of the leading causes of serious infections in newborns, such as pneumonia, sepsis, and meningitis.
The typical medical approach to preventing GBS infection is to treat women who test positive for GBS with repeated courses of IV antibiotics during active labor, with the intent to kill the GBS bacteria.
This is considered the universal approach and is the standard of care in the United States. IV antibiotics reduce the rate of GBS infection from 0.5% to 0.025% and are administered to every GBS positive mother who births in the hospital.
Unfortunately, antibiotics cannot target GBS alone, so a broad range of healthy flora is lost to both mother and baby.
The facts and figures you need to know about GBS
Obviously, no one wants a baby to suffer from a dangerous infection, but it’s also important to understand that the risk of the average baby becoming colonized and then becoming infected by GBS is quite small.
If a pregnant woman who has a GBS colonization is not treated with antibiotics during labor, the baby’s risk of becoming colonized with GBS is approximately 50%. But we’re talking about colonization here, not infection.
Most GBS colonized babies do not develop GBS infection.
The chance of a baby developing a serious, life-threatening GBS infection from a GBS positive mother without antibiotics (according to the CDC) is 0.5-2%.
What are the options for addressing GBS at The Retreat?
We’re able to offer IV antibiotics to treat GBS during labor, so if a woman has a positive GBS test and chooses to treat with antibiotics, we fully support her and her decision, and we can provide her with that course of treatment.
In any case, we take the possibility of a GBS infection in baby seriously, however, and our midwives follow a risk-assessment approach.
If we see any indicators that your baby may be at increased risk of harm from GBS (past GBS infected babies, GBS levels high enough to show up in urine, early labor, prolonged rupture of membranes, signs or symptoms of infection in mom or baby), we may recommend treating with antibiotics in house, or transfer to the hospital.
Are there alternative ways to prevent GBS infection?
When a woman wants to proactively address GBS, whether she has had a positive test or simply wants to be on the side of caution, we can offer information and recommendations on the following GBS treatment alternatives:
- Chlorhexidine (Hibiclens) — This OTC antiseptic can be applied to the walls of the vaginal canal at intervals throughout labor, with the intent of reducing the presence of any GBS bacteria.
- Garlic — Taken orally or inserted into the vagina during sleep, we can give you recommendations on the use of garlic to promote healthy vaginal flora.
- Probiotics — Building up good bacteria is one of the best ways to prevent imbalances and abnormally high levels of any given strain, including GBS.
- Vitamin C — We can discuss using Vitamin C to help your body and flora stay in healthy ranges throughout your pregnancy.