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I remember the first time I heard about group B strep, otherwise known as GBS. I was in middle school watching one of those labor & delivery shows on TV. You know, the ones that scare the daylights out of women awaiting the day of their birth. It was one of those.

The episode featured a woman who happened to be GBS positive. She was interviewed about her condition, and I can’t say I remember everything she said, but I know that after that episode I got the impression that GBS was a rare, scary, and potentially life-threatening disease that necessitated a hospital birth, if not a cesarean. Many women are also taught to think of GBS this way, or they are just not educated about it at all. And I’d like to remedy that.

What Is Group B Strep (GBS)?

The first and most important thing you need to know about GBS is that in and of itself, it is not a bad thing. At any given time, around 25% of women (pregnant or not) are carrying a bacteria called Group B Streptococcus in their vaginas and/or rectums. Most likely all of us have been colonized with it at one or more times in our lives, and almost all the time, it is completely harmless.

The concern comes, though, when a woman is GBS-positive at the time of birth. Since it usually lives in the vagina, the baby can contract it on the way out, and it could be harmful to him or her. However, the risk is very low. Of babies who are born to GBS-positive moms, about 0.5-1% will contract the disease, and of those, 10% will die (Group B Strep Association, Cleveland Clinic). This risk is significant enough for some, and less than concerning for others.

How Do I Know If I Am GBS-Positive At the Time of Birth?

Somewhere around 36 weeks of pregnancy, your care provider will want to test you for GBS. Of course, you have the option and right to refuse, but it’s probably a good idea to go ahead and get it done. However, if you’ve had three or more consecutive GBS-negative pregnancies, you may consider forgoing the test altogether.

Your care provider will test you for GBS by simply swabbing the inside of your vagina with a tiny q-tip, culturing the sample, and sending it off to a lab (unless he or she has a lab in the office). The lab will look at the sample under a microscope to determine whether or not you are carrying GBS at that time. By your next visit, your care provider should have the results of your test.

How Do I Prevent a Positive Test Result?

Since GBS goes in and out of your body, there are several ways to ensure that it will not be present at the time of your test and birth. Since they are all easy and low-risk, it is a great idea to do one or a combination of them – it gets more complicated if you test positive. You should start doing these things a few weeks before your test and, if you test negative, continue until you have your baby. 

  • Apple cider vinegar: This method is quite possibly the most effective. Three times a week, take a bath with 1/4 cup of apple cider vinegar added to the bath. The smell might be less than desirable, but it works. The theory is that the bacteria cannot live in the acidic environment of the vinegar and therefore dies. Try adding some lavender oil to mask the smell.
  • Echinacea: Get some Echinacea capsules at your local health food store and follow the instructions on the bottle. Echinacea is great for all kinds of bacterial infections.
  • Raw garlic: Either eat several cloves a day (be creative – there are lots of raw food recipes that call for garlic!) or insert one into your vagina every night and take it out in the morning.

What If I Still Test Positive?

There are a few important things you should know about the protocols for treating GBS-positive moms in labor:

  • When a woman tests positive for GBS at 36 weeks, it is the general protocol to assume she is still positive at the time of birth.
  • It is also the conventional practice to treat these mothers with IV antibiotics every four hours in labor. However, evidence shows that a GBS-positive woman’s water can be broken for up to 18 hours without antibiotics before a significant risk is present (American Pregnancy Association).
  • While the antibiotics effectively kill the GBS, they also kill all the good bacteria that your baby should be colonized with when passing through the birth canal.
  • Being GBS-positive does not risk you out of a home birth. Even if you decide to receive the prophylactic antibiotic treatment, your midwife can give it to you intravenously at home.

Given this information, you have a few options if you test positive for GBS at 36 weeks:

  • Ask your care provider to test you again in a week or two weeks. In the meantime, continue the preventative measures listed above.
  • Receive the antibiotic treatment every four hours in labor. Consider eating and drinking fermented foods and beverages before and/or during labor to increase the chances of your baby being colonized with good bacteria.
  • Plan on doing nothing unless you go 18 hours with ruptured membranes. If that happens, reconsider your options (most likely a cesarean).

No one can make the decision for you, but hopefully this information will make it easier for you.

Have you ever tested positive for GBS? If not, why? If so, what did you do?

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This is the writings of:

Liz Puffenberger
Liz of Now Let Me Rejoice isn't sure if she's an actual hippie or just a closet hippie, because she doesn't wear Birkenstocks and she shaves her legs. Also, she wasn't alive in the 70's. She does, however, believe in living the way God intended - especially when it comes to birth. Her passion for caring for women and babies has brought her to serving families as a doula and pursuing education in midwifery. Someday, she wants to be a partera (midwife) in a poverty-stricken Spanish-speaking country (namely, the Dominican Republic). She also has formal plans to have a Hello Kitty themed baby shower when the time comes for such an event. She is a lover of coffee, bacon, and lavender. But mostly coffee. And bacon. And lavender. Check out her doula website at http://barefootandpregnantdoula.weebly.com.

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1 Comment

  1. I got a positive GBS result at 38 weeks and was distraught at the thought of:

    A. Having to go into hospital as soon as labor started because our plan was to stay at home for as long as possible, to avoid being sucked into unnecessary hospital interventions to “hurry things along”.

    B. Exposing myself and baby to high levels of antibiotics.

    I did a lot of reading and talking with my husband, the midwives at our practice, and our family doctor, and was pleased that – although they always began by giving me the worst case scenarios – they were all on board when I said I would decline the antibiotic IV.

    The interesting things I learned during my “research” into GBS were:

    1. To help reduce the chances of a positive result, start taking a probiotic supplement e.g. Florajen 3 at 30 weeks to cultivate good gut health (I guess you should clear this with your HCP first).

    2. The antibiotic route isn’t all that…
    “This review finds that giving antibiotics is not supported by conclusive evidence. The review identified four trials involving 852 GBS positive women. Three trials, which were around 20 years old, compared ampicillin or penicillin to no treatment and found no clear differences in newborn deaths although the occurrence of early GBS infection in the newborn was reduced with antibiotics. The antibiotics ampicillin and penicillin were no different from each other in one trial with 352 GBS positive women. All cases of perinatal GBS infections are unlikely to be prevented even if an effective vaccine is developed.” (http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007467.pub3/abstract)

    3. My midwife told me that the American College of Nurse Midwives had concluded that babies born in water have a reduced risk of picking up the GBS infection during birth.

    4. When being tested for GBS, ask for a vaginal swab only. You may have a colonization of the bacteria in your bottom, and that shouldn’t be a factor during birth.

    5. In the UK women are not routinely screened for GBS because the risk is seen as so low. Therefore thousands of women each year outside the USA are not routinely bombarded with antibiotics for a condition they may or may not actually have at the time of birth.

    Pardon the pun, but do your own research and let your gut tell you what’s best for you and your baby.

    Reply

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