Full Circle Midwifery

What is GBS?

Group B Streptococcus (GBS) is a bacterium that is normally found in the intestinal tract.  The human body is full of bacteria, most of which are helpful for digestion, absorption of nutrients, and maintaining the immune system. It can be normal to find GBS in the anal and vaginal region of a woman as well.  When GBS is present in the anal and vaginal region of a pregnant woman during labor and delivery, there is a very small risk that the bacteria can be passed on to the newborn, and the baby could become sick. Approximately 0.5 percent of women found to have GBS bacteria in their genital areas at 35 to 37 weeks into their pregnancies will go on to deliver a baby who becomes ill from GBS. This is 0.5 percent of women who receive no antibiotics during labor and delivery.  This means 99.5% of women who test positive for GBS and don’t use antibiotics, will not have a baby ill from GBS.

GBS Testing

The US Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG) recommend that all pregnant women be screened between weeks 35 and 37 of their pregnancies to determine if they are carriers of GBS. This test is done by taking a swab of the pregnant woman’s vaginal and rectal areas. Studies show that approximately 30 percent of pregnant women are found to be colonized with GBS in one or both areas. You can choose to get tested by us or another health care provider.

How does GBS affect a baby?

If a baby does become ill from GBS it is serious.  Babies have difficulty isolating infection and can easily become septic (get a blood infection).  Babies can also develop meningitis and pneumonia.  Though the risk of the baby actually becoming ill from a GBS mother is low, it can be fatal. Of the infants who do develop a severe early-onset GBS infection, approximately 6 percent will die from complications of the infection.

What puts a baby at risk?

There are certain factors that make it more likely a baby will become ill from GBS. One is a prolonged rupture of membranes (more than 18 hours).  If this happens to you, you will be responsible for closely watching for signs of infection, and will be monitored by the midwives.  To reduce the risk of any kind of infection, no vaginal exams are done until well into active labor.  Both the baby’s and mother’s vitals are monitored to assure health and detect any sign of infection.  Another factor that increases a baby’s likelihood of infection and mortality is prematurity.  We provide education on many things that reduce the likelihood of early labor, and most of our clients deliver at term.  A maternal fever during labor from any source of bacteria or virus is a risk factor warranting transport and treatment.

How is GBS treated?

In the medical model of care, the standard treatment for all women who test positive for GBS and those of unknown status is IV antibiotic treatment during labor.  This means one third of all pregnant women are being treated for what saves the lives of 0.02%.  There are also drawbacks that come from antibiotic use, some of which include antibiotic resistant bacteria, allergic reactions, and diminished healthy flora in mother and baby which can reduce disease fighting capabilities.  We encourage all women to be healthy and create a healthy balance of bacteria by eating well, supplementing appropriately, and living a healthy lifestyle.

For those clients who choose to test and are found to be positive, an immune-enhancing protocol is advised prenatally and a hibicleanse wash can be used to reduce the transmission of bacteria during labor.  We have handouts on both protocols.  Please ask for them.  The baby is then monitored closely for any signs of infection (all babies are monitored for infection).   IV antibiotics are not available in a homebirth setting.

While the risk of a baby becoming ill from GBS is very low, the actual illness is serious.  Please weigh the risks and your level of comfort with the options.  As with all choices, the best choice is an informed one.