What is GBS (Group B Streptococcus)? It is a type of infection that lives in the intestines and can travel down and live in the vagina or rectal area. Approximately 25% (AMA, 2017) of healthy pregnant women are carriers during their pregnancy.
Women are usually tested during their 36th week of pregnancy. This is done via swab to the vagina or rectum. If the woman tests positive it is standard practice that she receive IV antibiotics during labor to avoid the chances of passing the infection onto the baby.
When the mothers bag of waters break, it is possible for the infection to travel up to the baby and then be swallowed where is could get into the babies lungs lead lead into early GBS.
“In 1993-1994, the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics recommended screening all pregnant women for GBS and treating GBS-positive women with intravenous (IV) antibiotics during labor. Since that time, we have seen a remarkable drop in early GBS infection rates in the U.S.—from 1.7 cases per 1,000 births in the early 1990’s, to 0.25 cases per 1,000 births today “ CDC-2010
Antibiotics for GBS, Pro’s and Con’s
We are sure you have heard us talk about the acronym B.R.A.I.N. before. If you haven’t check out our blog about using your B.R.A.I.N with Interventions. Should you get antibiotics or not? Like every other intervention, there are risks and benefits. So let’s break it down here a little:
Benefits of antibiotics for GBS
For treating with antibiotics you could avoid early or late GBS infection in the newborn- In a study done by NCBI Link (NCBI, 2012) they reviewed 143,384 newborn neonates. Out of the 143,384 newborns 93/94 of them tested positive with early GBS Sepsis.
Not treating you could avoid getting antibiotics that could potentially damage both yours and your babies gut flora. Studies are vague but they do show that antibiotics can affect a newborns gut flora/microbiome at least temporarily (ASM, 2012).
Risks of antibiotics for GBS
Not treating with antibiotics could potentially raise the babies risk of being colonized with GBS by approximately 50%. The risk of that having a serious life-threatening complication is approx 1-2%. If a woman decides to receive antibiotics during labor the risks go down by approx 80% so the total risk of something serious could drop to 1-0.2% (see more information on this study and the percentages here).
Alternatives to antibiotics
According to (CDC, 2018), because GBS can grow back so quickly doctors may not give antibiotics before labor begins.
Oral antibiotics and vaginal washes are not effective for preventing GBS. Research shows that giving antibiotics during labor could lower the newborns chance of GBS by 83%.
It is possible for GBS to show up at one gestational week and then be gone another so, you could ask your provider for a “rapid test” the day you’re in labor to confirm that you are in fact still GBS positive.
Some women have chosen to do Chlorhexidine (aka Hibiclens) which is a vaginal suppository that kills bacteria on contact. It typically lasts for 3-6 hours. However, studies are not great on the true effect of using Hibiclens during labor to avoid GBS infection rates.
Trusting your intuition
We say it a lot and lets be honest you probably will continue to hear us talk about INTUITION. It’s so very important to listen to your intuition while making choices in the birth setting.
There is such a variety of options on GBS and following your own intuition will lead you down the best path for you and your baby.
For a lot of mothers the risk of GBS is enough that antibiotics is a better alternative for them. It leaves them feeling more confident that their baby will be protected. Others may see the chance being so low that they would rather not have antibiotics that can risk their babies overall future health and gut flora.
The same set of data and facts are there for everyone. Everyone is entitled to make a decision based off of their specific circumstances and what risks they prefer to accept.
Should you do nothing?
You could do nothing and take the universal approach.
The “risk based approach”, although not approved by the CDC, is when you would hold off on accepting any antibiotics unless other factors/symptoms were present for example; if your bag of waters has been broken for 18 hours or more or your temperature starts to rise.
Things You Can Do to Reduce the Risk of Contracting GBS
Some people may question why they are testing positive for GBS when they are healthy overall, eat well, and exercise. As mentioned above, approx 25% of ALL women test positive for GBS even those who are very healthy. There are some things however, that women have done that may reduce the chance of testing positive for GBS.
- Probiotics may help lower your chances of being GBS positive. Check with your provider for recommended dosage.
- Inserting a clove of garlic vaginally for one night, typically the night before being tested, and drinking minced raw garlic in the morning can help get rid of any infection.
- Taking up to 2,000 mg of Vitamin C per day helps boost the immune system overall.
- Colloidal silver, typically in a tincture, is also a powerful immune booster.
- Grapefruit seed extract, taken orally, may act as an antimicrobial and reduce the chances of GBS.
- Rinsing vaginally with apple cider vinegar will help you absorb good nutrients and has been known to help kill bad bacteria.
Just like most things in life, there are pro’s and con’s to both accepting antibiotics, and not accepting antibiotics.
Although screening for GBS at 36 weeks gestation has shown to lower GBS infections on newborns it is also showing potential hard to the newborn’s health/gut flora. Results could vary from week to week and a “rapid test” is possible during labor.
We encourage you to continue your research and check out our good friend Rebecca Dekker at Evidence Based Birth as she dives right into GBS and a lot of really great studies, and follow your mama gut.
Intuition speaks so loudly it’s important to follow what you feel is best for you and your baby.
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