Kaleem Joy, Licensed Midwife
Group Beta Strep...What Your Doc May Not Tell You.
When you were first pregnant, you were given a laundry list of different blood and vaginal tests to see how your health was. Additionally the list included genetic screening of the baby for any chromosomal issues. Since then you have been sailing along, rubbing that cute tummy and feeling the baby move and dance inside you.💕
You jump in the car, well maybe not jump, you slide into the car and off to your 36-37 week visit you go. If your planning a home birth, your midwives will join you at your home instead. Cup of tea anyone?
They will explain about GBS and ask to do a vaginal and rectal swab to send to the lab. Most Doctors will want to do the swab on you and many midwives will have you go in the bathroom to swab yourself. It's super easy and it requires a long q-tip swirled in the vagina and passed or inserted in the opening of the anus. It is then put into the tube provided and walla, test done. Off to the lab it goes and in 72 hours they will have results. Here is where the fun begins.
You're working each day to feel confident and calm about your upcoming birth. You're meditating and using affirmation (of course your taking the Natural Childbirth 101 courses and using the affirmations you downloaded 👍) You are told the risk about GBS and fear climbs into your zen zone.
The risks can sound scary and so can the risk of taking antibiotics on the microbiome of the baby. So you research your options of antibiotics in labor, which the doctors absolutely insist on, some midwives can offer antibiotics, if desired, and can also share natural remedies to help reduce risk factors in a home birth. Humm what WILL you do?
GBS lives in and on the body very happily as one of the normal human bacterias. It mostly lives in the intestines and in some women it can migrate into the urinary system. Because of the close proximity of the anus and vagina, those little bugs can migrate into the vagina. They then colonize and walla you have a positive test.
YOU DON'T HAVE AN INFECTION You and your baby are healthy. This is just a screening for a higher growth of something that is in 1 in 4 women.
Some of the natural ways midwives will use to reduce the risk may be :
Probiotics throughout pregnancy that has the Lactobacillus Reuteri in them.
Any fermented foods such as kombucha, kemchi, sauerkraut, kefir, yogurts. These help the bowel where it originated to mind it's manners and stays local.
Colloidal Silver at 37 -38 weeks both oral and vaginal (so long as the water bag is intact) appears to kill GBS. It can grow back quickly if stopped.
Echinacea and goldenseal capsules started at 37 weeks to 2 week postpartum boosts the immune system and does go through the milk when nursing.
Cranberry capsules starting at 37 weeks. It stops bacteria from sticking to mucous membranes which means it's harder to grow.
Some midwives have women irrigate their vagina with 1/2 strength 3% hydrogen peroxide and water starting at 37 weeks until labor starts or water bag releases. ( 10 cc syringe insert just enough to flush the vagina 2x a day )
The medical recommendation is for Ampicillin antibiotics (or alternative if allergic to penicillin medications) are given by IV in labor as soon as you arrive at the hospital or when in active labor at home. They repeat the antibiotic every 4 hours and the recommendation is 2 dose before baby is born.
What about the risk to the baby?
Here is what they found:
Early onset after baby is born is within the first 12-48 hours and late onset is usually 1-8 weeks.
Symptoms include: irritability, lethargy, respiratory distress, unwilling to feed, maybe fever and eventually seizures.
Note: Fever is often not a sign in the first few days or week. After it may be accompanied by a fever as it can lead to meningitis.
Risk factors are :
Prior baby who had a GBS infection,
Urinary Track infection and especially if it was GBS bacteria,
Mom had fever in labor of 100.5 or higher,
Water bag releasing 18 hours or longer until baby is born. ( likely there are more vaginal exams which can increase the risk of infection in general)
NOTE: the testing and research is on hospital labor and birth with general population and does not take into account the health of the mother and baby, the risks during the birth such as repeated vaginal exams, rupturing the bag of waters, prolong labors, internal monitors, epidurals, which all interfere with the normal bacteria of the body.
We don't have good studies about healthy women in a home birth or freestanding birth center setting to see the difference in how care and place can affect the statistics.
Let's bring this in for a landing. Most parents follow the recommendation of their care provider without doing their own research. I want to encourage you to start doing your research and making informed decisions. Taking ownership for your choices will empower your journey and help you feel more confidence in what you say Yes to.
Use the research and evaluating your own health and wellbeing, labor progress and risk factors, to make your own decisions. Sometimes you may run into a well-meaning care provider that does not like the choices you make. Thank them for their opinion and for their support as you are the parent to your baby.
Enroll in Natural Childbirth 101 Classes. Become an amazing informed parent so confidence flourishes and birth unfolds in an empowering journey for you and your baby. Classes will encourage you to walk the journey YOU desire and have the resources to support your decisions.
The research that is used to decide the treatment and testing comes from the American College of Obstetricians and Gynecologist (ACOG), Center for Disease Control (CDC) and March of Dimes.
Evidence based birth site often is a great resource for many topics. https://evidencebasedbirth.com/groupbstrep/
According to the CDC ( Center for Disease Control) 1 in 4 women will carrie GBS in their body which means the test will come up positive.
According to the American College of Obstetricians and Gynecologist, 1-2 babies in 100 will contract GBS who are not treated with antibiotics , IV antibiotics in labor is the treatment of choice. Ampicillin is the drug of choice. A 2 gram does is given for the first does and then 1 gram every 4 hours until the baby is born. According to the research 1 in 4000 newborns will contract GBS if IV antibiotics are NOT given in labor and 1 in 200 will contract GBS if antibiotics ARE give in labor.