Group B Strep: an introduction..
Group B strep and birth choices
Please note- this topic is MASSIVE, so please take this post just as a VERY brief intro. Further reading has been shared at the bottom but I would absolutely recommend Sara Wickham’s book on GBS- here.
Diagnosed with Group B strep in pregnancy? What does this mean for your birth?
GBS is a normal bacteria that actually around 20-40% of us have living in our gut or vagina every day. Even in pregnancy it’s usually completely harmless, however if a baby develops a GBS infection in can be incredibly serious- it may cause preterm birth, pneumonia, sepsis or meningitis. Around 1/1750 babies born to a mother with known GBS will develop a GBS infection.
One of the tricky things with GBS is that it ‘comes and goes’, and whilst you may have been testing ‘positive’ one week, a couple of weeks later you may not.
In the U.K. women are not routinely screened for GBS as there is no high quality evidence showing whether or not it would improve outcomes.
It would also lead to around 99.8% of babies to mothers with GBS being exposed to unnecessary antibiotics- the impact of which is unknown but may affect their gut microbiome and resistance to antibiotics.
If you are found to have GBS in pregnancy, The current recommendations for birth are that you will be offered a course of IV antibiotics every 4hrs in labour. Which reduces the chance of your baby developing GBS infection from 1/400 to 1/4000. Your baby will be closely monitored for 12 hours after birth and if symptoms of infection develop they can be given IV antibiotics too.
Receiving antibiotics in labour doesn’t take long and shouldn’t affect your ability to mobilise/ continue with the sort of birth that you are hoping for.
Sometimes women are encouraged to be on the labour ward for this reason- if this isn’t somewhere you want to be, then it’s important to have a conversation antenatally about how your birth choices can be best supported.
Can this be offered on a midwifery led unit or at home?
Can you attend the hospital to receive them and then head back home?
You may prefer not to have antibiotics at all.
If you’ve been diagnosed with GBS, I’ve shared a long reading list below. Gather your information, Ask your healthcare providers how they can best support your decisions and make the choices that feel best for you and your baby!
Group B Strep Information
Sarah Wickham (Midwife) resources https://www.sarawickham.com/topic-resources/group-b-strep-resources/
Group B Strep Support (GBSS): www.gbss.org.uk
RCOG Green-top Guidelines:
www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg36
RCOG Patient info https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-gbs-pregnancy-newborn.pdf
Waterbirth https://gbss.org.uk/wp-content/uploads/2017/12/2007_04_Practising_midwife_water_birth_article.pdf
Research into screening https://www.bmj.com/content/364/bmj.l463.shor
Ongoing support from GBSS https://gbss.org.uk/info-support/we-are-here-to-help/
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