 What is Group Beta Strep (Group B Strep, GBS)? GBS is a bacteria that is naturally present in our body, usually in the colon and genital tract. It is carried by about 40% of adults and while not strictly considered an STD, infection due to OVER colonization increases with sexual activity. It is estimated that up to 26% of pregnant women are colonized with GBS. What does GBS have to do with your birth?If a mother has a high colonization of GBS it is possible for the uterus and amniotic fluid to become infected. If this happens, the membranes may rupture prematurely, preterm labor may set in, and in some cases a cesarean may become necessary. Ultimately the primary concern for a GBS carrier is the possibility that her baby may become infected with GBS. About 1-2% of newborns born to untreated mothers who were positive for GBS will develop GBS disease. GBS disease is a serious respiratory illness, which for a small percentage of babies, mostly preterm babies, can result in death. In some cases GBS can contribute to infections of incisions and lacerations as well as intrauterine infections in after the baby is born. If you are a GBS positive mother in the hospital you will be “required” to receive IV antibiotics every four hours during labor to prevent transmission of GBS to your baby. You will also be advised to come to the hospital as soon as your membranes rupture or your labor starts in order to start this protocol. If we look at the numbers for GBS disease in newborns we can put this in better perspective. About 1 or 2 in 1000 babies will develop GBS disease. Of those 1 or 2 babies only a quarter will become so ill that they will die. So 1 in 4000 babies, or about 80 babies per year in the United States, die of GBS disease. This is an extraordinarily low number. By comparison, between 4 in 10,000 and 4 and 100 women have a life-threatening allergy to penicillin, which is used during labor to eliminate GBS. Furthermore the broad use of antibiotics contributes to the development of antibiotic resistant infections, including GBS. Use of antibiotics at birth may also put babies at risk for infection by other organisms later on and disturb the development of the baby’s gut flora which it first develops by passing through the mother’s flora during birth. Exposure to antibiotics during labor and birth may compromise the baby’s immune system not only in the short term, but also for many weeks, months, and possibly years to come. GBS Testing: When, Why, and How?GBS testing is usually done between 35 and 37 weeks. In mainstream medicine this is done for all women across the board. Some out of hospital providers, however, will only screen those who are at higher risk such as those women with recurrent or an active UTI and those who have previously tested positive for GBS. Currently the most common way to test for GBS is to take a swab of the vagina and rectum and culture it in some kind of medium including a selective antibiotic which encourages the growth of the GBS organism and restricts the growth of other organisms. A swab can be taken at a prenatal appointment with your provider, but it is then sent to a lab to be cultured. In some practices providers will allow women to take this swab themselves in private during their appointment. Conventional & Alternative Treatments for GBSThe CDC currently recommends not only that all pregnant women be screened but that all who test positive should be treated with IV antibiotics in labor every four hours. Though not evaluated scientifically there are several alternative treatments.
Understanding and Reducing Risks The babies at the highest risk for infection are:
As briefly discussed above, broad spectrum antibiotics are not without risks themselves, both short and long term, for the health of the mother and the baby. Simply put, the long term risks associated with early exposure to antibiotics are not known. It is best to reduce the potential for vertical transmission by limiting, or avoiding all together, any procedures which bring bacteria from the lower vagina up to the uterus not only in labor, but also in pregnancy. This includes vaginal exams prenatally and in labor, sweeping of the membranes, artificial rupture of the membranes and internal monitoring during labor. Especially avoid vaginal exams once membranes have ruptured. Using upright positions may also prevent GBS infections from going into the upper vagina, cervix, and uterus. Learn morePlease check out more information about Group Beta Strep and ask your provider to share more information, not just by word but also studies and research. The below resources are excellent for researching Group Beta Strep. Several were used to put this post together and there are many more! **Please do NOT use chat rooms or lists, comment threads, message boards, etc for doing this type of research. You need to see credible sources, not opinions and personal experiences** ***Gentle Birth, Gentle Mothering, Sarah Buckley, MD*** This is a must read for all new families for so many reasons! These are available for you from our Greenwood, Indiana lending library if you choose to work with us during your pregnancy. Myles Textbook for Midwives, 15th Edition. Diane Fraser, Margaret Cooper Understanding Diagnostic Tests in Pregnancy, 6th Edition. Anne Frye Pregnancy, Childbirth, and the Newborn. Simkin, et al. The Thinking Woman's Guide to a Better Birth. Henci Goer Obstetric Myths Versus Research Realities, Henci Goer Optimal Care in Childbirth, Henci Goer Explore these websites for quick information right now: www.evidencebasedbirth.com/groupbstrep/ http://www.cdc.gov/groupBstrep/index.html http://gbss.org.uk/health-professionals/research-papers/ 
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