Group B Streptococcus

Childbirth practitioners globally continue to debate the issue of how to handle the testing and treatment of Group Beta Strep (GBS) effectively. Opinions and protocols vary widely even among midwives. 

Our approach is to provide clients with information, including risks, benefits, and available treatment options.  Our informed parents decide if they want to do the routine culture at around 36 weeks and then, how they want to proceed should results be positive. 

What is GBS?

Group B Streptococcus (group B strep, GBS) is a bacteria that commonly lives in people’s gastrointestinal and genital tracts.  Most of the time this bacteria is not harmful and does not cause illness or present symptoms. About 1 in 4 pregnant women carry GBS bacteria in their body. Sometimes the bacteria invade the body and cause certain infections, which are known as GBS disease. 

Risk Factors

GBS disease is most common in newborns. These are the factors that can increase a pregnant woman’s risk of having a baby who will develop GBS disease:

  • Testing positive for GBS bacteria late in pregnancy

  • Developing a fever during labor

  • Having 18 hours or more pass between when their water breaks and when their baby is born

  • If a baby is premature, there is an even higher risk for long‐term complications and/or death

Testing

The CDC recommends routine screening for vaginal strep B for all pregnant women at 36 weeks. Our clients can collect this sampla on their own, or with help as needed. The test is a swab of both the vagina and the rectum. The sample is sent to a lab where a culture is analyzed for any presence of GBS.

 

Standard Treatment/Antibiotics

If you choose to have a  culture and it returns positive, the standard medical protocol in our area is to give IV antibiotics during labor.  The antibiotics help protect babies from GBS infection, only when given during labor. Antibiotics are not given before the onset of before labor because the bacteria can grow back quickly.  The antibiotics are administered by IV. The most common type of antibiotic that is used is beta-lactams, which includes penicillin and ampicillin. Alternative antibiotics can be given to women who are allergic to these types of antibiotics.  About 1 in 10 women have mild side effects from receiving penicillin. There is a rare chance (about 1 in 10,000 women) of having a severe allergic reaction that requires emergency treatment.

 

According to the FDA, “part of the problem is that bacteria and other microorganisms that cause  infections are remarkably resilient and can develop ways to survive drugs meant to kill or weaken them.  This antibiotic resistance, also known as antimicrobial resistance or drug resistance is due largely to the  increasing use of antibiotics.” Group B Streptococcus (GBS) is a type of bacteria found in 10 – 35% of all healthy, adult women. A  person can have these bacteria without having signs of an infection. Group B Strep is not the same bacteria that causes strep throat. A baby is exposed to GBS during labor and delivery.

Microbiome

During a vaginal birth the baby is colonised, for the first time, by maternal vaginal bacteria. Initial human bacterial colonies resemble the maternal vaginal microbiota – predominantly Lactobacillus, Prevotella and Sneathia. When developed correctly, these beneficial bacteria lay the foundation for a strong immune system and overall health.

 

Parents sometimes choose to decline antibiotics as they disrupt this important microbiome.  It is vitally important that parents are aware of safe, alternative treatments in the attempt to reduce GBS colonization while supporting the healthy flora to minimise the threat of GBS infection.  

Work to strengthen your body’s natural ability to reduce GBS.

There is no rule to preventing the presence of this bacteria.  As mentioned above, 1/3 of the population carry it at any given time and it is usually harmless.  The tips below are meant to help you work to strengthen your body’s natural ability to reduce GBS by maintaining a strong immune system and encouraging other, beneficial bacteria to grow in your body.

 

  • Focus on nutrient‐rich foods, eat an abundance of fresh fruits and vegetables, avoid  commercially processed meats, non‐organic dairy products and white sugar. Proper hygiene when toileting (wiping from front to back) will help to reduce transmission of GBS from rectum to urogenital  tract as well. 

  • PB‐8 acidophilus.  Follow instructions on bottle as to when it is best to  take acidophilus. This will help to keep up your good bacteria. Eat plenty probiotic rich foods, especially kefir and yogurt.  You can also use yogurt vaginally. 

  • Oregon Grape Root Tincture.  This tincture is made specifically to kill strep and staph bacteria. The  suggested dose is 6 drops of the tincture daily throughout pregnancy. 

 

  • Boost up your vitamin C by eating many vitamin C rich fruits, vegetables and supplement 500-mg daily.

If you tested positive for GBS here are some tips to reduce population

 

  •  Insert 2 raw garlic cloves (you must bruise them just prior to inserting them) into the vaginal vault  every other night prior to bedtime until delivery. 

 

  • Eat 3 to 4 raw cloves of garlic daily.  The best way to do this is to chop, crush or press garlic,  place it in a glass, let it sit for about 10 minutes, then add enough water to drink it down. Chase with orange juice.

 

  • Make a garlic elixir by blending 1/2 cup of honey, 1/4 cup of apple cider vinegar, and half a bulb of  fresh garlic until liquified. Take tablespoon up to twice daily.

  • Astragalus- Dried, cooked or in tea. Cook two strips into a pot of rice or soup 2‐3 times per week Remove the strips when done cooking and eat the rice or soup.  Astragalus is an immune system tonic used in Chinese medicine. ​​​​

  • Immune Booster Tincture (includes Echinacea root, Echinacea purpurea, peppermint, and nettles).  This helps boost mom and baby's immune system. Take 20 drops, twice daily for 10 days,  come off for 2 days, then back on again. Keep this up until delivery.  

 

  • Colloidal Silver can be purchased in most health food stores. It is antibiotic in nature and safe in pregnancy. Colloidal Silver is one of the most powerful natural antibiotics.  It comes in liquid form and the suggested dose is 1 Tablespoon, 3xs  daily, between meals. Hold the liquid in your mouth a few minutes before swallowing.

 

  • Tea tree suppository. 

  • Make an infusion of burdock root and echinacea root. To prepare the infusion, steep one‐half ounce of each of the herbs in four cups  of boiling water for two hours. Strain and take the above dose, storing the rest in the refrigerator for the next day. 

  • Ask your care provider about antimicrobial douche and perineal wash.

 

 

After the birth you want to be sure to NURSE, NURSE, NURSE your baby as much as you can possibly  stand it – this will give your baby much needed colostrum which is LOADED with antibodies to help your  baby’s immune system grow and thrive! You will also want to be sure that anyone who comes to visit you and your baby WASH THEIR HANDS THOROUGHLY before they touch either one of you AND don’t  plan to take your baby out unless you have to until they are 10 days to 2 weeks old.

 

 

GBS Disease in the Newborn

There are two forms of Group B Streptococcus infection:

  • In early‐onset GBS  disease, a baby will become ill within seven days of birth. In severe early‐onset GBS infection, about  6 percent of affected babies will die from complications of the infection. Full‐term babies are less likely to die; 2‐ 8% suffer fatal complications. Premature babies have mortality rates of 25‐30%. 

  • Late‐onset GBS infection is more complicated and may not have anything to do with whether you had GBS during birthing. It occurs between seven days and three months of age.

 Symptoms of early onset GBS disease 

Symptoms of early‐onset Group B Streptococcus infection include any of the following:

  • Fever or  abnormally low body temperature

  • Jaundice (yellowing of the skin and whites of the eyes)

  • Poor feeding

  • Vomiting

  • Seizures

  • Difficulty in breathing***

  • Swelling of the abdomen

  • Bloody stools.

 

***The most common symptom is difficulty breathing, which is also the most common complication in babies whose  mothers choose drugs during birthing. Since these symptoms can occur in so many circumstances not related to GBS, a C‐Reactive protein test can be given to a symptomatic baby to reveal the presence of  an active infection.

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Too many women slip into, by default, a hierarchy of power during their pregnancies and births that place care providers in power over them. Women should be at the center, empowered. We not only provide midwifery, doula, and postpartum support, but we also work to connect you with a local network of care professionals to ensure your complete care. 

Our Story

I wish every woman would know how capable they are and how intelligent their bodies and babies are, and how they are designed for reproduction. When I was 16, I ended up doula-ing for my mom's best friend throughout her labor. When I saw the way she and her baby were treated, I knew this was my work. I got pregnant at 19 and had a lovely home birth. I took a couple of years off to be with my baby and got my doula certificate during that time. In 2003/4 I took midwifery assistant training with a local midwife, and in 2009 I enrolled in midwifery school and started attending home births as a student. I wish more women knew how amazing and how different a home birth/midwifery care can be. I would love to see all the women in our birthing have access to the kind of care that is right for them. To many women slip into, by default, a hierarchy of power during their pregnancies and births that place care providers in power over them. Women should be at the center, empowered. I would like to see more women educating themselves and taking charge of their health.  I want to meet more women who are excited about catching their own babies.  

- Shelton Livingston LM, CPM, Doula

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