Group B Strep: Everything you need to know
If you’ve been told you have Group B Strep, or you’ve had a previous positive test, you may have questions about it. Here is everything you need to know about Group B Strep.
What is Group B Strep?
Group B Strep (GBS) is a type of bacteria that typically lives in the rectum or vagina. This bacteria is present in around 20-40% of all women. For most, it causes no issues or harm.
What are the symptoms of Group B Strep?
Generally, there are no symptoms at all. It is normal and natural to have Group B Strep in these areas of your body.
Can Group B Strep be a problem if I am pregnant?
If you have Group B Strep and your baby is exposed during labour or birth this can potentially cause an infection in your newborn. It is the most common cause of severe infections in babies and can lead to things such as meningitis, sepsis or pneumonia.
If you are found to have Group B Strep then you will be advised to have antibiotics in active labour. These are called IV antibiotics as they go in via a cannula in a vein, generally in your hand. If your waters break or once you have regular contractions, call your hospital and they will invite you in.
Can I take the antibiotics before labour?
There is no evidence that taking these antibiotics before labour reduces the infection in newborn babies. They are shown to be highly effective at preventing infections in newborns when given as soon as possible once labour has started, and then at regular intervals until baby is born. This massively reduces the risk of GBS infection in your baby.
What if Group B Strep shows in my urine?
Group B Strep found in your urine during pregnancy can be a sign of a urine infection. For this you would be offered a course of oral antibiotics from your GP. When you go into labour your will be offered antibiotics again for the reasons described above.
Who is tested for GBS?
Women who have had a previous GBS positive test in a previous pregnancy (regardless of if their baby developed an infection) will be offered a test by their community midwife between 35-37 weeks. If you go into triage for a suspected pre-term labour or if your waters go but contractions do not start, you may be offered a vaginal swab that may pick up GBS.
If you want to have a GBS test, speak to your midwife to see if you can be tested via the NHS. You can also order a private GBS test via the Doctor’s Laboratory. This is GBS charities preferred provider. You can order the test online and then complete it at home. You will want to do this test within 5 weeks of giving birth for the most accurate result. If you have a positive result, make sure you tell your consultant or obstetrician.
GBS can fluctuate, so having it at 20 weeks pregnant does not mean you will still have it at 40 weeks.
Can I have a water birth if I am GBS positive?
So the short answer is yes. Having GBS isn’t a reason in itself to not have a water birth. The issue with a cannula is that it needs to be kept dry. One option is to wear a glove to keep the site dry. I have known women to have the cannula sited, antibiotics given and then the cannula removed and then re-administered ready for the next dose. You could also just make sure you keep your hand out of the water. The issue is that birth water around the cannula can cause irritation or even infection in the cannula site. It is important for you to weigh up yourself the risks and the benefits and make an informed choice.
You can read Jamie’s experience of Using EBRAN to support with an empowered birth: A consultant led pregnancy here.
What if I don’t know I am GBS positive?
Your body has lots of defences in place to protect baby from bacteria. For example, your amniotic sac (the membranes surrounding baby with your waters in), your closed cervix and your show which acts as a barrier. The biggest of these is your membranes, which we can tell have been broken when your waters start to leak. All women will be offered an induction and monitoring if their waters break after 24 hours. After 48 hours all women will be offered antibiotics. All women will also be offered a vaginal swab. This is to reduce the chances of babies being exposed to GBS for women who do not know their GBS status, and to protect baby from other bacteria.
If your waters have been broken for over 24 hours it would be advised that baby has extra monitoring after they are born. This would be a check of their heart rate, temperature and breathing rate more often after birth.
What will happen if I have an elective cesarean?
If you are having an elective cesarean then antibiotics are not advised as baby is unlikely to have been exposed to the bacteria. You would be offered antibiotics if you have already started labour or if your waters have broken.
Can I still have stretch and sweeps?
Yes.
When should I go into hospital if I am GBS positive?
With all women we advise that you stay home until you have regular contractions. This still applies to you with GBS. Once your contractions are 3-5 minutes apart we will advise you to come in. If you have any concerns or are unsure – call the hospital and they can give you tailored advice. If your waters have broken you will be advised to come in.
Where can I give birth? Can I have a home birth?
When planning where to give birth, you will need to consider your need for IV antibiotics. The majority of areas cannot facilitate home births. This is because midwives have to have an obstetrician to prescribe the antibiotics and we also need an IV drug to be checked twice before we can give it. With a home birth, for the majority of early labour one midwife is present. This is similar to stand-alone birth units; no obstetrician is present.
I have heard of times where women and their midwives have navigated this. It is also worth discussing with your midwife and seeing if you have any additional options.
You may be able to give birth at a midwife-led unit attached to a hospital with a consultant-led unit as the consultant may be able to come to you.
What will happen to my baby after birth?
Babies born to mothers who are GBS positive will be recommended to have regular observations. In their first 12 hours they will have regular checks by midwives of their temperature and heart rate.
If you’d like to watch Beth talk about GBS over on Instagram, you can do so here. Want to read a positive Group B Strep birth story? In early pregnancy Faye tested positive for Group B Strep and you can read her birth story here.
