Group B Step (GBS)
Here's what you need to know about GBS (Group B Streptococcus)
GBS (Group B Streptococcus) is a naturally occurring strain of bacteria that lives in the digestive tract both when you are and aren't pregnant. Still, it can pose a risk to the baby if colonized during delivery.
The risk of your baby picking up the bacteria during a vaginal delivery is very low, but if your baby were to develop GBS disease, it is very concerning.
How do we know if a person has GBS?
Your healthcare provider will perform a routine swab to test for GBS colonization around 36-37 weeks (in many cases, you'll be given the swab and perform the swabbing yourself in the clinic washroom!)
This "universal screening approach" is currently used in 60 countries, including the U.S., Canada, Mexico, Brazil, Chile, Argentina, Uruguay, France, Germany, Spain, Australia, Portugal, Iran, Oman, the United Arab Emirates, and Japan. (Le Doare et al. 2017).
About 30% of pregnant people will test positive for GBS, but what's tricky is GBS can be colonized today and gone tomorrow.
If you test positive, antibiotics through an IV drip will be suggested.
If a pregnant person is a carrier of Group B Strep and not treated with appropriate antibiotics during labour, then there is a 1-2% chance that their baby will develop early GBS disease.
Another Method:
Sometimes other risk factors are used instead of testing for GBS with a late week swab, and, instead, labouring people are treated with antibiotics if they have one or more of these other risk factors:
GBS in the urine at any point in pregnancy.
Previously gave birth to an infant with early GBS disease.
Preterm labor.
Fever during labour.
Waters have been broken for more than 18 hours.
This "other risk factor approach" method is currently used in 25 countries, including the United Kingdom, Ireland, the Netherlands, Norway, Sweden, Finland, Iceland, Saudi Arabia, Tanzania, South Africa, India, Bangladesh, Thailand, the Philippines, and New Zealand (Le Doare et al. 2017). However, I have seen healthcare providers use a combination of the two methods in Ontario.
Is there anything we can do to reduce the chances of having GBS colonization?!
Newer research suggests that GBS growth can be lessened naturally! So, why are people only told about GBS at their 36-week appointment? Maybe we need to talk about GBS sooner and how to reduce colonization chances.
Here are a few ways to reduce GBS:
Since the gut and vaginal microbiome are interconnected, a healthy, balanced gut can reduce chances of colonization.
• Gut Healthy Food - yogurt, kombucha, coconut oil, kefir, garlic
• Probiotics - Certain strains are research-proven to target gut health and reduce GBS
• Balanced Diet - Cut out/reduce foods that can grow "bad" bacteria like sugar, processed foods, grains
• Working with a Naturopathic Doctor is a great way to reduce your chances of testing positive for GBS. You can find a trusted naturopathic doctor in Toronto on my resources page, "Alternative Healthcare Providers."
More quick tips on GBS:
• There is a chance that your GBS status could change between the time of testing and your delivery. In one study, approximately 9% of negatively tested people at 35-36 weeks became GBS positive and 16% of the GBS-positive people became GBS-negative by the time they went into labour.
• If you test positive, you can refuse antibiotics. In fact, some births are so quick that there's no time for antibiotics. In cases where antibiotics are declined, the baby(ies) are monitored more closely for signs and symptoms of infection.
• You can deny the GBS test altogether. Even if you deny the test, a healthcare provider may still treat you as a positive patient. If you do not want treatment, you must advocate for no antibiotics.
• You do not need to begin antibiotics with the first signs of labour! You can delay the doses of antibiotics in labour until you're into active labour (or sooner if your waters release.) Of course, if you're concerned about a fast birth, you can be more conservative about when you want to start treatment.
• In Ontario, midwives can administer IV antibiotics in your home, keeping a homebirth as an option if you wish.
• It's essential to ask questions, have informed consent and make the best decision for you and baby(ies) regarding GBS. Check out this article from Evidence Based Birth - The Evidence on Group B Strep to help navigate conversations with your healthcare provider.
Looking for someone to help you navigate all the tests, scans and decisions you need to make during pregnancy?
