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Jan 142013
 

There is a lot of information about Group B Strep and pregnancy. “Lots of information” inevitably means that there is a lot circulating, some true and some not.

If you are pregnant, Group B Strep should be of great interest to you. Toward the end of your pregnancy, you will be asked to take a Strep B test (amongst others). Depending on the results of that test, you may have to make some very important decisions which would affect your baby.

We want to give you what you are asking for: the facts. Then you can make the best decision for your family.

Pregnancy can be a stressful and fearful time because there are so many decisions to make. Some women just go with the flow and trust their care provider to have all the answers. Other women do the research because they want to know the facts and the truth for themselves. They want to be in charge and make the best decisions. They believe in team work and that their care provider is not “all knowing” but rather a part of the team. They do not want to be told what to do, so if you are one of these women, we want to help you.

So if all the talk about Group B Strep and pregnancy stresses you and you want some facts, here we go.

 

Group B Strep and Pregnancy

Group B Strep and Pregnancy: What is Group B strep?

Group B Strep also called Group B Streptococcus – or GBS and/or Strep B for short – is a bacterium that normally lives in the intestinal tracts of many healthy people without any consequences.

So if that is the case, then why is Group B Strep and pregnancy a big deal?

That is such a wonderful question!

Group B Strep COULD become a problem IF it is present in your genital area when you give birth. If this was to occur there could be a SMALL risk that GBS would be passed on to your baby. GBS can be deadly to a baby.

Is GBS the same bacteria which causes strep throat?

No.

Group B Strep and pregnancy are an issue because this bacteria can cause bladder and uterine infection in the mom resulting in a stillbirth. GBS can also cause a blood infection (sepsis), pneumonia and meningitis (an infection of the fluid and lining of the brain) in newborn babies which can be fatal. But before you become too alarmed let’s give you some statistics.

Before prevention and detection methods were used, it is estimated that about 8,000 babies contracted GBS per year and of these babies about 5 percent of them died, which is devastating and sad and too many.

Group B Strep and Pregnancy: ACOG’s Recommendations

For the reasons mentioned above, ACOG – the American Academy of Obstetricians and Gynecologists – and the CDC – Center for Disease Controlrecommend to test all pregnant women between 35 and 37 week of gestation.

The test involves a painless swab of the vaginal area and of the rectum.

The results of the test are available in a few days. It is reported that about 30% of pregnant women will test positive in one of both areas. As you can see this represents almost 1/3 of all women tested.

 

Group B Strep and Pregnancy: If You Test Positive, Then What?

Again both the CDC and ACOG recommend that all women who test positive be given IV antibiotic during birth through IV.

During childbirth, the antibiotic most commonly used as a prophylactic – preventative – for Group B Streptococcus is penicillin. So if you are allergic to penicillin, another method must be used. That poses a problem. The other drugs of choice – namely Ampicillin and Amoxicillin – are just about worthless for treating Group B Strep.

Why is that?

The overuse of antibiotics – for anything and everything which has gone on for decades – has created drug resistant “bugs.” If you think penicillin is immune to this phenomenon – think again! It is a fact that it takes more of the drug for a longer period of time to eradicate bacteria.

It may not be common knowledge, but already research has found resistant strains of Group B Strep. It is now a fact that 12 to 21 strains of Group B Streptococcus are resistant to all forms of antibiotics currently used.

So in light of this should 1/3 of pregnant women be given a drug which has the potential for more harm than good? Is treating Group B Streptococcus this way proving to be worth it, namely saving the lives of babies?

To find the answer, please read on.

 

Group B Strep and Pregnancy: The Facts

No woman can make a truly informed decision until she is told all the facts. Simply being told “you test positive and you must take antibiotics” is falling short of “being given all the facts.”

To begin, if as mentioned before, many healthy people walk around with GBS in their intestinal tract can the term “infected” be an accurate one? Why do some women carry the bacteria and never have a problem and others do?

For most people Group B Streptococcus is a non issue. It is only of concern when it shows up in your vaginal area during birth and then again only in certain cases. Of the women who have GBS, only .5% will have a baby who becomes ill with GBS when given no antibiotics during labor.

So testing of the genital and rectal area is a very poor predictor of which babies will – or might – become sick with GBS.

 

Group B Strep and Pregnancy: Is Antibiotic Therapy Effective?

Some studies do show that the use of antibiotics during labor has decreased the rate of GBS infection among newborn babies. So this is great news. The bad news is that the same research shows that while there is a decrease in the number of infections there is no decrease in the rate of death. In short, the same number of babies die whether antibiotics were used or not.

It gets worse. Other research is showing that the benefit of less GBS infections is being outweighed by increases in other forms of blood infection!

Remember 98-99% of babies born to colonized women will not become infected.

So here are the facts: The worst case scenario, is that 40% of women are colonized and that 2% of those babies will become infected, if nothing was done at all – so no antibiotics or anything else at all – .0225% or 1 in 4,444 babies would die of early onset Group B Strep. We agree that even one death is tragic but even with antibiotics the morbidity – death – rate stays the same!

 

Group B Strep and Pregnancy: How do Babies Fair?

A study done in 2002 – and published in the American Journal of Obstetric Gynecology – showed that of 43 ill newborns with blood infections caused by Group B Strep and other bacteria and whose mothers had received antibiotics during labor, 88 to 91 percent of these infections were now resistant to antibiotics.

Do you think it was a coincidence that the drug the bacteria showed resistance to was the very antibiotic used on the moms during labor?

Now, of the babies who had also developed a blood infection during labor but whose mother did not receive antibiotics only 18 to 20 percent of their infections were resistant to antibiotics.

Again, coincidence?

 

Group B Strep and Pregnancy: Prematurity and GBS

One of the risk factors of GBS is prematurity. Nutrition is known to reduce the rate of prematurity but also to help you – and your baby – have a stronger immune system.

So if you go into premature labor, you are even more likely to be pressured to take the meds.

Keep in mind that a premature baby is even at greater risk to drug-resistant bacteria. This is no laughing matter when babies die.

At St. Joseph’s Hospital in Denver Colorado, 4 moms whose water broke before 37 weeks were given medication. Infection of the amniotic fluid occurred in all 4 cases. Sadly two of the babies died from drug-resistant bacterial blood infections. Another was stillborn.

So if you choose to take the test and are positive what are you to do?

 

Group B Strep and Pregnancy: Risk Factors

There are 3 main risk factors for GBS:

  1. As mentioned above, prematurity is one (baby born before 37 weeks).
  2. Developing a fever during labor – which is not due to an epidural.
  3. Prolonged rupture of membranes (PROM) – Water broken for 18 hours. This is another reason why you should
    avoid having your membranes ruptured AND receiving any vaginal exams.

 

Group B Strep and Pregnancy: Forms of Strep B Infection

There are two forms of Group B Strep infection:

  1. Early-onset GBS: The baby becomes sick within seven days of his birth.

Of these babies about 6% will die from the infection. Full term otherwise healthy babies (good birth weight) fair better.

  1. Late-onset GBS: In these cases, the baby will become sick between 7 days and up to three months of age.

 

Group B Strep and Pregnancy:
Are There Alternatives Methods to Antibiotics?

Are there alternatives methods to antibiotics?

Well the answer is not clear cut. Yes, there are alternative methods (one was used by Alisha with success – see end of page) and no because none have been researched extensively at this point. However, for many moms natural methods make more sense and have proven quite effective as evidenced by a negative re-test and a healthy newborn.

Group B Strep and Pregnancy: The first mode of treatment involves strengthening your immune system through various means – which in our opinion is just plain common sense, GBS or not:

  • Garlic
  • Vitamin C: 3 gm per day.
  • Grapefruit Seed Extract: Has antibiotic, antifungal and antiviral properties.
  • Echinacea: 250 mg or drink a cup of Echinacea tea
  • Oregon Grape Root: Use the one for children in a glycerin base.

    Note: Please choose either Echinacea or Oregon Grape Root.

  • Bee propolis
  • Glyconutrients
  • Eat live cultures:
  • Natural yogurt or kefir
  • Sourdough bread
  • Fermented foods
  • Aged natural cheeses
  • Lactobacillus: Orally as above or in good quality capsule. Internally in the form of a gelcap daily for 2 weeks (a gelatin capsule of high quality lactobacillus inserted vaginally once or twice a day works well).
  • Strep nodose

Group B Strep and Pregnancy: The second mode of treatment involves the ph and sometimes flora of your vaginal area:

  • Lactobacillus: as mentioned above a good quality capsule inserted internally once or twice a day for 2 weeks.
  • A tampon soaked in a 2% Tea Tree essential oil and 98% Olive oil inserted into the vagina and left for up to 4 hours each day for 6 days.
  • Goldenseal tincture: Add 1/2 teaspoon of goldenseal tincture to 2 cups of warm clean water (spring water is best). Use this mix in peri bottle and spray the area once a day for a week. Another method can be to use a sitz bath and soak your bottom into it. Some recommended douching. However, we do not recommend douching while pregnant. Use this in addition to lactobacillus implant daily for 2 weeks.

    Note: Goldenseal should not be used before 37 weeks as literature says it could induce labor.

     

  • Chlorhexidine: A double placebo blind study was performed to determine whether chlorhexidine (a .02% dilution) applied with a squeeze bottle before the birth, reduced mother-to-child transmission of Group B Streptococcus and other micro-organisms. The study involved 1,130 women. One group used chlorhexidine and the other a sterile saline solution. The vaginal douching with chlorhexidine significantly reduced the vertical transmission rate from 35% with just the saline solution to 18% with chlorhexidine. This study concluded that vaginal douching with 0.2% chlorhexidine during labor significantly reduced both maternal and early neonatal infectious morbidity. Moreover the squeeze bottle procedure was simple, quick, and well tolerated.

 

1 tablespoon to 1 pint of water.
Do this twice a day for 3 days then once a day for 3 days. Retest.

 

Group B Strep and Pregnancy: Alisha’s Story

When I was pregnant with Johnathan, I tested positive for GBS. I was terrified.

What was this disease I had contracted and what would happen with my baby?

The midwife at the birth center didn’t give me a satisfactory explanation. I went home to do research on Group B Strep and pregnancy – all the information I found scared me more!

But then finding out that most – if not all – people carry it anyhow, I was relieved.

So what to do? I was told I would have to have antibiotics during labor. This did not make me happy. I asked if I could re-test. They agreed.

A midwife (not at the birth center) told me to spray with a mixture of chlorhexidine. I did it every day for a week. Re-tested… NEGATIVE!

So I didn’t have to take antibiotics, but I was kept at the birth center for observation for about 6 hours to make sure Johnathan was okay. He was!

When I was pregnant with Kathleen, since I had already tested positive with Johnathan, I was already at risk and would require antibiotics again and possibly even be transferred to the hospital. Not gonna happen!!

Fortunately, my midwife trusted me, did not require the test, but recommended that I spray with the chlorhexidine at term and before I knew I was going into labor. Kathleen was perfectly healthy.

 

Comments:

Hi, I am 31 (not pregnant) and after 3 months of constant UTI’s and and painful bladder infections, I CURED MY GROUP STREP B INFECTION NATURALLY WITH THIS!!……A glass of Organic Cranberry juice in the morning, a 1000mg of Vitamin C with lunch and a Probiotic before dinner (Ultimate Flora Woman’s Probiotic bought at the vitamin shoppe!) I am sooooo happy!! I hope this helps someone in my same situation!

 

Group B Strep and Pregnancy: Resources

  • B. F. Anthony et al., “Epidemiology of Group B Streptococcus: Longitudinal Observations during Pregnancy,” Journal of Infectious Disease 137 (1978): 524-530.
  • J. A. Regan et al., “Vaginal Infections and Prematurity Study Group: The Epidemiology of Group B Streptococcal Colonization in Pregnancy,” Obstetric Gynecology 77 (1991): 604-610.
  • H. C. Dillon et al., “Anorectal and Vaginal Carriage of Group B Streptococci during Pregnancy,” Journal of Infectious Disease 145 (1982): 794-799.
  • Mothering Magazine
  • Midwifery Today
  • K. M. Boyer et al., “Selective Intrapartum Chemoprophylaxis of Neonatal Group B Streptococcal Early-Onset Disease: II. Predictive Value of Prenatal Cultures,” Journal of Infectious Disease 148 (1983): 802-809.
  • S. J. Schrag et al., “A Population-Based Comparison of Strategies to Prevent Early-Onset Group B Streptococcal Disease in Neonates,” New England Journal of Medicine 347 (2002): 233-239.
  • M. Dabrowska-Szponar and J. Galinski, “Drug Resistance of Group B Streptococci,” Pol Merkuriusz Lek 10, no. 60 (2001)
  • C. V. Towers and G. G. Briggs, “Antepartum Use of Antibiotics and Early-Onset Neonatal Sepsis: The Next Four Years,” American Journal of Obstetric Gynecology 187, no. 2 (2002): 495-500.
  • http://www2.cochrane.org/reviews/en/ab007467.html
  • http://www.gentlebirth.org/archives/gbs.html
  • http://www.preciouspassage.com/treating_group_b_strep.htm
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