You might have heard of it, you might have seen a Facebook post about it or read a poster somewhere. Group B Strep is becoming more widely known about and talked about in pregnancy. So what is it and what impact can it have on your pregnancy, your labour and birth and your baby?
What is Group B Strep?
Simply put, Group B Strep is a bacteria which is found in about 30% of women. That’s one in three of you and your friends. Most of the time, this bacteria causes no problems whatsoever. It’s like those bacteria in your digestive system which help you to break down your food. Group B Strep bacteria (GBS) are most often found in your vagina or rectum, although occasionally they can transfer to your urine. This can cause a urine infection, which should be treated with antibiotics as soon as it is found.
How do I know if I’ve got Group B Strep?
Most women discover they have Group B Strep because it appears in their urine during pregnancy. They may or may not have any symptoms of a urine infection. Your midwife may find it in the urine sample you provide at your booking appointment. Alternatively, you may be aware of a urine infection and Group B Strep is identified as the cause.
With the increase in awareness of Group B Strep and the implications it has on pregnancy, some women ask to be tested. This testing is best done between 35 and 37 weeks of pregnancy. Your own midwife can usually do this at your GP surgery. You will need to sweep a long-handled cotton bud around the inside of your vagina. You put the cotton bud into a tube with a tiny amount of solution in it and the tube and cotton bud are sent to the laboratory. In a day or two, the laboratory can tell you if the sample has grown Group B Strep.
The newest type of test for Group B Strep is the enriched culture medium test which may or may not be available within your local area. Please ask your own midwife for details.
Implications of Group B Strep on Pregnancy
Finding out that you have Group B Strep during your pregnancy does not have a large impact on your care during the pregnancy itself. If the bacteria is found in your vagina or rectum, you will not need any antenatal treatment. If it is found in your urine, we recommend that you have some antibiotics to treat the urine infection.
Implications of Group B Strep on Labour and Birth
You will be advised to have antibiotics in labour if you have been identified as carrying the Group B Strep bacteria, whether that is during the current pregnancy or at any point in the past. These will be given via a drip in the back of your hand or in your arm. You will get a dose every 4 hours for as long as labour lasts. It’s really important to mention to the hospital that you’ve had Group B Strep when you phone them in labour. The midwife takes into account the time it takes for you to get to the hospital as well as the time it takes to provide the antibiotics when they invite you in to be assessed.
Providing antibiotics in labour has been shown to reduce the risk of the baby getting Group B Strep. It is a pretty simple procedure which can keep your baby safe. That is why it is recommended practice in the UK. Please discuss this further with your midwife or Obstetrician if you have any other concerns.
Implications of Group B Strep on Your Baby
Whilst most babies are fine even with exposure to Group B Strep, a small minority can get an infection from it. An even smaller minority can have serious consequences from that infection.
For that reason, if we know that you have carried Group B Strep in the past or in the current pregnancy, we recommend the use of antibiotics in labour. We also recommend that you stay in hospital for at least 12-24 hours after the birth. This enables us to monitor your baby’s heart rate, breathing, temperature and general condition every couple of hours and ensure no infection occurs.
If any signs of infection occur, such as an increase or decrease in temperature, breathing rate or heart rate, your baby will be referred to a neonatal doctor to assess what treatment may be required. Sometimes the baby will need a course of IV antibiotics, which usually lasts between 5 and 7 days. In most cases, you will still be able to care for your baby yourself while the antibiotics are given. A small number of cases may need extra support from a Special Care Baby Unit to help them fight the infection.
Please try not to read every internet story on Group B Strep. There are very heartbreaking cases out there and the internet would have you believe they are the most common kind. The reality as seen in the midwifery, obstetric and neonatal world is that most cases of Group B Strep infection will respond quickly to a course of antibiotics with no long-term effects.
You can read more in the Royal College of Obstetricians and Gynaecologists patient information leaflet, available here.