The Group B strep test is a very common test that is performed when a woman is around 35 – 37 weeks pregnant. It is a simple, non-invasive test; so why would anyone consider refusing it? Testing positive almost always means that a woman will have antibiotics during labor and possibly after birth as well. There are upsides and downsides to this which need to be carefully considered before deciding to go ahead with the test.
What is Group B Strep?
GBS is a bacteria that is naturally found in some peoples’ bodies (up to 40% of healthy people), in our digestive tract. It shows up around the anus and vagina. It is not the same bacteria that causes strep throat; that is Group A strep. Although GBS is always present in these individuals, it usually does not cause problems. However, if it grows more than usual, it can cause infection, which, if it is passed to the baby during birth, can be life-threatening.
The test is performed by swabbing around the vagina and anus and culturing it to test for the bacteria. A woman’s GBS status can change from week to week as her gut flora shifts. A woman who tests positive at 37 weeks may be negative again by the time her baby is born. There is a rapid test now available that can be used in labor, and women who have a large about of GBS bacteria would show up as positive (and be at higher risk of passing it to the baby).
Only about 1 in 200 babies born to women who are actually GBS-positive at the time of birth will have a baby that gets infected. Since only 1 in 4 women is carriers, and far fewer than that will be positive at the time of birth, the real chances of a baby getting GBS is less than 0.1% or 1 in 1000. Some estimates are much lower than that.
What if I’m Positive?
If you test positive for GBS, most health care providers expect that you will receive IV antibiotics in labor — usually penicillin. Antibiotics are given every 4 hours during active labor until delivery, and some doctors will follow up by treating you again after birth. Antibiotics come with their own risks, including wiping out good gut flora (which is passed to the baby during birth, colonizing his initially sterile gut) and possibly leaving you at risk for other infections.
Up to 10% of GBS is now penicillin-resistant (likely due to overuse of antibiotics) and estimates place resistance levels at around 50% within the next 30 or so years. Stronger antibiotics can be used, but have a higher risk of side effects (and again, bacteria will become resistant to it, it’s more dangerous for the newborn, etc.). GBS is twice as common in countries that frequently overuse antibiotics.
Newborns who are treated are more likely to suffer respiratory distress. Antibiotics used during labor led to increased allergies and asthma in the newborns down the road.
Certain things increase your risk that your baby will get the infection too: your water breaking a long time before delivery, internal exams (especially after your water breaks), having preterm labor, a fever during labor, a previous baby with GBS, or a UTI during pregnancy caused by GBS.
Newborns who do contract GBS are in serious condition. It can cause shock, pneumonia, meningitis, and can leave permanent lung or brain damage (from mild learning disabilities to severe mental retardation). GBS can also cause infections in mothers, especially after a c-section.
What Can I Do?
The best thing is to prevent GBS in the first place. Although it is impossible (usually) to prevent getting, as adult women typically show no symptoms, you can keep the bacteria from growing at high levels.
Consume a healthy diet that is low in sugar and grains (and especially free from refined versions of both) and full of probiotics. Consume yogurt, kefir, or other probiotic foods daily (I love kombucha, but it shouldn’t be started in pregnancy. It is fine to keep drinking if you already do so). Consuming probiotics will help to keep your gut flora well-balanced, making it unlikely that GBS will be able to grow out of control.
Should you test positive, immediately begin consuming large amounts of oral probiotics, and apply yogurt or other probiotics to your skin (vagina/anus area). Consult with your doctor or midwife; there are often herbal or homeopathic preparations that they can specifically recommend to reduce your risk of disease (these can take a few weeks to work, though, so don’t delay!).
Don’t consume any sugar close to the time of birth (if you are positive) and keep consuming probiotics. You can often change to GBS negative by doing this. (Sugar feeds the “bad” bacteria.)
Many women who are low-risk, consume excellent diets, and are planning to birth in a birthing center or at home opt out of the test (which I did in my second pregnancy, and will again — I was negative the first time). Since the absolute risks of having a baby who contracts GBS are so low, and the risks of overuse of antibiotics are so steep, it is often better — especially for low-risk women — not to get the test at all.
Others feel safer having the test and taking steps to correct it (probiotics, homeopathics, etc.), especially if they are high-risk.
Thanks for this information! I will have to make a decision about this in the next few weeks. I eat yogurt just about every day, so I don't think I have too high of a risk for it…
Soooo interesting!!! I tested postive with my last baby, and didn't know it til I was in labor!!! And my midwife (through hospital) was talking of putting me on antibiotics. I didn't know the options, so let her put me on. Even though everything within me screamed NO!! My babies all had bad yeast infection/diaper rashes from newborn up and I wanted to avoid it if at all possible!! Now I'll know for next time!!! But I am also taking HUGE steps now to heal my guts flora and the lyme disease that I have. Next time around, I am hoping a praying for a whole different experience!! Thanks for the info!!
I had the test during both of my pregnancies. First time, I tested negative, the second time positive. I had probably 3 rounds of penicillin, and I began noticing my (breastfed) daughter having allergic symptoms after around 3 weeks of age. (Constant spitting up, blood in stool, eczema, etc.) I really wish now that I would've known alternative treatments to this. She is now 17 months, and doing a lot better. I have not introduced the most allergenic foods to her yet- with one exception- but she is overall very healthy otherwise.
If one chooses to have the test done, do you know if you can ask to be retested closer to your due date- or in labor before agreeing to antibiotics?
If I ever have another pregnancy, I am definitely re-considering this one!
Why shouldn't you start kombucha during pregnancy? I'm currently 31 weeks and was introduced to it about 2 weeks ago, and I love it! This is the first warning I've heard regarding it and pregnancy.
On a related note, I tested neg with my 1st child, and am hoping to do so again (especially since my diet is so much improved!) But should I be positive, I do worry about the antibiotics. As a child I was on pennicilin or another antibiotic practically every other week for severe ear infections (why they never gave me tubes, I'll never understand!) And as a result, most antibiotics have no or little effect on me, except the scary strong ones. I thought once you tested positive, you just were and there was no way to reverse it, but reading you article, I have renewed hope! Thank you!
Hi Brittany,
Kombucha CAN cause detox in some people, which can be difficult to deal with during pregnancy. Many sources (including WAP) recommend not starting during pregnancy or exclusive breastfeeding. But, there are always exceptions. 🙂 If you're doing fine with it, go ahead, just go slow! I started around the time my son was starting solids but was almost exclusively breastfed and had no issues either (and he LOVES it now!).
I am only 17 weeks along, but I was told at my last appointment that the GBS was detected in urine samples so I automatically get the antibiotics at delivery. BTW- I should be delivering at a birthing center with midwives. In my previous two deliveries I was tested negative. I am freaked out about this, but my husband is a very by the book kind of guy….just do what the doctors say. I avoid antibiotics all the time and when they are prescribed to my kids my first question is always "How necessary is this?" In the past my doctor has been great and given me the prescription, but guidelines for watching my kids so I know when to use the antibiotic if it were absolutely necessary. So far my almost 4 year old has had one antibiotic and my almost 2 year old son has had none. I hate the idea of my newest child starting life with an antibiotic. Is it possible to test the child for GBS after delivery to determine if they have contracted the bacteria? What I don't understand is that in general we eat very well! Mostly organic and free range meats from a local farm, raw milk and eggs from the same farm. I do have a sweet tooth, but I am usually really good about avoiding sweets, we don't eat a ton of fruit. I was good before I got pregnant about getting fermented foods, but I haven't really been able to make them recently and money has been tight for buying them, but I still try to get some every day- at least dairy kefir. I don't understand how I got GBS and how to change my diet to help except eating more fermented foods and less grains…the thing is my husband is currently deployed and will be away for most of this pregnancy so I am trying to balance eating healthy with being an only parent.
Oh man I was positive for strep b and I had a pretty awesome diet except for the sugar (mostly fruit). But my midwife made me put raw garlic cloves in my…well the birth canal. For about a week until he was born. It kicked it right out of there! I was very hesitant since im used to eating the stuff :/ but my midwife is wanted from far and wide for good reason! So needless to say my son was born with no problems 🙂
I had the test and tested negative with my first four babies. My fifth baby was a homebirth and my midwife is very hands off on tests if you want her to be, it's really up to you. My husband and I decided we didn't want it so we didn't take it nor did we recieve any kind of just in case treatment. My delievery went just wonderful with no signs of anything wrong at all. My son is now 9 months old and I didn't do any tests during my pregnancy and I'm so thankful for that. Actually, my pregnancy was so relaxing due to this I made it full term when my previous three were premature! I'm all for hands off care in pregnancy, the added doesn't seem to help me. 🙂
I tested positive with my three pregnancies and got the antibiotics during labor. My first labor was very quick so there wasn't enough time to get the full dose of drugs and my daughter had to be observed longer. I had no idea GBS was related to diet! Thank you for this info! I am now in pregnancy #4 so hopefully if I change my diet a bit I won't be positive again. The fewer interventions the better.
I tested positive with my 3rd child, but due to my penicillin allergy, I was given a different kind of medicine the night before (I am not sure what it was… it's been 2.5 years!). I didn't notice any health issues with my little girl, so I'm not sure if this other medicine was out of my system by the time she was born or what. It is nice to know there is something you can do to be proactive about GBS instead of worrying about it for almost 4 weeks like I did. I had a friend who apparently tested negative for GBS at her appointment, but ended up having it when she delivered. Long story short, her little girl died shortly after birth from complications. So, I was really nervous until she got here, lol.
Yes, the chance of having a baby with a Group B Strep infection is low. But if baby does get it, he or she can become very ill and even die within a few hours of birth. Also, just because you were negative in one pregnancy does not mean you are negative in subsequent pregnancies. It doesn't seem like a big deal to get a few antibiotics to potentially save your baby's life.
I know you won't publish this because it disagrees with you, but please read Wren's story and reconsider- http://hurtbyhomebirth.blogspot.com/2011/03/wrens-story-on-1st-anniversary-of-his.html
Babies do die from GBS, and it's an entirely preventable death.
I'm not sure about using yogurt to treat bacterial infection? Yogurt is usually used to treat fungal infections and that is a totally different life form from a bacteria.
Mama Tao,
Eating it will certainly help, because it will bring the good gut flora into balance from the inside. As for applying it, the probiotic bacteria may help some women that way too.
Be careful ladies. I tested positive during my last pregnancy and did all the home remedies. I was so sure all that would work and I declined antibiotics in labour. My baby contracted GBS pneumonia. He spent 6 weeks in NICU (4 of them on a ventilator). If you test positive and want to use home remedies at least get tested again before giving birth to make sure you are clear. Don't make the same mistake I did. I was lucky that my I didn't lose my baby because of my mistake.
I tested positive for GBS in my first pregnancy and at that time did not understand the implications of it. My midwife assured me it was no big deal. However, when my water broke and my labor did not start shortly thereafter, I think they forgot about my GBS positive and I was not hurried to the hospital, although I had been advised earlier that I would need the antibiotics.
No one told me anything about sugar or probiotics. I wish I had known these things in your post then. It all makes so much sense. I was seeing a team of 5 midwives and because of this lack of communication I'll not go that route again! (I have ONE midwife at a different practice lined up for next time.)
I was told that I should show up at the hospital within the next 12 hours after my water broke of it's own accord. Of course, I still had nesting to do, so I procrastinated and came in as late as possible. My labor still hadn't started by 18 hours, so they gave me cervadil, then later on pitocin.
We did have otherwise a good birth experience, although not the one I dreamed of. It was AFTER that things went downhill.
My daughter had contracted the GBS and had to be put on heavy antibiotics and kept in the NICU for a whole week. Even as she was being treated, no one would tell me what was really going on, just that she had some vague infection.
I was so angry that they were holding my new baby hostage and at that time I had no idea it was because of the GBS. I think they deliberately withheld that information from me for fear of a lawsuit perhaps. It was the most heartbreaking experience, one I hope to never repeat, having to be wheeled out of that hospital without my baby. This all made nursing difficult at first , but we are both delightfully stubborn and we made it work despite the setback.
Now that I know how serious GBS can be if you are one of that fraction of a percent that their baby catches it, I will definitely be taking your proactive approach with this next baby we are planning.
We just last month got my first daughter's NICU bills paid off. She is three and a half. Thank God she had no damage from it. That first week of precious time we lost and all the IV's sticking out of her head were for her good and wiped out the infection quickly.
"Since the absolute risks of having a baby who contracts GBS are so low, and the risks of overuse of antibiotics are so steep, it is often better — especially for low-risk women — not to get the test at all."
This sentance makes no logical sense. If you are negative you don't get the antibiotics. If you are negative you are not exposed to any of the so-called "risks" of antibiotics. If you are tested, you can make an informed choice of how to proceed and whether you are willing to risk GBS pneumonia.
Do you have any scientific basis for the claims you are making about the effects of diet on GBS? If so, it would be nice to see your sources at the end of the post. Otherwise, there should be a disclaimer of "I believe this, but have no scientific basis to believe that its true."
Not necessarily true about not being given the meds if you are not positive. Since you can fluctuate between positive and negative for GSB, a lot of hospitals just routinely give the meds for just in case purposes. Thats what my hospital does. I was positive with my first child, but was told when I came in to deliver that I would be given the meds even if I’d tested negative since I could be positive at that point. I wasn’t on them long enough with my daughter for them to do any good and had to stay a few extra days, but she was perfectly fine. I also couldn’t have the penicillin meds since I’m allergic to it. I’ve read, though I’m not saying its true or proven just something people should look into when deciding what to do, that the penicillin med doesn’t really help improve infant mortality rate, likelihood of getting GSB or the complications from it(well it went from like .7% to .3%…so reduced it by about .4%,) and basically that the meds didn’t really help much in most cases(since the mortality rate didn’t change and the babies were just as likely to die)….it was some study(sorry I don’t remember where I read it, and I no longer have access to the computer I saved the link on, so you’d need to research it. As with everything else you give yourself or your child, I highly recommend researching it and not just taking someone elses words as true, lol. I still need to cross reference and see if that study was true, but I thought I’d put out there that there was a study with those findings so you could all look for it and maybe use it to help you decide.). And that the other meds helped even less the the penicillin ones(since a lot of the strains were resistant to non-penicillin meds). I’m not sure what to do this time around, but I’m thinking of just opting out of the treatment…maybe even the test(if I do test and test positive then I might medicate….but I’m still undecided.). Just wanted to put out there that sometimes hospitals either don’t tell the patients what their getting or have a policy to give things like GSB meds to all patients regardless of having tested positive or not. I was given at lest 2 meds I wasn’t told what were(till after they were given and I asked) and at least one I didn’t consent to at all.. to and I was having no complications….(pitocin after my daughter was delivered to help with the placenta though there was no need. That one I did not consent to and wouldn’t have……and some kind of pain med that was put in my IV bag…lasted about 10 mins before wearing off completely…during that 10 mins though it almost knocked me completely out..and then my contractions were back in full force and I was told I couldn’t have any more meds for another hour…)
Oh and @Jane: I wasn’t disagreeing with you about her posting sources, I’d like to see those too really since it’d be a nice help to deciding, lol. I just was disagreeing that a woman won’t get the meds unless she tests positive, since a lot of hospitals still give the meds anyway. And, on a side note, yes I know its bad that I cannot show my sources…but like I said, I no longer have access to the computer that had the links saved. I just remember reading about it and thinking it was interesting, so I wanted other women to know about it and be able to look for it themselves.
This is an interesting article – could you post links or at least references for where it's been shown that you can get "keep the bacteria from growing at high levels". I'm obviously looking in the wrong places because I can't find any evidence that these work.
And am I being naive by thinking that if up to 40% of women carry GBS, then 60% or more of women who follow the suggestions above won't be carrying GBS – but then they wouldn't have been carrying it anyway?
Just trying to get my head round this 🙂
Thank you for this! Tested positive both times with my girls. First time had the antibiotic and my baby had lots of asthma issues in the first 2 weeks. refused them the second time, but the docs were not supportive and essentially told me I was selfish not putting the baby first. Either way, she was healthy and great! These third time we are doing a home birth so I won't be getting the test but I will be actively treating the GPS as best i can the homeopathic way to prevent infection.
I’m very near birthing baby #3 (I’m a “homebirther”), and as with the previous two, have tested positive for GBS. My wonderful midwives have given me the option of IV antibiotics both times, but made it clear that there were other options. Both times I’ve gone the route of once into active labor using a hibacleanse (sp) douche/rinse everytime I use the restroom, and also wiping the vaginal area with hibacleanse wipes. My water has always remained intact until the pushing part of labor, and so passing the infection on wasn’t really a problem (assuming I still had the infection at time of delivery – I never retested). So many factors play into this, and truly you must do what you feel is right and safe for your soon to be born little one. I was/am happy to go the most non-intrusive route, but am glad more drastic measures are available if needed. This time I’ve been struggling with a yeast infection and have been fighting it with garlic inserted vaginally, which works great for me, and I’m hopeful this will also help with the GBS, as some studies have shown it effective. And, no or little sugar is always a good thing, along with the yogurt or whatever cultured product you like.
Hi! I just wanted to add in to the conversation. 🙂 With my first 3 babies, I declined the GBS test altogether. Reason being is that, my research has shown that IF babies get sick, they respond better to antibiotics AFTER birth and do not develop antibiotic resistance the same as babies that do that mom’s got antibiotics during labor. (I love this article – http://www.mothering.com/community/a/treating-group-b-strep-are-antibiotics-necessary)
However, with my last pregnancy, my midwife was new at doing homebirths (I’d had 2 previous homebirths after cesarean) and she was trying to CYA in case of a transfer. She really pushed for me to get the test done. Plus, based off my diet and following her protocol of garlic and vitamin c and such, we totally expected a negative for GBS test anyway. So, I appeased her. Turns out, it was positive! considering I’d never even tested before, its highly possible I was positive with my other babies. But still, it did not change the way we chose to approach it. We knew the signs to look for and if our baby was sick, we’d seek treatment at that time.
Hibiclense was offered as an alternative to antibiotics. I said no way. At which time, my midwife confided that she would make the same choice as I was. That from her research, when your water breaks, it does essentially the same thing as a vaginal rinse. The amniotic water washes out your birth canal and fills it with all the bacteria and flora that the baby has been living in for the past 9 months. That bacteria is good and essential to a healthy baby. So, as long as your water doesn’t break too early, it should be fine.
And finally, there is growing research and concern that babies that are born sick with GBS, MAY have contracted the illness in utero. Babies even born in the cull at full term have been born sick. But its not very often. Enough to question the idea that the baby is getting sick during birth from bacteria being transmitted from the moms vagina.
All that to say, our 4th child was born fine and healthy, without the introduction of antibiotics, or a vagina wash, or any of that other stuff.
Thank you for this great info! I have a blog of my own about digestive problems in babies and I will be making room on my blog for a link to your info!!! 🙂
I was tested but worried so much about it and am so relieved I tested negative. I am mid-twenties, healthy and active and this is our first pregnancy. I made changes only about two weeks before I was tested, including: drinking Kefir, eating live-active yogurt everyday(I already did), eating extra garlic, taking 1,000 mg of Vitamin C, switching from whole grain bread to Sourdough(it’s fermented and beneficial to your digestion!), lowering my sugar intake, rinsing with apple cider vinegar, always wiping front to back, wiping with Witch Hazel on occasions(and before I was swabbed) and wearing cotton-only no thong underwear. Not sure if I would have tested negative without these changes but I’m not sorry I made them! Good luck to you and good job wanting the best for your babies!
Thanks for posting this! Unfortunately, my first baby was the unlucky 0.1% and she was born brain dead due to the GBS infecting her brain before birth. I did test positive during my pregnancy, but antibiotics during labor were too late.
I’m pregnant with my second, and am trying very hard to stay GBS negative. I am getting the antibiotics if I am positive, since I have the previous risk factor. GBS also caused me to have a post-pregnancy UTI that damaged my urethra, so I now have urethritis (chronic inflammation of the urethra without an infection). I have to eat traditional and minimally processed foods, which is what led me to your blog.
Thanks for the information.
[…] antibiotics can have a much longer impact than just during the birth and days after. There is even information linking antibiotic use in labor and in baby’s early days to higher rates of allerg…, which makes sense under the gut bacteria […]
This is an interesting article. I just wanted to share and say that I tested positive with my first boy and got antibiotics during labor and baby boy is perfectly fine. My second time I tested positive again, but unfortunately didn’t make it in time to the hospital for the antibiotics. My water broke and labor started about an hour later, we went to the hospital and he was born 40 min after we checked in. He came so fast that my doctor said she wasn’t worried about him catching anything, but I still will have to stay for 48 hours as hospital protocol. During the baby’s first 6 hours of birth he kept grunting, the nurses said he came so quick he is getting all the extra fluids out of his lungs, but he looked in pain to me so we had him tested and he was the unlucky 1% that got GBS. I have to stay in NICU for 10 days while baby got antibiotics. We have 2 days left and so I’m sitting here googling more info about GBS and came across this article. Thank God the hospital had a NICU and the treatment began early enough to catch it before it could harm him. But being here instead of at home with my babies is pretty upsetting. All I want to say is that I’m all for a natural. I barely ever take any sort of medication, I try to use essential oils and homeopathic remedies. I drank kambucha everyday of my pregnancy and even more so toward the end of pregnancy, I barely eat sweets, and yogurt and kifir is part of my diet unintentionally. However, even though the risk is so small, there still is that risk of your baby getting GBS and the side effects of antibiotics are a lot better than possibly loosing your baby. I wouldn’t mess with it and eliminate any kind of risk. Also the test is just a cotton swab, why wouldn’t you do it just to see if you are positive? That way at least you know what to look for in a baby that gets GBS and be prepared to treat the baby asap, GBS can make babies very sick very fast!
The swab doesn’t make sense because your GBS status can change from week to week, antibiotics come with risks, and testing does not improve outcomes on a population level. Watch your baby and if you see any signs of illness, get help fast.
Hi! I tested positive for my first baby, who is now 1 year 8 months. After much prayer and research, I refused the penicillin with confidence. I did try, as recommended to me, garlic suppository and oral and suppository probiotics, as well as echinacea and astragalus teas, and i still tested positive for the second test. This bummed me out, but my conviction to decline antibiotics held firm. I have excellent health and diet- whole foods plant based. My pregnancy went smoothly, with no sickness or risk factors. My doctor was not worried. My labor was very short- 2.5 hours with no problems. Baby came out perfectly and is very healthy now. I just tested positive again for second baby. Will decline again, but might take probiotics. Please tell me, what would I apply to the skin as you mention above? Inside vagina and anus? Real yogurt? I can make soy yogurt. Would you recommend probiotic suppository? Id rather use that than food! Thank you for your testimony. I believe that life style and health have a major part that is not really mentioned on more official websites. I also believe The Lord blesses when we choose to honor the laws of health, doing the best we can to work with nature and not against it. He really proved Himself in my first pregnancy, and I know He will do it again this time. Due Jan 3, 2018.
[…] antibiotics can have a much longer impact than just during the birth and days after. There is even information linking antibiotic use in labor and in baby’s early days to higher rates of allerg…, which makes sense under the gut bacteria […]
I tested positive with my second and third and used the antibiotics for both. Alternative methods of treatment seemed to involve a lot of putting things in one’s vagina which wasn’t for me. Also, as a mom, I know that there are ways to heal and develop gut flora, but the side effects of a GBS infection could be devastating and life long. At the end of the day, I am less interested in finding fault with doctors and more interested in my child’s health. “All things doctors try to do are bad” is not a pillar of my life’s philosophy. The tendency by some to try to tear apart every birth intervention there is has gotten to such an extreme point that I find it difficult to trust the advice. My family uses a blend of approaches.
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