There are multiple tests and exams that will be recommended for you during your pregnancy. It is important to know what these tests and exams are looking for, how it is performed, the risks, the benefits, and what the results mean. Having this knowledge is the first step in informed decision making.
Group B Strep (GBS) Screening
What is Group B Strep (GBS)?
Group B streptococci is a bacteria common in the digestive and reproductive systems of both men and women. One in four women are colonized or carriers of the bacteria. If you are found to carry GBS, this does not mean you are sick or unclean. GBS is very common and considered a naturally occurring bacteria.
Most women never show any symptoms of carrying GBS. However, it can cause symptoms similar to a yeast infection and may easily go misdiagnosed or undiagnosed.
Very few babies exposed to GBS become infected (approximately one in two hundred), however the risks associated with infection can be very serious, even deadly. GBS is believed to be most commonly infect a baby as he passes through the birth canal, however, it can infect the baby prior to birth. This is called prenatal onset. It can lead to preterm labor, miscarriage, still birth, or serious illness. Early onset occurs when the baby shows symptoms within the first week after birth and late onset occurs after the first week. GBS most commonly causes sepsis (infection of the blood), meningitis (infection of the area surrounding the brain), and pneumonia (infection of the lungs). Survivors can experience blindness, deafness, mental disabilities, and cerebral palsy.
Symptoms of GBS Infection in Babies
- High-pitched cry, shrill moaning, whimpering.
- Marked irritability, inconsolable crying
- Constant grunting, as if constipated
- Projectile vomiting
- Feeds poorly or refuses to eat, not waking for feedings
- Sleeping too much, difficulty being aroused
- Fever or low or unstable temperature; hands and feet may still feel cold even with a fever
- Blotchy, red, or tender skin
- Blue, gray, or pale skin due to lack of oxygen
- Fast, slow, or difficult breathing
- Body stiffening, uncontrollable jerking
- Listless, floppy, or not moving an arm or leg
- Tense or bulgy spot on top of head
- Blank stare
- Infection (pus/red skin) at base of umbilical cord or in puncture on head from internal fetal monitor
If you are concerned that your child may have GBS infection, call your doctor or go to the emergency room immediately.
Fortunately, there is screening and medications that can significantly reduce the chance of spreading the bacteria to your child.
How is the screening performed?
GBS screening is typically offered to mothers between thirty-five and thirty-seven weeks of pregnancy. During a normal exam, the physician or midwife will use a sterile swab (looks like a long Q-tip) wipe the area of your vagina and rectum.
The samples will be sent to a laboratory to be cultured. If group B streptococcus grows, the woman will be said to be positive for GBS. It typically takes about two to three days to get results from the laboratory testing. Some hospitals have fast testing in which they can perform the screening in an hour but this is still rare.
What are the risks and benefits of having GBS screening performed?
Because this infection is not always found in your body, it is possible to test negative at one point and find out you are positive a month later. This is why they ask you to have the screening late in your pregnancy. So, there is the risk testing negative but then developing the infection closer to the birth of your child and not taking precautions. This isn’t really a risk of the test itself but it is something to keep in mind.
The other negative is also not really a negative of the test but a negative side effect of being diagnosed as GBS positive. The antibiotic treatment can come with and experience that some mothers may find less than they had imagined. If you are to be given the IV antibiotics, this may require you to arrive at your place of birth earlier than you would have originally planed. If your water breaks but you do not start having contractions, your physician or midwife may recommend induction if you do not go into labor soon. Also, antibiotics can occasionally upset your stomach. There is also concern that antibiotics may disturb the baby’s intestinal flora.
The benefits of this test is that with the right steps taken, the serious complications of infection in your baby can be virtually eliminated. The treatment is not very invasive and does not eliminate the possibility of you working toward the birth you have planned. The administration of the IV antibiotics can be given at birth centers or in your midwife’s office if you are choosing to have your baby at a birth center or at home. Between doses, your IV can be disconnected or even removed completely. You are free to move around and even leave the facility, if you choose.
What do the results of GBS screening mean?
If you test positive for GBS, you will be given antibiotics to reduce the baby’s chance of acquiring an infection to one in two-four thousand.
Once your water breaks or once you are in labor, you will be asked to report to your birthing place. An IV will be placed in your arm and you will be given IV antibiotics. The antibiotics take about four hours to become effective so you need to report to your birth location early in your labor to make sure you have plenty of time for the antibiotics to go to work. If you believe you may be in labor, always call your physician or midwife to report and remind them of your positive GBS test.
Group B Strep International also recommends additional ways to protect your baby if you know or may suspect being a carrier of group B strep. I highly recommend you read their material if you test positive. Some of these recommendations include:
- Keep a copy of your culture results with you and bring them to your appointments and to your place of birth
- “Alternative medicine” have not shown to be effective at prevention GBS infection.
- Limit internal exams.
- Discuss induction with your provider well before your due date. Stripping or sweeping of the membranes and artificial rupture of the membranes (AROM) should not be performed on a GBS positive mother, unless she has had IV antibiotics four hours prior.
- C-sections do not eliminate the possibility of spreading the infection to your baby so make sure you discuss having the IV antibiotics well in advance if you plan on having a c-section.
- Internal fetal monitors should not be used prior to having IV antibiotics for at least four hours prior.
- If you give birth before four hours of IV antibiotics, the hospital may culture and recommend observing your baby for forty-eight hours after birth.
- Make sure that everyone who cares for your baby knows what the symptoms of GBS are and what to do if he starts showing signs of infection.
The chance of spreading GBS to your child is low and virtually nonexistent with proper treatment. GBS is easy to screen for and easy to prevent spreading to your child. A positive diagnosis does not mean you are unhealthy, unsanitary, or broken. It is a normal bacteria and nothing you do or avoid can prevent you from being a carrier. However, there is an easy way to avoid your child becoming infected by the bacteria before his immune system is ready to fight off bacterial infections.
If you are in the Denton, TX area and are interested in hiring a doula for your birth experience, contact me today to schedule a free consultation. If you enjoyed this article, you may be interested in checking out my Exams, Tests, Interventions, and Treatments Resource Page.
- “Group B Strep”. 2016. Cdc.Gov. https://www.cdc.gov/groupbstrep/about/prevention.html.
- “Group B Strep Disease”. 2017. Mayoclinic.Org. Accessed February 3. http://www.mayoclinic.org/diseases-conditions/group-b-strep/home/ovc-20200548.
- “Group B Strep Infection”. 2011. Marchofdimes.Org. http://www.marchofdimes.org/complications/group-b-strep-infection.aspx.
- “More About GBS And How To Help Protect Your Baby”. 2017. Groupbstrepinternational.Org. Accessed February 3. http://www.groupbstrepinternational.org/what-is-group-b-strep-2/.
- Simkin, Penny. 2013. The Birth Partner – Revised 4Th Edition. 4th ed. Boston: HARVARD COMMON PRESS,U.S.