Hear me out just a moment while I step on my soapbox! I want to talk about Group B Strep (GBS) testing and its management in labor. I'm not here to tell you what to do, but I want to tell you what you 𝒄𝒂𝒏 do. The typical management in the US is to get tested around 36 weeks and if you test positive you are told to immediately go into the hospital to receive IV antibiotics every four hours until the baby is born. Some providers ask you to come when your water has broken and others, before your water breaks. Why could this be an issue? Well, lean in and learn: 𝟭. Coming into the hospital early could severely alter your plans (the environment can affect the flow of labor and put you at a greater risk of more interventions). 𝟮. Prolonged use of IV fluids could affect breastfeeding. 𝟯. You're killing the bad AND good bacteria in your system which also affects the baby's microbiome. 𝟰. About 30% of pregnant women have GBS and that doesn't inherently mean it's a bad thing. We're all made of bacteria. The issue is whether your baby gets exposed, colonized, and infected. Not all of those three things happen in labor. 𝟱. GBS is a transient bacteria, meaning that if you were positive 4 weeks ago you might not be when you go into labor. In other words, you are possibly treating a problem you might not have. Also, the test isn't 100% accurate, and testing negative could be a false result and you'll labor with an unknown positive diagnosis. Why are you doing all this? For the 1-2% chance your baby will get infected. Meaning 98% of you will be unnecessarily treated like there will be an issue. The math ain't mathing on this one. But labor care in this country is all about treating a problem before it becomes a problem. I'm not trying to discredit the real effect GBS can have on a baby. I'm just laying out the numbers. But I do understand if some of you aren't even willing to take that small risk, don't want to defy provider recommendations, or just want to know if you have other options. I'm not here to tell you what's right or wrong, but I want to encourage YOU to call the shots knowing what the risks/benefits and options are. 👉Agree to antibiotics if you get a fever, premature labor, or your water has been broken for 18+ hours. 👉Agree to go to the hospital and get antibiotics only after labor is well-established. Studies have shown that at least one round of antibiotics 2-4 hours before the baby is born can still greatly reduce the chances of infection. 👉Decline vaginal exams that can increase the chances of infection. 👉Decline antibiotics and testing and treat the newborn if there are signs of infection. This is the usual approach in the UK. 👉Ask for a quick screening GBS test in labor instead of the standard one in pregnancy. Read more at Evidence Based Birth Comments are closed.
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