First of all, if you're reading this you probably tested positive, or are about to test and you're worried about being positive. I just want to reassure you of two things. 1. You didn't do anything to be GBS+. It's naturally occurring in a lot of women, and sometimes it's more active and present in the vagina than at other times. 2. It's not a big deal! There are lots of things to think about in labor and delivery, but being GBS+ doesn't have to derail any plans or hopes you have for your birth.
So, what is it anyways?
Group B Streptococcus is a bacteria that naturally occurs in your digestive tract. Sometimes, it can move up and down and can end up in your rectum and subsequently, your vulva and vagina. While it is natural and common, it can cause problems for your baby. While uncommon, illnesses such as meningitis, sepsis, and pneumonia in newborns can be caused by the GBS bacteria. In the United States (at least at the hospitals near me), it is standard practice to administer antibiotics to all GBS+ mothers while they are in labor to prevent the spreading of the bacteria to the baby. Penicillin is the most commonly administered antibiotic for GBS, but if you have an allergy or adverse reaction to penicillin other antibiotics can be used.
What should I expect?
Antibiotics will be administered every 4 hours while you are in labor. They are given via IV line, and it usually takes about 30-45 minutes to administer the dose from start to finish. During this time you will have to be hooked up to the IV, but in most cases you can still move around within the radius of the IV line. You will probably be asked to stay out of the water, but you usually still labor around the bed, on the labor ball, or in some cases walk the halls with a rolling IV pole. If you need to move, ask your nurse what your options are! They’re there to help you, don’t be afraid to ask. Some women experience nausea during the administration of the antibiotics, but most don’t feel any side effects. If you are nauseous, tell your nurse. They might be able to give you anti-nausea medication to combat the nausea if it gets too strong. Otherwise, you can labor as normal!
After the dose is administered, you can ask for a “hep lock” or a “saline lock” where they cap your IV line, so that it’s still in your arm or hand, but it’s not attached to anything which allows you to move freely. This is a great option for those who do not want an epidural at that point, and don’t want to be stuck in one spot. Some providers won’t allow you to labor in the water at all with GBS+, but there is no evidence that doing so is unsafe.
What if I don't want antibiotics?
This is completely dependent on your provider. According to the research compiled by Rebecca Dekker from Evidence Based Birth, the negative effects of antibiotics on your baby's microbiome are quickly resolved through breastfeeding. If you prefer to take a risk- based approach (where you watch for signs of infection in the mother or baby), discuss this with your provider.
GBS+ testing doesn’t have to be a big deal! You still have lots of options, while still getting the antibiotics your doctor recommends. Don’t be afraid to ask for what you want! As with any intervention, it is up to you to weigh the risks and benefits and decide how you feel about it.
Sources:
Rebecca Dekker with Evidence Based Birth ( https://evidencebasedbirth.com/groupbstrep/ )
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