18 responses to “GBS -The Constant Conundrum”

  1. Aspiring MIPP

    An excellent, well written and informative post Lisa. If I may, I have a question in regards to your clients not having a test for GBS unless requested. Is this an informed decision on their part when they either request it or not, or do you not mention the possiblity of GBS infection at all?
    I ask because I recently discovered your amazing blog and found it such a wonderful resource of inspirational information, that I have bookmarked it and visit often to learn all I can.
    Go Lisa!!

  2. Lisa Barrett

    Hi there,

    I do of course inform my clients about GBS swabbing as part of what is routinely available. All the information here is passed to them so they can make a decision on what they need for themselves. If they request a swab they go to their gp or if they have a hospital back up they take up an appointment there as I do not offer the screening myself. At a homebirth there are no IV antibiotics there is only a watch and wait philosophy and natural resourses so clients have to think very carefully how they would feel about a positive result before undertaking the test.

  3. Cinnamon

    Sigh. GBS is my particular bugbear as it was what caused my undoing at hospital (GBS+ plus PROM = baby going to die, apparently). One other side effect you didn’t mention in your post is the high likelihood of developing nipple thrush which can really disrupt breastfeeding as I had the misfortune to find out a few weeks after DD was born.

  4. Aspiring MIPP

    Thanks Lisa. I always come here when I get disheartened about birthing in this country. Your writings always makes me feel so much better!! I have real hopes that this blog will help to bring about real positive change.
    Have a great weekend.

  5. midwife of the plains

    Lisa,
    What do you think about the use of chlorhexidine as an external periwash during labor for those mamas who are GBS+ and opt for it? Or a dilute tea tree oil solution as a periwash? Thank you for this very informative post.

    Love
    Brenda

  6. Lisa Barrett

    Midwife of the plains, 20 years ago when I started it was standard practice to used chlorhexidine to wash a perineum and also hibitane to wash the baby. It was stopped because soapy water was found to be as effective. I find it amusing that a full circle has happened. Looking at the stats it suggests that doing nothing is as effective as anything else as the mortality rate hasn’t really altered. I am always open to looking at my practice over and over so if you have anything that shows it to be successful I’d love to check it out. Garlic probably has the best results over all.

  7. Anonymous

    Great info. I am embarking on the garlic regime. I am 32 weeks pg, in the UK. I am going to do the garlic for 2.5 weeks and pay for an ECM, GBS test. I have everything crossed it comes back negative. In addition to the garlic pessary I am eating a raw clove a day in a tspn manuka honey, taking 250mg vit c 4x a day and echinacea once daily. as well as a daily yakult probiotic drink.
    I have also read about colliadal silver, but I am not convinced of it’s safety. Do you have any experience with CS in pregnancy?

  8. Lisa Barrett

    I have only had experience with CS postnatally. I’m not really sure of it’s safety in pregnancy, maybe you could talk to a Homeopathic practitioner they would be able to tell you more.
    Please let me know the result of your swab. Good luck.
    Lisa

  9. Lisa Barrett

    I accidently deleted this comment

    "I used to visit sites like yours all the time and feel very empowered. It's only in recent months that I can talk about what happened to me in 2008. I'm pregnant again and feel like if nothing else, my loss will teach other women that NOTHING is worth putting your baby at risk.

    Let's start by saying I was NAIVE, really really really naive. I wanted a homebirth, I wanted to take control and I wanted a spiritual, natural delivery. My baby girl died from and infection that could have been treated if I'd been in a hospital. GBS.

    My life will never be the same again. OBs aren't out to rob you of your power as a woman, they are there to protect you and your unborn baby.

    I wish someone had wrote this for me years ago."

    I am very sorry for your loss. Individual circumstances are hard. However some babies die from GBS at the hospital. I often wonder if they feel they will have a homebirth next time.

  10. Anonymous

    Seeing as the autopsy revealed swift antibiotics would have resolved the infection, it's more than just "unfortunate".

    I wonder if you've ever considered what it's like to have to get an autopsy on your much awaited and loved baby. To hold a cold lifeless body. As someone that this actually HAPPENED to, that lived through unspeakable grief (rather than just digging up and posting articles to support your opinion) I find your flippant response lacking human feeling and logic.

    Homebirth is NOT safe in this country. The women who google GBS and homebirth need to get balanced reading, not just rhetoric.

  11. Lisa Barrett

    Dear,

    as it happens you nothing about my obstetric history which has been long and complicated. I did not dig up articles to support my opinion. The opinion came from the research. The research doesn't say a baby will never die. I don't think an autopsy can actually say that swift antibiotics can resolve an infection, that is actually an opinion post mortem deals with facts. Once again I am very sorry for your loss. I do know what it is like to have unspeakable grief. My response was not flippant but very serious. Babies DO die from infection at the hospital, way more often than they do at home. Hospital is not a guarantee of a live baby. Homebirth IS safe in this country the perinatal mortality in SA at home is 7.9% and at the hospital 8.2% the latest study figures say just this. LESS babies died at home than at the hospital.

  12. Bonnie

    Hi – thanks for the great post. I’ve found it hard to find info on pros/cons of GBS treatment so really appreciate your research and thoughts on the subject. I’ve been GBS+ with both my pregnancies; took the penicillin IV in labour with my first and luckily didn’t develop thrush or any other problems from it, had a healthy baby. This pregnancy, I’m really considering not taking anything and just going with “wait and see” and treat if necessary.

  13. jmasher

    HI,

    I am planning a homebirth for my second chlid. I recently was informed about GBS and the various options by my midwife. During my first pregnancy I never heard of GBS!! (hospital midwives, Obstetrician – no-one even mentioned it!). After the birth I developed a Group B Strep infection (stitches) and was quite unwell, thnakfully my baby was unaffected.

    This time I have decided not to utilise the offer of prophalaytic antibiotics or have a test, but try prevention using naturopathic/homeopathic remedies. I have no scientific evidence that this work, but the anecdotal evidence from other independent midwives that use this is positive to date. The treatment is safe for pregnant women and it recommended that it be started 4-6 weeks prior to EDD; acidopholus – 4 billion cells per dose, echinacea 2 x 350mg capsules, garlic 2 x 580mg capsules, vitamin c 500mg with 200mg bioflavinoids, grapefruit seed extract 15 drops. This formula is to be taken twice per day. I’m going to try this and take the “wait and see” approach.

    I will let you know the outcome, post birth!

  14. Jade

    I had my first two babies under the care of my GP, birthed in hospital. I did not learn about GBS until after I had my second baby. When I asked my Dr about it he explained he doesn’t have his patients do the test because GBS is transient and he believed it was better to take the wait and see approach.
    My third baby was with a midwife planned hospital birth. She offered the test. We discussed my previous experience and the options. I decided to do the test just to see what it would say, It came back that I was positive. I decided to refuse antibiotics unless indicated. She supported this.
    Fourth baby with a different midwife. I wanted to refuse the test. She didn’t think this was advisable. I said that even if I did the test and it came back positive I was still refusing antibiotic unless indicated because I wouldn’t have my baby relieve a large dose of antibiotics just in case. She was very adamant that is wasn’t just in case, that a GBS exposed baby could die very quickly. I found her reaction really interesting considering her stance on everything else. She is the most respected midwife in town(we only have three). She suggested I do the test, if it was positive and I refused antibiotics, at least we would have a heads up if the baby became sick. I agreed I would do the test and I knew I would still refuse antibiotics unless indicated. I knew I would be having a locum for the delivery as my midwife would be out of country the month I was due, might not even matter anyway. I was negative so it didn’t matter in the end. I can’t remember the time line exactly, but the pregnancy did start out as a planned hospital birth and later we switched to a planned homebirth, so maybe when we had the discussion she was thinking about the hospital.
    Fifth baby now due in 18 weeks. I have only seen locums as my midwife is on holidays, she has cut back her practice getting ready to retire. My second appt was with the woman who help deliver our my last, we did discuss any testing still to come that I might do. She knew I was refusing glucose screening and wondered about GBS. I am unsure at this time and she said doesn’t matter, no decision to be made now as it is still weeks away. There was certainly not the push to have the test that I had last time.
    Very different reaction between my GP and different midwifes I have seen. I am curious to see what her stance will be this time. She will be back by my next appt and will be here at my delivery time. I can only imagine her strong reaction was due to a bad experience or a lot of pressure from the hospital. I mentioned the conversation to a couple of friends who had her care as well, they have a like minded opinion regarding antibiotics and also found her reaction interesting as it is polar opposite of her general care.
    Anyways long story regarding my GBS experiences.

  15. AP

    Since the routine screening and use of antibiotics to reduce the GBS load on a woman, (and hence the chance of passing to her baby), the rate of serious GBS infections in babies of our hospital dramatically reduced. Whilst it is not common with or without antibiotics for a baby to die from an infection afterwards, it make so much common sense to try and prevent to the best of our ability the chance of this bug causing problems for any baby.
    Most women when counselled, thankfully are happy to be treated with antibiotics, which is entirely sensible. Yes there are reactions to antibiotics, and yes, we should not be using them needlessly, but potentially saving a babies life or reducing the chance of them having a serious infection, I reckon that is a sensible use of antibiotics.
    By all means use your natural therapies (although unproven) to assist with natural immunity and getting rid of GBS, but there is no substite for appropriate antibiotics to reduce the GBS load during labour.

  16. eternalstudent

    Hi Lisa,
    I just wanted to thank you for this read, and all the comments that have been left on this subject. I am a student midwife in my last couple of months of my course, and am currently writing an essay about ‘routine’ antenatal screening. As a student I find it really difficult to speak up about the evidence in regards to GBS screening and ‘treatment’. At out midwives clinic I too often hear the words ‘at 36 weeks we will do the vaginal swab to see if you need ABs in labour’, and then on the flipside, one of our OBs won’t even discuss the option for screening. In this ’1st world’ country, legally we should be offering all women options and we should be obtaining informed consent. I find this extremely frustrating when women are just told what will be happening in their pregnancy and birth, instead of hearing all sides of the arguement.
    Reading your blog is so refreshing, and it keeps me motivated to keep going because there are people like you out there who are the protectors and guardians of normal birth.
    Rant over.