GBS (Group Beta Strep) is a bacteria that is found in everyone's gut. Sometimes there is an overgrowth of the bacteria causing you to present as "GBS positive". This doesn't necessarily mean you have an active infection, but your GBS count is high enough to be recognized as a medical circumstance to be aware of. The tricky thing about GBS is that is comes and it goes, although typically in hospital settings once you test positive, they have to treat you as positive for the remainder of your pregnancy.
You'll also notice that at nearly all of your appointments you are giving a urine sample which is then tested for a range of things. Sometimes GBS can be detected in urine which is a sign that a woman is heavily colonized with GBS (Click here for more info on GBS in urine). Often times it is recommended that antibiotic treatment begin immediately during pregnancy in this case.
To learn more about the evidence on GBS ,
and medical & alternative treatments click here!
So, how does GBS affect your birth plan?
After reading the link of evidence above, you'll want to discuss your decision to accept or deny antibiotics in labor with your care provider.
**If you deny antibiotics, you and your baby will be monitored for 48 hours for any signs of infection or concern. This type of monitoring is non-invasive and your baby can still stay in your room with you during this time.
**If you accept antibiotics, then this may change the status of your IV. If you had previously chosen not to get an IV, your staff with at least need a HepLock placed to administer the antibiotics every 4 hours. If you don't want an IV pushing fluids your entire labor, you can request the IV fluid be taken off when antibiotics are not being administered. Your hospital may still want to monitor your baby for 48 hours for infection, so this protocol may be something you will want to speak to your health care provider about.
You and your care provider may also discuss if this changes when you need to come into the hospital. For example, if you have a history of fast labors, your provider may recommend coming in earlier than normal to ensure antibiotics are administered at least 4 hours before the baby is born for it to be deemed effective. This conversation can help you determine how long you can labor at home before going into the hospital.
It may also mean coming into the hospital when your water breaks immediately, even if you aren't in labor yet. An important conversation to discuss with your doctor, whether GBS negative or positive, is about how quickly they prefer to induce once your waters break without labor. Some providers give only a couple of hours, and some providers give 18-24 hours to see if your body will go into labor naturally. While a birth plan is typically all of your ideal preferences, it is important to have a plan B in the event of an induction (and plan C in the event of an unexpected cesarean birth). This will help you educate yourself on the options and be prepared for this scenario. It will also help you feel empowered to be involved in the discussion and decision making process, which hopefully creates a less emotionally traumatic conversation.
Can I still encapsulate my placenta if I am GBS positive?
Absolutely! I have seen a variety of recommendations in regards to GBS positive results and encapsulation technique, so I will just have to tell you my professional recommendation. The concern for passing GBS in your birth canal is when antibiotics are not used at all, or were not sufficiently used in time before the birth of the baby, making them ineffective. If used in time to protect the baby, this means it would also protect the placenta from exposure in the birth canal. If you chose the Raw Preparation method, then this method can still be used in this case. If you deny antibiotics and are planning on encapsulating your placenta, I would advise that you choose the Traditional Chinese Medicine method of preparation. The steaming and higher temperature of preparation will be effective against the GBS exposure of the placenta.
Will antibiotics in labor hurt my placenta?
While everyone has different feelings towards antibiotic exposure, the good news is that the treatment used, penicillin, has a very short half life so it isn't just building up and building up with each administered dose. While it does pass through the placenta and to the baby, it does not appear to be contraindicated for health. Opposite of common belief, the placenta does not act like a trap for toxins and medications. The placenta allows the maternal blood system to remove waste and toxins from the baby and the placenta so medications, toxins, and waste are not being stored in the placenta, including the antibiotic.
Is there anything else I should know?
Yes! Typically, many women are concerned about what happens in labor, and the affect on the gut flora inbalance that may occur from antibiotics. You can plan ahead by consulting with your physician or naturopath about adding in Vitamin C and probiotics to your diet to help protect your gut flora balance.
I have also noticed that some of my clients that ended up having thrush (a yeast infection in the baby's mouth and of your nipples/breasts) while breastfeeding were also GBS positive and sometimes used antibiotics, or had recently needed antibiotics. While this doesn't happen to everyone, you are more likely to experience a yeast overgrowth after using antibiotics. After speaking with a Lactation Consultant about how to prevent thrush we discussed these ideas as possible solutions:
1) Use probiotics prior to birth and continue them after birth as well to help re-balance your gut. This can help prevent and battle the overgrowth of candida (yeast).
2) To prevent a yeast infection of the nipples or breast tissue consider getting a prescription of Newman's All Purpose Nipple Ointment. It contains an anti-fungal in it, to help treat and prevent infections, including yeast.
3) Seek care with a Lactation Consultant immediately after birth. If you're going to use a hospital based LC, make sure that they are easy to reach for weeks to come. You should also consider hiring a private CLC for in-home services, and more one-on-one care than what most hospitals are able to offer. Ensuring you do this, can help prevent a bad latch which can create cracks and nipple damage. When cracks and nipple damage happen, yeast is more likely to grow and it is easier to travel into the breast tissue and become a breast infection.
4) Air dry your breasts after nursing to prevent the dark and moist area that yeast thrives on.
5) If you do develop a thrush or a yeast infection of your nipples/breasts, then there are natural remedies you can try at home including diluted Apple Cider Vinegar washes/ingestion, Grapefruit seed extract/oil, Epsom salt soaks, and probiotics. Newman's All Purpose Nipple Ointment and a 2 week round of Diflucan may also be options to speak to your LC and physician about. You should also speak to your care provider, or your child's care provider about a treatment for the baby, since yeast can be passed back and forth. The Lactation Consultant I spoke with recommended a nystatin swabbing of the gums to treat thrush. All pumping supplies should be sterilized throughout the entire treatment for thrush. Work with your physician or Lactation Consultant to find a remedy that is right for you!
To hire a private CLC in Metro Detroit, check out MiLK, our sister company, at www.milk.solutions
In the end, GBS can feel like a big deal at first, but when you consider all of your options and make a plan with your care provider, it can be one thing of the list of parenting issues that you will overcome with confidence!