Most women aren’t thinking about preventing GBS in pregnancy because they have never had reason to know what it is! If this is your first pregnancy, this article will give you a bit of background so you know what is going on when your care provider announces that they will be testing you for this bacteria. If you have been pregnant before, GBS may be familiar to you. Either way, the techniques for preventing GBS in pregnancy are the same. Some measures should be started as soon as possible and others are specific regimens to save for testing time around 36 weeks.
What is GBS and how can it affect my baby?
Group B Streptococcus (GBS or Group B Strep) is a type of bacteria that is found in the lower intestine of 10-35% of all healthy adults. Most pregnant women are tested for vaginal GBS at 36 weeks unless they had a positive urine culture earlier in their pregnancy. GBS is a normal vaginal bacteria, but if your baby becomes infected with GBS during the birth process it can cause illness in your baby. IV antibiotics during labor prevent GBS infection in babies for at least 90% of babies born to moms who test positive for GBS.
Approximately 8,000 babies in the US (.2%) develop a serious GBS infection during birth after being exposed to the bacteria as they move through the vagina. GBS infection can lead to permanent disabilities or death, although approximately 70% of infected babies fully recover and have no long term consequences. Preterm babies are at a greater risk for GBS infection and complications than full term babies.
What basic precautions can I take to prevent GBS?
Because GBS is an intestinal bacteria and the intestines empty through your anus, the best way to prevent GBS in pregnancy is to keep your vagina free from contact with anything touching your rectal area. Wipe from front to back after elimination, wash hands before inserting tampons, and avoid sexual positions and activities where anything may come into contact with the rectal area before entering the vagina. Be sure that doctors and midwives wash their hands and use sterile gloves before any vaginal exam, and consider having them cleanse the outer lips of your vagina with an antibacterial wipe before the exam.
Practices that reduce the incidence of vaginal infections in general include: wearing breathable, cotton undergarments, loose fitting clothes, and avoiding thongs. Remove wet swimsuits after swimming. Decrease refined sugars in your diet which may provide a food source for overgrowth of bacteria. Avoid douching and other feminine hygiene wipes which may change the pH of your vagina.
Are there supplements or other suggestions for preventing GBS in pregnancy?
Yes. There are many other suggestions for preventing GBS in pregnancy, but there are no studies regarding their effectiveness that would hold up to standards for evidence-based practice. There are, however, many women who have experienced a reversal from positive to negative cultures for GBS (a change in results of the Group B Strep test) after following one or more of the following methods:
- Boosting competitive and healthy bacteria in order to compete for resources needed by the GBS, and therefore weakening or killing the GBS: Take probiotic supplements such as acidophilus and bifidophilus orally, eat fermented foods such as yogurt, tempeh, and aged cheeses, and/or insert plain yogurt or an opened probiotic capsule into your vagina. For oral protocols, follow the directions on the probiotic you purchase. Oral probiotics increase levels of these good bacteria on a systemic level and specifically target the intestines. Vaginal application is the most direct way to introduce good bacteria into the vagina. Lactobacillus is the most common healthful vaginal bacteria. For vaginal applications, begin by cleaning the labia with an antimicrobial wipe and then insert an open capsule or a finger full of plain (unsweetened!) yogurt just before bed for two weeks before testing for GBS.
- Boosting the immune system: Avoid sugars and refined carbs, increase vitamin C and vitamin D, preferably through food sources, and eat a healthy diet high in protein and vegetables.
- Kill the bacteria: Garlic, colloidal silver, and tea tree oil are natural products regarded with the capacity to kill bacteria. Soak tampons in olive oil infused with a tea tree oil or collodial silver solution or sew a thread through a peeled clove of garlic (to assist with removal) and insert into the vagina, or insert a capsule of garlic powder. The capsule will dissolve. These measures may be used one or two nights before testing for GBS.
- Homeopathic remedy: SanPharma Notatum
**If you test negative on the Group B Strep test while using one of these methods, it is recommended that you repeat the method at 39 weeks to prevent GBS from recolonizing. You can take/eat oral probiotics and boost your immune system continuously until your baby is born, but do not continue the regimen’s for killing the bacteria for more than 2 days once every 2 weeks.
Where can I get more information on using these methods?
Your doctor or midwife may be familiar with some of these methods for preventing vaginal Group B Strep. If not, the Midwife Archives chronicle midwives experience with these methods and additional suggestions, however the archives are not systematic and often pull phrases from research out of context. Be savvy when reading information there. Midwifery Today has a library of articles on GBS which may be helpful. Naturopathic doctors, herbalists, and other natural health practitioners may be able to recommend safe dosages for pregnancy. Your doula or childbirth educator can share the regimens used by other women and their experience.
What are the benefits of preventing GBS in pregnancy?
While IV antibiotics in labor can prevent GBS infection in newborns, the best protection of all is to avoid the bacteria in the first place. Some women prefer to avoid the need for an IV during labor to eliminate the distraction and the inconvenience of having an IV. In addition, there are several potential side affects associated with antibiotics during labor. These include a small risk of allergic reaction to the antibiotic, increased incidence of yeast over-growth which can cause nipple pain or thrush during breastfeeding, and possible bloating or digestive discomfort for you or your baby. Some believe that antibiotics in labor may contribute to the causes of colic, though colic often remains unexplainable.
So what should I do to prevent GBS in pregnancy?
That is where you come in! This article presents a lot of options that may be very beneficial and are likely harmless, but that are not studied enough to verify efficacy or guarantee safety. It is likely unnecessary to do everything listed in this article to prevent GBS in pregnancy, and sometimes even if you do them all you will still be positive for GBS.
I recommend starting with the general measures (such as breathable underwear and specific hygiene practices) as soon as you learn about these methods. Around 33 weeks, read through the more agressive suggestions under the supplements and other suggestions category and decide how important it is for you to prevent GBS in pregnancy. In response to those feelings, which of these suggestions seem worthwhile to you? Take a copy of this article to your 34 week appointment with your midwife or OB and ask them if they have additional information for you to consider before making a final choice. In the end, follow your gut, and put into practice the measures you are up for.