Do I need antibiotics before baby is born?

We all have lots of bacteria that live in and around our bodies. Group B Strep is a normal bacteria that lives in the GI tract (gut) of some men and women. It can travel to and colonize the rectum, vagina, and urinary tract. This bacteria lives in the vagina and the rectal area of 1 out of 4 women, but most women don’t show symptoms of infection even though they carry the bacteria. 

GBS is not a STI, but research shows that women with some risk factors are more likely to carry GBS: multiple sexual partners, male-to-female oral sex.

Why do we care about this bacteria?

The problem with this bacteria, GBS is that if your baby is born through your birth canal and gets this bacteria on his or her body (baby has immature immune system), there is a 1% chance of your baby developing either pneumonia (lung), meningitis (brain), or sepsis (blood).

These are potentially life-threatening illnesses. They can cause great harm or even death to your baby. So, your healthcare provider wants to know if you are positive for Group B Strep.

How is a Group B Strep screening performed?

You will be laid back on an assessment bed (similar to getting a pap smear) in your healthcare provider’s office. Your doctor will then place a speculum in your vagina, then your doctor will swab your vagina, cervix, and rectum. A total of three areas are swabbed during this test: the rectum, vagina, and cervix.

When the test results are returned, your doctor will notify you if you are Group B Strep positive or negative.

If you are negative, GREAT! You can simply notify the nurses that you are Group B Strep negative when you arrive at labor and delivery.

If you are Group B Strep positive it is very important that you notify the nurse immediately when you arrive on the labor and delivery unit. 

How will you be managed?

If you are GBS Positive, you will need to receive antibiotics at least 4 hours prior to your baby being born.

Antibiotics during labor decrease the amount of bacteria in mom and decrease the risk of your baby getting sick (0.2% risk of getting infected after antibiotics rather than 1%). 

Antibiotics need to be in your system for a minimum of 4 hours before your baby comes through the birth canal.

Some healthcare providers will want you to receive antibiotics at the onset of labor and receive antibiotics every 4 hours until birth.

Antibiotics take about 20-30 minutes to infuse. Then you can ask for a hep-lock after the infusion. 

Are antibiotics harmful to baby?

IV antibiotics given during labor have a short-term negative effect on the baby’s microbiome, but this negative effect can be lessened by breastfeeding.

Antibiotics get rid of good and bad bacteria in mom. The good bacteria from the birth canal have been destroyed! Baby needed those. 

Antibiotics also affect the development of gut bacteria in the baby (at least temporarily). 

Baby can breastfeed within the first hour of birth and breastfeed until at least 3 months for a healthy gut in the baby.

What if I didn’t get antibiotics? Should my baby be tested?

Maybe you didn’t make it to the hospital in time to receive the antibiotics…

No testing if: If your baby is not showing symptoms within 1 hour of birth, if you did not give birth before 37 weeks, if you didn’t have an infection of the uterus, or if your water did not break greater than 18 hours before giving birth.

Baby needs 48-hours of observations if born to a GBS mom that did not receive antibiotics. 

How do I labor at home if I need to get antibiotics? 

Be at the hospital 4 hours before. Talk to your healthcare provider. 

Can you decrease your risk for carrying GBS?

GBS is linked to your GI tract. Therefore, it is thought that if you can get a healthy gut then you can decrease GBS.

Get a healthy gut to decrease the amount of GBS.

One study showed the benefit of taking 2 Probiotic capsules at night starting at 35-37 weeks. The first randomized trial on using probiotics to reduce GBS colonization in pregnant people had promising results, with 43% of GBS positive women becoming GBS negative by the time of birth.

Women with higher levels of lactobacilli in the vagina have lower levels of GBS. Lactobacilli strongly inhibits the growth of GBS by increasing the acidity of the vagina.

Also, consider a healthy diet: fresh berries, fresh vegetables, garlic, prenatal, and decreased sweets. 

Probiotics that I recommend: 

PRO45: #1 Clinical Grade Probiotic Formula – https://amzn.to/2UuBBWT

Probiotics 60 Billion CFU – Dr. Approved Probiotics for Women – https://amzn.to/2JqflXO 

Studies used for this blog post:

The Evidence On: Group B Strep – https://evidencebasedbirth.com/groupbstrep/

Science Daily – Antibiotics administered during labor delay healthy gut bacteria in babies – Delay increased with longer durations of exposure to the antibiotics https://www.sciencedaily.com/releases/2017/11/171128160344.htm

CDC – GBS – https://www.cdc.gov/groupbstrep/about/prevention.html

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