What is GBS?
Group B streptococcus (GBS) is a normal bacterium that is carried in the vaginal or rectal areas of 10 to 30 percent of all adults, but only 20 percent of laboring women will test positive for GBS. It is ordinarily harmless and goes unnoticed, unless it is passed from mother to baby in childbirth where it can cause serious infection and even death. Babies who develop GBS infection may also develop neurological disorders, vision or hearing loss, cerebral palsy, developmental delays and other permanent disabilities. It is the most common cause of sepsis in newborns.
What are the risk factors?
In addition to being GBS positive, other risk factors for transmitting GBS are: low birthweight, previous GBS-infected baby, urinary tract infection with GBS prenatally, yeast infection, multiple sex partners within the last year, external genital redness and scaling, use of tampons, purulent vaginal discharge, vaginal pH over 5, onset of labor before 37 weeks, rupture of membranes before 37 weeks, rupture of membranes more than 18 hours before birth, internal fetal monitoring for over 12 hours, multiple birth, obesity, black race, age less than 20 years old, fever of 100.4 degrees or more during labor, and immune system compromise. Those mothers with 1 or more of the clinical risk factors above and a positive GBS culture are at most risk of infecting their babies.
How common is it?
Approximately 1 in every 1000 babies gets GBS disease. For babies older than 37 weeks gestation*, the risk is 0.75 in 1000. If you are GBS negative and have no risk factors, that number goes down to 0.3 in 1000. The rate of death without antibiotics is 0.01 in 1000, and the rate of anaphylactic shock due to an antibiotic reaction (even if not allergic before) is 0.01 in 1000.
Is testing available?
A vaginal/rectal swab at 35-37 weeks which cultures for GBS can be done by a physician or nurse-midwife. Because GBS can be intermittent, chronic, or transient, the test can miss up to 10% of GBS positive women. I provide a urine test to determine your pH and whether you are presenting with symptoms of a UTI.
What treatments are there?
Research indicates that IV antibiotics in labor can reduce the risk of GBS transmission by 66 percent. If you choose to have antibiotics administered, transfer of your care to a physician or nurse-midwife is required. Of the alternative treatments listed below, only antepartum Hibiclens is proven to be as effective as IV antibiotics:
1) Prenatally (from 36 weeks until delivery):
a) Immunotherapy
i) Vitamin C: 250 to 2000mg of vitamin C with bioflavinoids daily.
ii) Zinc: one capsule daily.
iii) Echinacea: two capsules should be taken 2-4 times daily, alternating 10 days on/10 days off.
iv) Colloidal silver: 3 teaspoons per day between meals. Liquid should be held in the mouth for as long as possible before swallowing. It can be diluted with water if the taste is too metallic.
v) Garlic: take one capsule daily
b) Vaginal flora
i) Vaginal wash
(1) Echinacea: 1 oz. echinacea root to 1 pint of boiling water and steep for 10 hours.
(2) Hydrogen peroxide
(3) Vinegar: 3 Tbsp. in 1 pint of water
ii) Acidophilus perles: one capsule daily of 100 million to 1 billion lactobacillus units in an oral, enteric-coated dose. Can also be inserted into the vagina.
iii) Cranberry: One capsule three times daily
iv) Probiotic foods or capsules such as Gy-Na-Tren’s Megadophilus
c) Vaginal antibacterial agents
i) Garlic: insert a whole, peeled garlic clove with slits cut into it (more or less cuts depending on skin sensitivity) for 8 nights in a row; you may sew a string through it for easy removal. Repeat once weekly until delivery. Skin irritation can occur.
ii) Tea tree tampon: insert a tampon soaked in 2% tea tree essential oil and 98% olive oil. Leave the tampon in for 4 hours, repeat every day for 6 days.
iii) Vaginal wash: 4 to 6 Tablespoons each of thyme, calendula, rosemary and yarrow; cover with 1 quart boiling water; cover and let steep 4 hours. Strain into a clean jar and add ¼ cup sea salt, 10 drops of lavender essential oil and 1 oz. of echinacea tincture. Wash once daily for 7 days.
2) Intrapartum
a) Immunotherapy
i) Vitamin C: 250mg every 4 hours for as long as membranes are ruptured.
ii) Colloidal silver: 3 tsp. every 6 hours
b) Vaginal antibacterial agent
i) Chemical wash: 4 T. (15mL) of chlorhexidine gluconate (Hibiclens) in 2 ¼ c. water; fill peri-bottle half full (140mL) and squirt over vulva; repeat every 6 hours. Skin irritation can occur.
ii) Herbal wash: Thyme/calendula/rosemary/yarrow mixture above; use as a vaginal wash once in labor prior to rupture of membranes.