Group B Strep - Can I Have a Home Birth?
/You’ve probably heard of Group B Strep, and if you’ve ever had a child you’ve probably had to test for it. Are you still eligible for a home birth if you test positive?
The simple answer - yes! You can still have a home birth if you test positive for Group B Strep. There are just a few extra steps you may need to take and discuss with your midwife.
Group B Strep - What Exactly Is It?
Group B Streptococcus (GBS) is a common bacterium that can be found in the digestive and reproductive tracts of healthy adults. While typically harmless and often temporary, GBS can pose serious risks to newborns if transmitted during childbirth, especially if they are premature or have weakened immune systems.
GBS Testing During Pregnancy
Pregnant women are usually screened for GBS between 36 and 38 weeks of gestation. The test involves a simple swab of the vagina and rectum, which is then analyzed for the presence of the bacterium. A positive result indicates that the individual is a GBS carrier, though this does not necessarily mean the baby will become infected.
About 25% of pregnant women will test positive for GBS, and about 1 in every 200 babies born to mothers who test positive will develop symptoms.
Risks of GBS for Newborns
While GBS doesn’t usually cause symptoms in adults, it can lead to severe infections in newborns, including:
Early-onset GBS disease (EOGBSD): Occurring within the first 24-48 hours after birth, this can result in pneumonia, sepsis, or meningitis.
Late-onset GBS disease (LOGBSD): Developing between one week and three months after birth, this form can also cause meningitis and other complications.
Other complications: Preterm labor, stillbirth, and infections in the mother, such as urinary tract infections or chorioamnionitis, can also be linked to GBS.
Treatment Options for GBS in Hospital and Home Birth
The standard medical approach for those who are GBS-positive giving birth in a hospital is intravenous (IV) antibiotics, typically penicillin or ampicillin, administered during labor. This significantly reduces the risk of transmission to the baby. However, some may seek alternative options, especially in home birth settings.
For those planning a home birth, GBS management involves careful consideration of risks and alternative treatment strategies. Some approaches include:
Informed Decision-Making: Home birth midwives provide education about GBS, its risks, and potential interventions, allowing families to make choices aligned with their values and comfort levels.
Holistic and Preventative Measures: Some midwives recommend probiotics, garlic, chlorhexidine vaginal rinses, and dietary modifications to promote a balanced microbiome and potentially reduce GBS colonization.
Antibiotic Administration at Home: In some cases, midwives may administer IV antibiotics at home if the mother chooses this option and the midwife is trained in IV administration.
Monitoring and Early Detection: Babies born at home to GBS-positive individuals are closely monitored for early signs of infection, such as respiratory distress, temperature instability, or difficulty feeding.
Emergency Transfer Plan: If a newborn shows signs of infection, immediate medical intervention in a hospital setting is crucial. Midwives attending home births have established emergency transfer protocols for timely care if needed.
While conventional treatment involves IV antibiotics, alternative management strategies may be preferred by some families. Open communication with your midwife or other healthcare provider is important to go over risks, explore options, and create the safest possible birth experience for both parent and baby.
