Thursday, 5 March 2009

Group B Strep

Today I am writing about a subject that I feel is really important and needs to be investigated and understood further, it’s one that seems to be worrying a great deal of parents to be - Group B Strep

Almost every week receives enquiries about Group B strep and the advice we give tends to run on the same principles. Having watched the video on the mybirth site we then tell the enquirer to contact the Group B Strep organization, which gives fantastic support and in depth information. They should also speak to their midwife or consultant obstetrician who will have up to date information. So, what is Group B strep?
It‘s a bacteria commonly found in a third of all male and female intestines. A quarter of women of childbearing age will carry the bacteria in their vagina at any given time. This bacterium is totally harmless in healthy individuals and is only of concern to a newborn infants and very young babies. As many as 700 babies per year are infected with this bug in the UK, and up to 75 die from further complications, the affects of this bacteria can run from septicaemia and pneumonia to meningitis. Keeping in mind that there are almost 700,000 babies born every year in this country, with approximately 175,000 pregnant carriers, the risks of infection are still very low, but to those infected by it the results are very real and can be disastrous. For in-depth information about Group B strep and the possible risks to babies visit

Although this bacterium was identified as far back as the 1960’s it didn’t gain an awful lot of attention until much more recently, and I don’t recall when training as a midwife in the early 1980’s any mention of it either. Today, most hospitals in the UK will have a protocol for dealing with Group B strep infection; the recommendations may vary from hospital to hospital, but in general the offered course of treatment is intravenous antibiotics for women who are in labour and are known to be G B Strep positive. If there is no opportunity for IV antibiotics in labour the baby may be given them post birth. The whole point about antibiotics is to ensure that the baby is treated either prior to birth or immediately after, thus eliminating the risks of G B Strep infection. This scenario brings up many issues; many mothers would prefer that their babies were not subjected to antibiotics at such a tender age, other women do not want to have IV antibiotics in labour, and for many women if they want a homebirth most hospital trusts would rather they came into the maternity unit for the antibiotics, so the women’s choices are limited, there is also the question about the twenty five percent of pregnant women who are carriers, the majority of whom will not pass on the infection to their baby and will be unaware that there maybe an element of risk.

My third child was born almost 24 years ago at 31 weeks of pregnancy. She developed pneumonia almost immediately and for several days her life hung in the balance whilst the doctors fought to save her life. She was pumped full of drugs, antibiotics and intravenous infusions and blood transfusions and she finally pulled through,
There was mention of infection and I don’t remember its name but it could well have been Group B strep. As a mother I felt guilty that I had infected my child with this bacteria, and today I am glad that no one should be made to feel guilty with such a common infection, but from my perspective I think it would have been great if I had known about this bacteria and the risks it posed to my unborn baby. For women today the information is out there but is not discussed regularly in ante natal clinics for fear of alarming many mothers to be, but if you knew there was a potential risk you could then make the informed choice of whether to be tested or not.

Many mothers are asking why there isn’t a routine screening programme in the UK like there are elsewhere and the simple answer is that the government believes that a routine screening programme is not cost effective; some women maybe screened one day and be found to be positive for the bacteria and yet a few weeks later the same woman with no treatment in the interim will test negative. Therefore many women and their babies maybe subjected to antibiotics that they no longer need. Testing late in pregnancy could help to eliminate some of those who are no longer testing positive.

There is a petition being sent to the Prime Minister asking for routine screening in the UK which closes on the 11th March so if this is something you feel strongly about click on the link.

At the moment there are tests that women can obtain privately which screen for the bacteria; swabs are taken from the rectum and vagina (the mother can do this herself) and then sent off for analysis, details are on the site. My belief is that women should ensure that they are well informed about all aspects of their pregnancy, whether its making the choice to have a hospital or homebirth, screening for fetal abnormalities or the risk of passing on a very treatable bacteria.

If you have any comments or would like to contribute to the debate please do so, the more people who discuss the issues the better.