The Facts About Group B Strep Test


Pregnant women in America get lots of tests. We’re tested for gonorrhea, chlamydia, syphilis, and AIDS, for diabetes, for iron, for ketones, and they even undergo genetic testing for our unborn children. One of the last tests doctors “require” is the Group B Strep test.

What doctors tell us about Group B Strep is that, first, it can be life threatening, that it can lead to blood infections, skin or soft tissue infections, and pneumonia. They tell us that GBS can cause seizures, meningitis, and other problems.

What they don’t tell us about Group B Strep is that it’s very unlikely that a baby will show symptoms even when the mother tests positive for it. Nor will they tell you that the current testing available is highly unreliable. They probably won’t provide you with an impartial handout and definitely won’t give you any alternative treatment protocol.

Shortcomings of the Group B Strep Test

The test is performed by taking a swab sample from the vagina and/or anus. The swab is taken once, close to the end of pregnancy. Group B Strep can crop up at any time, however, meaning that today you may not have it but tomorrow you will. And so today you might test negative but tomorrow you could test positive.

Group B Strep can be detected on some days better than on others, meaning that today your doctor may not see it but if he tried again tomorrow he would.

But the test is only performed once.

The following facts were taken from the handout below:

“A positive result means that the mother is colonized, not that she or the baby will become ill.”

“Women who are colonized with GBS but don’t develop any complications have a relatively low risk of delivering an infant with GBS disease.”

Other factors which make a baby higher risk are listed at the bottom of page one below.

Treatments and Alternatives

As only 1-2% of babies actually become ill after delivery from a colonized mother, there is mostly nothing to worry about but worry is our game here in civilized lands and so we take that 1-2% margin very seriously.

The treatment for GBS is an IV drip of antibiotics during delivery. Antibiotics lowers the mother’s and baby’s immune systems by changing the vaginal flora. This also means that mother is largely immobile during delivery which can lead to other complications. There are several other risks associated with antibiotic use for both mother and baby as listed on page two below.

A Group B Strep treatment alternative offered in Europe but not in the US is Hibiclens. This is an effective treatment, much better than an anti-biotic IV. It is an antiseptic, though, and still can change the vaginal flora.

If neither of the above steps are taken the baby should be closely watched by an attending midwife for a few hours following the birth  since most of the symptoms develop early.

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  1. Good topic, Peggy. I just had my GBS test last week. It’s no big deal, just a swab, but they sure do freak you out about it and the potential complications! Just 1-2% of babies born to GBS+ moms actually show symptoms…that’s a very, very small number. At least the test is not as invasive or risky as an amneo, which I declined even though I fit the “risk category” as a 36 yo woman on her third pregnancy.

    I was reading (and I can’t remember where but I’l rifle through my bookmarks and send the link) about how vaginally delivered babies have very different gut flora profiles than C-section babies, and how the mother’s own gut and vaginal flora and subsequent breastfeeding behavior play a huge role in the development of an infant’s own flora, digestive efficiency, and disease resistance. Fascinating buggers, those trillions of microorganisms that live in (and on) our bodies. I’m excited by the research that is being undertaken on this topic.

    • Yes, research has shown that there is a difference between the gut flora of a c-section baby and a vaginally delivered one. It’s too bad that the treatment for GBS is rounds and rounds of penicillin. (Way to ruin a good gut flora.) It is unfortunate that more signs than just a positive test aren’t evaluated.

      I cannot put myself into the same class as women who eat junk food diets, who don’t exercise, etc. Yet the doctors do. This is where I find most fault with these tests. That responsible and irresponsible women are put into the same class.

      I know a lot of people find this view to be a bit arrogant but it really isn’t. Some of us just work harder to keep ourselves in good shape. Doctors don’t (and can’t) take that into account.

      I probably should have added that if you are not eating well, taking care of your vaginal flora, keeping stress low, staying off drugs – prescription, over the counter, or otherwise – exercising, and generally staying healthy, you might want to get the test…

  2. Not enough is known about gbs by mainstream doctors, however dr hilgers of the
    PP institute has studied it extensively and is treating much differently. I had 3 miscarriages and 1stillbirth due to gbs. I now have a 3 mo old after becoming a patient of hilgers. Infertility and gbs go handinhand….it’s just not recognized or treated early by midwives or most obgyns because of the blanket approach to dealing w gbs. I agree w you on older infants at birth, but don’t discard testing early and the affects of gbs if it enters the upper cervical area or crosses to the uterus.

  3. I tested for GBS when I was pregnant. I was very intimidated by my doctors so didn’t even try to decline antibiotics. Then my son had IV antibiotics for three days due to mystery fluid in his lungs. Needless to say, we both got thrush and he had a foot fungus problem for a while. And he did NOT develop good gut flora. I really hope my new diet prevents group B next time because I just don’t want to deal with it.

    • Lisa, 3 days of anti-biotcs? Poor thing. He’ll recover. I know you’re working hard for it.

  4. Great post! Another way to minimize the risk of GBS is to refuse the artificial rupture of your water/membranes (AROM). The baby cannot get your GBS if your membranes are intact and membranes have to be ruptured for quite a while before infection sets in.

    • A long labor would be equally risky then.

      • How long are we talking? As long as baby and mother are dealing well, then let the labor continue.

      • Re-reading this I think I interpreted your response incorrectly. Did you mean that it would be risky to labor for a long time with ruptured membranes? Or that any lengthy labor, even with intact membranes, would be risky?

  5. It is completely bewildering to me as to why they swab the anus. GBS is not a problem in your digestive tract! Gut colonization isn’t an issue, so why do they test for it? If they get a positive, they don’t know whether the colonization is vaginal. I understand that gut colonization can make vaginal colonization more likely, but come on – they’re digging for positives. My midwife had me swab myself, vaginally only.

    Regardless, like you said – a positive at 37 weeks doesn’t give you *any* information because colonization is transient. Silly.

  6. I work in a newborn intensive care unit. If you’ve ever seen a baby die from GBS infection, you might feel differently. Years ago, when many of us were only kids, there was no preventative treatment used for GBS. Many more babies were infected, about 5% of these died (that’s 1 in 20!), and many who survived were left with disabilities. These prophylactic antibiotics decreased the rate of invasive GBS infection by approximately 70% and have therefore saved countless lives. The system and testing is not perfect, and yes, mothers’ flora can change in those few weeks between testing and delivery. And some babies still get sick. But right now, it’s the best we can do and it saves a lot of lives.

    • Thank you Karyn! I am an L&D RN and too have seen how sick babies can get from GBS. Not many get it but the “primal” mother in me would make sure to do anything and everything to keep my baby from getting it.

  7. My strep B test came back negative at 35 weeks. However, at 37 weeks, we chose to induce labor because my blood pressure was dangerously high. My labor and delivery went smoothly. But within an hour or two, my fantastic/life saving pediatrician noticed my daughter’s breathing was very labored. She ordered lab work, but thankfully, started IV antibiotics immediately – not even waiting for lab results. This step may have saved my child’s life. She did, in fact, test positive for Strep B and she had to stay in hospital for 10 days on IV antibiotics. She also had to undergo a spinal tap to make sure she did not have meningitis, which she luckily did not have. These were the scariest days of my life! As you mentioned, sometimes a woman can test negative one day and positive the next – I am proof of that. But, this test is the best way a preventing other mothers and infants from having to stay in the hospital for weeks or months for treatment. I would recommend trusting your doctor, taking the test, and having antibiotics during labor if you test positive. I certainly will the next pregnancy!

    • Thanks for commenting, Kathryn. You are right, if you don’t get the test, you’ll probably have to stick around in the hospital for 24 to 48 hours longer than you otherwise would, and you will be given antibiotics. Of course, you can reject them, but the doctors and nurses won’t be very happy with you. This disease, like so many others that can infect children can be dangerous. It is always best to listen to your doctor.

      The information I provide here is food for thought. Every woman and situation is different. I’m so glad you and your baby are well!

  8. Hi Peggy. I really like the hand out you posted. Where did you get it? I would like to reference it.

    • I got it from my midwife! Let me try to get a hold of her and I’ll ask here.

  9. I was GBS positive in my urine at 10 weeks. My home birth midwives really got on me about treating it. I started on garlic ( vaginally and orally), tea tree oil tampons, vitamin C, probiotics ( vaginally and orally), paleo/low sugar diet my entire pregnancy, enchinacea tea, etc. I had a negative swab at 36 weeks. I went into labor at 41 weeks and had to transfer to the hospital due to meconium. I am so glad this happened. My daughter was born with an Apgar of 1 and her breathing became rapid after they got her to breath. She spent 7 days in the hospital for antibiotic treatment for GBS. It was devastating. I would have much rather had the 4 hour dose and been the one poked than have my beautiful girl poked and prodded for a whole week. We are battling thrush and she is on an infant probiotic but we are just grateful she is okay.

    • Miranda,

      I am so sorry this happened to you! When anything goes wrong at birth it is so scary. It’s a good thing your midwife (?) transferred you to a doctor.

      The medicine used in Europe may have been more effective than the natural methods you chose. While I don’t have any direct experience with that myself, I know that in general that the methods you mentioned don’t always (or even often) work for vaginal infections like candida and bacterial vaginosis. Before getting to the bottom of my own struggle with those infections I did all of those things and they didn’t help me either.

      I think it is worth noting that women are coming from a very different place these days and that vaginal infections can be hard to battle.

      The thrush that you and your baby are battling will end. Drink kefir or load up on probiotics. It’s great to avoid antibiotics but when you can’t, it’s not the end of the world.

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