Group B Strep Treatment: What to Do If You Test Positive for GBS

When you’re in the home stretch, an unexpected diagnosis can throw you for a loop. But since 1 in 4 healthy women are colonized with Group B Strep, a GBS diagnosis is a very real possibility for many pregnant women. So what happens if you test positive? Read on to learn all about Group B Strep treatment to increase your chances of having the natural birth you desire.

I Tested Positive for GBS. Now What?

Most providers in the United States treat Group B Strep in one of two different ways.

Preventive Group B Strep treatment

This conventional form of treatment is the most common the U.S., where health officials say the risks of GBS outweigh the risks of antibiotics. This form of Group B Strep treatment often includes automatic IV antibiotics, like Penicillin and Ampicillin, during labor if mama tests positive for GBS. According to the CDC, the antibiotics work best when administered for at least four hours before delivery.

These medications are usually safe for both mom and baby, but up to 4 percent of women may experience a mild reaction like a rash. In rare cases (approximately 1 in 10,000) antibiotic use can cause diarrhea, abdominal pain, nausea/vomiting, fever, or more severe allergic reactions like anaphylaxis.

Though the chances are much slimmer, research shows antibiotic use doesn’t guarantee baby won’t get GBS or an infection from it:

When antibiotics are administered during delivery, baby has a 1 in 4,000 chance of developing an infection from GBS.
Without antibiotics, baby has a 1 in 200 chance of developing an infection from GBS.

The risk-based approach to Group B Strep treatment

Even if you test positive for GBS at your 35-37 week prenatal appointment, research shows this can change.

Between 17 and 25 percent of women who have a positive swab at 35-37 weeks of gestation will be GBS negative at delivery.

Because of this, Group B Strep treatment with antibiotics is not necessarily the norm around the world. In the UK, for example, health authorities say that if all women are screened for Group B Strep, this automatically increases antibiotic use during labor, which has its own set of risks, including infection and antibiotic resistance. (source)

In the U.S, some providers will allow this wait-and-see approach. Instead of giving antibiotics to every GBS positive case, the doctor will assess mom’s risk factors, including:

Clear signs of infection during labor, like fever of 100.4 or higher
Pre-term labor (before 37 weeks)
Ruptured amniotic sac (water breaking) 18 hours or more before delivery
Having a previous baby who developed early-onset GBS disease

If mama shows no signs of infection, baby will be closely monitored for 12 hours after delivery for signs of infection.

Note: Exact protocol for your Group B Strep treatment will depend on the policies of the birthing place, so it’s important to discuss your options before labor begins.

How to Treat Group B Strep Without Antibiotics

If you test positive for GBS, the following strategies promote healthy vaginal flora, which may lower your chances of having GBS at delivery and passing it on to baby. No matter which method of Group B Strep treatment you and your healthcare provider decide on, these home remedies are worth a try with your doctor’s approval.

Probiotics

This midwife found that L. Rhamnosus is particularly effective in combating GBS. Not all probiotics have enough of this particular strand, but this is a great option

You can also:

Up your daily intake of fermented foods like homemade sauerkraut, pickles, Kefir, and yogurt
Or, target GBS locally by using a probiotic capsule as a suppository before bed. 

Bacteria comes and goes, so you should continue to take probiotics until you go into labor. Even better, continue taking probiotic supplements while breastfeeding to further transfer good flora to baby. (source)

Chlorhexidine wash (Hibiclens)

In the medical world, the jury is out when it comes to the effectiveness of using chlorhexidine to cleanse the vagina before and during birth. It’s a standard medical practice in some parts of Europe, and there is some evidence that it does reduce the rate of infection from GBS and other medical conditions. Still, some practitioners are wary of this technique, because it only temporarily cleanses the vagina and rectum.

For maximum effectiveness:

Mix 2 Tbsp. Hibiclens (4% chlorhexidine solutions) with 20 oz. sterile water in a periwash bottle
Slowly instill the solution into the vagina with very gentle pressure (this can be self-administered or assisted by your spouse or midwife)
Wash the exterior of the rectum separately
Repeat every 4 hours through labor

Garlic

Garlic is thought to have antimicrobial properties, and one small study suggests garlic was able to kill Group B Strep bacteria within 3 hours. More research needs to be done, but it seems like a promising alternative.

For maximum effectiveness, try:

Garlic paste: Mix 1 glove chopped and 1 teaspoon honey. Swallow this without chewing it. Repeat several times a day, preferably with a meal.
Eat garlic: Chop fresh garlic and add to salad, dressing, vegetables, and almost any savory dish.
Garlic elixir: Add ½ Cup Honey, ¼ Cup apple cider vinegar, and ½ bulb garlic to a blender. Blend until liquefied. Take ½ tsp. up to twice each day.
Garlic suppository: Peel a garlic clove and insert it into the vagina. Sleep with it in overnight, before removing. Rotate with probiotics. (Don’t forget to get your doctor’s approval first.) 

Echinacea

Herbs such as Echinacea may boost the immune system, and a healthy immune system naturally wards off colonized bacteria. Since mama’s antibodies are passed to baby through colostrum and breast milk, a strong immune system in mama means a stronger immune system in baby. You can also try elderberry syrup, which works the same way.

For maximum effectiveness, try taking a 1/2 tsp. of Echinacea tincture two times each day for no more than 6 weeks.

Astragalus

A root used for centuries in Chinese medicine, Astragalus is an adaptogen, meaning it helps protect the body from physical, mental, and emotional stresses. There haven’t been any studies on the effectiveness of Astragalus in the treatment or prevention of GBS, but it has long been used to fight bacteria and viruses, as well as support the immune system.

For maximum effectiveness, take a 1/2 tsp. of Astragalus tincture two times each day.

Vitamin C

Studies suggest vitamin C supplementation after 14th weeks can strengthen the amniotic sac and help prevent the membrane from rupturing prematurely. This is important with a GBS diagnosis, since baby is more at risk of contracting GBS after the water breaks. 

Use a natural, food-based source of vitamin C, like camu camu powder. Just one teaspoon of this camu camu powder contains over 600 mg of vitamin C, over 1,000 percent of the RDA of this vitamin.

Collagen

Studies suggest GBS can penetrate the placenta’s collagen-rich membrane. When ingested, collagen can help protect joints, improve gut health, and improve liver function. Though scientific data is lacking, it makes sense that collagen may also help strengthen the amniotic sac.

To get more collagen, try:

Collagen peptides: Collagen peptides cost less than collagen supplements and are easy to add to any recipe. Try Vital Proteins collagen.
Collagen-rich recipes: Check out this post for my favorite collagen-rich recipes, including smoothies, waffles, and tea.

Water birth

According to a number of studies, giving birth in water reduced the risk of baby contracting GBS from low-risk moms.

“The literature provides a single case of early onset newborn Group B Strep (GBS) among 4,432 waterbirths, suggesting that low-risk women who give birth in water may have a far lower rate of newborn GBS than women who have a dry birth.” —  source

Diet & nutrition

As always, a rich and nutritiously dense diet helps support overall wellness, particularly before and during pregnancy. A few tips include:

Lower your sugar intake. This should include lowering your white flour intake, too. These are pro-inflammatory foods that feed bad bacteria populations.
Eat a balanced diet. Make sure to get enough protein, fruits and vegetables, complex carbs, and enough healthy fat, especially omega-3 fatty acids.
Incorporate cultured foods that support healthy gut and vaginal health, such as yogurt, sauerkraut, kefir, kombucha, etc.
Drink plenty of water: A pregnant women should aim for at least 10 cups of water each day. Dehydration can lead to complications, including preterm labor.

Dealing With a GBS Diagnosis

A Group B Strep diagnosis can feel like the end of your natural birth plan, but it doesn’t have to be. Try the above home remedies to balance your vaginal flora, but remember some things are out of your control. Many healthy mamas get a Group B Strep diagnosis. Work with your healthcare provider to find a Group B Strep treatment plan that best complements your natural birth plan. Your health and that of your baby’s is what’s most important.

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