Q & A: Group Beta Strep (Part 2 of 2)

So, you have GBS, along with 30-50% of other women (rates vary around the country, it seems to me about half my clients have had it). You of course have the option of getting IV antibiotics if you so choose, but only if you are having your baby in a hospital. (Side note: If you are giving birth in a hospital, and are GBS positive or GBS status unknown, ask your provider if not getting antibiotics is even an option. It has been my experience that most hospitals have a very strict policy of requiring the IV antibiotics, or rather, their malpractice insurance companies do. But that is a whole other topic.)

If you choose to give birth at home or a birth center, you will not have the option of IV antibiotics. Your options are:

1. Other forms of antibiotics: If you have read the literature and decided that you want antibiotics, you can have your doctor prescribe oral antibiotics that you would start taking at about 37 weeks. You can also get an IM dose (an IntraMuscular injection), which is effective for 10 days and then must be repeated. The effectiveness of these treatments have not been evaluated. Some of the severe risks of the IV antibiotics are lessened, but the more commonplace problems (vaginal yeast infections, thrush leading to breastfeeding problems) still exist.

2. Hibiclense douche: This is the standard of care for GBS treatment in many European countries (that have infant mortality rates better than ours). At the beginning of labor, you douche with chlorhexidine gluconate (brand name: Hibiclense). This product is available over the counter at the drugstore. For more info, read this study from Norway's Aker Hospital, or this study from Italy that found it to be equally effective as IV antibiotics! Of course, not all the studies showed it to be as effective.

3. Herbal Treatments: These vary far and wide; I have heard great success stories from using herbal vaginal suppositories, but have not personally had great success with this treatment. It's not that I believe they aren't working for others, I just don't think they are all created equal, and I haven't found the right one. (If you have, let me know!) I think the problem is that the vaginal suppositories need to have boric acid in them to be effective - and boric acid burns, so many don't include that ingredient anymore. What I have seen is a reduction in the colony level (ie: bacteria still there, but less of `um) from herbal treatments, which is a good thing. If you want to try these herbal treatments you can do at home, they likely won't completely rid you of GBS, but they will generally improve your immunity and perhaps lower the number of bacteria. (Of course, talk to your care provider first.)

4. Risk Factor based care: If you develop a risk factor, you transfer care to the hospital and get IV antibiotics. If you don't develop any risk factors, you proceed with your out-of-hospital birth.

5. Watching and waiting: Proceed with out-of-hospital birth, and if the baby shows signs of infection, admit the baby immediately for early treatment. Many GBS cases can be treated if caught early, but not all can be caught and treated in time.

All births, regardless of GBS status or choice of birthplace, carry some risk. Risks can never be eliminated - it is simply a matter of choosing which risks you feel most comfortable with.