What is GBS?

Group B Streptococcus (GBS) is one of the many bacteria that normally live in our bodies and which usually cause no harm. Screening for GBS is not routinely offered to all pregnant women in the UK. If you carry GBS, most of the time your baby will be born safely and will not develop an infection. However, it can rarely cause serious infections such as sepsis, pneumonia or meningitis. Most early-onset GBS infections are preventable. If GBS is found in your urine, vagina or rectum (bowel) during your current pregnancy, or if you have previously had a baby affected by GBS infection, you should be offered antibiotics in labour to reduce the small risk of this infection to your baby. The risk of your baby becoming unwell with GBS infection is increased if your baby is born preterm, if you have a temperature while you are in labour, or if your waters break before you go into labour. If your newborn baby develops signs of GBS infection, they should be treated with antibiotics straight away. On average in the UK and Republic of Ireland, every month 66 babies are diagnosed with group B Strep infection, 56 babies make a full recovery, 6 babies survive with long-term physical or mental disabilities, 4 babies die from their group B Strep infection.

what are my options?

Because we do not routinely offer screening in the UK then it means that not only are some infections being missed but it also is often restricting women’s choices. If you have previously carried a GBS infection in pregnancy often the only option given to you is IV antibiotics in labour. This can have an impact on your birth plan and some women simply do not want to have antibiotics unnecessarily due to the overuse of antibiotics causing resistance. 

If GBS was found in a previous pregnancy and your baby was unaffected, then there is a 1 in 2 (50%) chance that you will be carrying it again in this pregnancy. To help you choose whether you would like to have antibiotics in labour, you can have a specific swab test (known as the enriched culture medium or ECM test) It should be undertaken within 5 weeks of your birth and is the gold standard test for detecting group B strep carriage. NICE, the Royal College of obstetricians and Group B Strep support say that this should be offered, however many trusts do not offer this service. 

The group B Strep-specific swab test (ECM)

This test has been specifically designed to detect group B Strep. It involves taking two swabs from both the low vagina and the rectum. Research has shown that if performed correctly, within 5 weeks of birth then a negative result was 96 % predictive that you would not be carrying group B strep at delivery and a positive result was 87% predictive that you would be carrying group B strep at delivery. Many countries offer this test to all pregnant women at this stage of pregnancy, however, we still do not and even where there has been shown to be a previous infection it often still is not offered even though both the NICE guidance and the RCOG say it should be.

This is why I believe that it is important that I offer this service to women who would like this option. You may want never have been told you have had GBS, but still want it for reassurance or you may have carried it in a previous pregnancy and had a healthy baby and would like to explore your options this time. Whatever the reason I would happily talk you through them so that you fully understand what they mean to you and when you get your results again, I would explain thoroughly the implications and your options and liaise with the hospital that you have planned your birth in order for you to plan your care.