GBS Concerns

QUESTION

Dear Midwife,
I was given antibiotics to treat GBS through IV during the delivery of my first baby 2 years ago.

Now I am 35 weeks of my 2nd pregnancy, at 34 weeks, my doctor tested GBS on test and the result was negative and was told that no antibiotics is required even the labor would be on 40 or 42 weeks. My questions are

1) I thought that GBS cannot be treated, why this time it was negative?
2) Will the GBS come back any time between 34 weeks to 42 weeks? why the doctor was so sure that I don't need to have the antibiotics?
3) If I insist to have the antibiotics during labor, just to be safe, any there any harmful effect on the baby or myself?
4) What is your advice?

Thanks

ANSWER

1) I thought that GBS cannot be treated, why this time it was negative?
For adults GBS is kind of like the common cold; most adults who get them from time to time get over them on their own. Some lucky adults never seem to get a cold and some women never have GBS. The reason we test is that if you happen to have active GBS at the time of delivery, the baby can be affected. Before you were active, so far you are not with this pregnancy.

2) Will the GBS come back any time between 34 weeks to 42 weeks? why the doctor was so sure that I don't need to have the antibiotics?
The Centers for Disease Control recommends testing between 35-37 weeks, because they think that is close enough to delivery to tell whether the baby would benefit from IV antibiotics. In our practice, we re-test if 5 weeks passes without delivery, but I'm not recalling whether that is just us being safe or the CDC actually recommends that.

3) If I insist to have the antibiotics during labor, just to be safe, any there any harmful effect on the baby or myself?
Possibly. Overuse of antibiotics can lead to allergic reactions (in either of you) which can even cause death in some cases; and the baby could have trouble with thrush, just to give two examples.

4) What is your advice?
If your pregnancy goes past 39 weeks, I'd suggest re-testing, and go by the second testing results. If you deliver after 36 weeks but before 39, I'd say you don't need the IV antibiotics, because you can go by the test you already took. If the baby is really premature, some practices will treat even with a negative screen and others go by the screen. Hopefully, that won't come up for you!

-- Cynthia, CNM. PhD.

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.