Strep B Disappointment

Easter Sunday was a great day other than the fact I was dealt a bit of an emotional blow to my pregnancy hopes. My new midwifery office has an online portal that sends email reminders for appointments, and it also loads your test results there for you to check if you need to. I got an email that the results for my strep B test were in. Obviously by my saying I was dealt a blow, one can assume the results were positive, which they were, but I’ll stop here and give you some background on what the heck strep B is, how it affects a pregnancy and why my positive result may cause some problems for me in labor.

Between 35-37 weeks of pregnancy, moms are tested for something called Group B Streptococcus, or GBS. This is not strep throat. That is apparently a bacteria called strep A. Strep B is a bacteria that approximately 30% of women carry—I apologize for suddenly throwing these terms out, but it’s all medical—in their vagina or rectum. Apparently it can also be in your lower intestine, but since your baby doesn’t come in contact with that area, the test is performed by swabbing the other two areas mentioned.

I felt like this wordy post needed a picture. This is what I got when I Googled strep B. This and screaming baby pictures. (From I-am-pregnant.com)

(I believe, from the quick Google searches I’ve done, that men can also carry this bacteria, but since they don’t give birth, I haven’t really looked into how it affects them. Sorry if you're a dude and hoping for that information.)

The reason women aren’t tested until 35-37 weeks is because this bacteria can come and go. The carrier may never know she has it unless she becomes pregnant and is tested for it. Even then, she could’ve carried it at one point but not be carrying it at the time of the test, resulting in a negative result. Basically—I tested positive this time, but with my next pregnancy, or even if I were tested again in two months, I might not have it.

So how does this affect pregnancy?

When a baby is born and passes through the birth canal, there is the possibility it can pick up the strep B bacteria if the mother is a carrier. There is no way of knowing which babies will contract it and which ones won’t. The most common illnesses/diseases the bacteria causes in newborns are sepsis, pneumonia and meningitis—all very bad things for a newborn to have. There is some commentary on the bacteria also affecting the mother, but from the majority of what I’ve read and been told by medical professionals, the concern is for the baby, not the mother.

In order to prevent the baby from catching the bacteria, mothers are given penicillin intravenously every 4-6 hours during labor. Administering the antibiotic significantly reduces the chance a baby will get strep B. The most common stats I’ve read say 1 in 200 babies will pick up the bacteria if no antibiotics are given whereas 1 in 4000 pick it up with the antibiotic. So it’s a really good thing to let them give you antibiotics, though some women opt out. At that point, pediatricians watch the baby very closely for signs of illness.

[I should probably also mention that this bacteria hasn’t always been tested for—I’m fairly certain my mother wasn’t.]

Now, why did me finding out I tested positive make me so upset? It’s just a little IV, and I don’t even have to be attached to the pole. I can get the drug, have it plugged and continue to labor as I please—even giving birth in the birthing tub if I so choose.

Well, it just complicates some other hopes a bit more. Two main things will change. Number one: if my water breaks before labor starts (happens in fewer than 10% of women) I will have to get to the hospital for the antibiotic. If this happened and I had tested negative, I might be given up to 24 hours for labor to begin on its own (totally dependent upon practitioner). Because I tested positive, I’ll only have maybe 12 hours before they’ll want to induce.

Number two: I won’t be able to labor at home as long as I wanted. Because pediatricians like to see the dose given at least four hours before the baby is delivered (like you can technically plan these things), I will need to head to the hospital and arrive hopefully at 5-6 cm dilated as opposed to maybe showing up at 8-9. My midwife told me today that most docs like to get two doses in, but since some women progress quickly, that isn’t always possible. If for some reason I were to get there and give birth in less than four hours or even so quickly the meds can’t be given, they will just watch the baby very closely. But ultimately, they’re going to want me there sooner than if I had tested negative.

I’ve decided I’m going to end my post here and tell you the rest of the story with my next post. I was presented with some research of alternate ways to deal with a GBS positive result that I want to share, and I also think it’s important to talk about why I finally determined this upset me so much. All that to come…stay tuned!