WHAT IS GROUP B STREP & WHY DON’T MORE OF US KNOW ABOUT IT?

Truthfully,  Group B Strep was only vaguely on my radar,  I knew it to be an illness that can affect young babies but little more.  Now, having read this excellent list by Hannah Thompson,  I am a bit horrified at my ignorance, especially seeing as I have had 3 babies all of which were at risk of contracting GBS.

Here’s hoping this post can help raise awareness of the symptoms so that more parents know what to look out for:

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• Group B Strep (GBS) is a bacteria carried by around 25% of women. It is harmless in adults. For about 0.06% of pregnancies, the infection will spread to the baby during labour, and make the baby very sick.

• Our daughter Mabli was born last summer. We had a homebirth and after 27 hours, our 4kg baby was born safe and well on the sofa.

• I was utterly euphoric.

• When my placenta wouldn’t deliver, despite mine and the Midwife’s best efforts, I was told I would have to go into hospital for my placenta to be manually removed.

• I was still euphoric, cheerfully chatting to the medics in theatre operating on me, despite just having given birth and not slept for 24 hours. Hormones are incredible.

• The procedure required a full spinal block, so after a drug-free birth, I got anaesthetized to within an inch of my life. I was still euphoric.

• It was whilst I was recovering on the ward that we noticed Mabli’s breathing seemed a bit funny. We knew that newborn breathing could be erratic, and normally I am that awkward person who hates bothering people, but we were surrounded by medical professionals so we asked someone to look at her.

• After initially being told she was fine, we asked again, and an amazing Midwife pushed on our behalf – she took Mabli away for some tests, and discovered that Mabli was ‘grunting’, the medical term for laboured breathing.

• It spiralled from there. Mabli was put on intravenous antibiotics immediately, despite not knowing yet what was wrong and by that evening – her first night on planet Earth – we were called into the family room (which is as ominous as it sounds) where we learned that Mabli was on a ventilator in intensive care, sedated.

• It turned out I was a carrier of GBS and Mabli had been infected coming down the birth canal.

• Being colonized by GBS bacteria is mostly harmless in adults, but it can infect the blood, lungs and spine of newborn babies which can be extremely dangerous, and indeed, fatal. While the consequences are very serious, I want to stress again that the likelihood of this happening is extremely low.

• Expectant mothers can be tested for GBS in late pregnancy, between 35 and 37 weeks. If you are a GBS carrier, you can be given antibiotics intravenously during labour to prevent an infection in your baby.

• A GBS infection in a baby most often presents as sepsis, pneumonia or meningitis. The majority of babies infected by GBS will show symptoms within hours or days of life. Signs to look out for in your baby are:

  • Grunting, noisy breathing, moaning, seems to be working hard to breathe when you look at the chest or tummy, or not breathing at all.

  • Being very sleepy and/or unresponsive

  • Inconsolable crying

  • Being unusually floppy

  • Not feeding well or not keeping milk down

  • A high or low temperature and/or be hot or cold to the touch

  • Have changes in their skin colour (including blotchy skin)

  • Have an abnormally fast or slow heart rate or breathing rate

  • Have low blood pressure (identified by tests done in hospital)

  • Have low blood sugar (identified by tests done in hospital)

• • It is important to be vigilant in the first few hours after birth. It is also important to remember that the chance of GBS infection is incredibly low.

  • A friend had told me about GBS during my pregnancy. I even asked my Midwife about it, who explained that the NHS don’t routinely screen pregnant ladies for GBS for various reasons. Firstly, the statistics (the high percentage of carriers – 20-25% – versus the likelihood of infection – 0.06%) mean that routine screening would result in a large proportion of women being treated, even though the likelihood of illness to their baby is statistically minimal. Secondly, results can change, so screening is not entirely reliable. As I understand it, you can test negative for GBS even when you are actually a carrier. These statistics show that routine screening would result in many more medicalised births due to the prophylactic antibiotics needed. Finally, some people can react badly to antibiotics, and there is also the wider issue of antibiotic resistance.

  • My Midwife gave me the option to be tested and I decided not to. I accepted her explanation for why women aren’t routinely screened, and I wanted the best chance to give birth at home without intravenous antibiotics if I could.

  • GBS screening – and the lack of it within the NHS – is understandably an emotive topic. There are people campaigning for better awareness and easier access to testing, as well as some who say that the development of a vaccine would be the best solution. I am not  lobbying for anything here as it is a complex issue. I made the decision that was right for me at the time, and ultimately women should have the information to make their own choices too.

  • Mabli responded extremely well to treatment and got better very quickly. She was in NICU at Homerton Hospital in London for 5 nights, before being moved to the Special Care ward for a further 2.5 weeks. We were so very lucky.

  • We spent 3 weeks in hospital in the end – which is how long her course of antibiotics lasted. She was visibly fit and healthy after about a week.

  • I was lucky enough to stay with her at the hospital, which meant I had the best chance of establishing breastfeeding. It was an experience in itself: sleeping on a ward with a new baby, with other crying newborns beyond our curtain, machines beeping, nurses chatting, whilst figuring out breastfeeding.  So intense. The hardest bit was leaving her in her cot three times a day so that I could feed myself at the canteen.

  • I got through the longest three weeks of my life with the unwavering support of my partner Sam, plus the kindest words, gestures and cuddles from family and friends that are stored in my heart forever.

  • I still think about the other parents that I met during that strange time living in the hospital.

  • The staff in the NHS are remarkable, and I spent a lot of time sitting on my camp bed during feeds thinking how utterly gruelling it must be to work a night shift; how strange to have such a massive weight of expectation on you; and just how very, err, intense, it must be to work every day in intensive care, with people who are (understandably) hyped to the eyeballs with stress. Not every interaction I had was perfect – a particular low being one of the nurses tucking into a bag of snacks my friend had left for me at the nurses station – but the good far outweighed the bad. (She apologised profusely!)

  • I particularly want to shout-out to nurse Egle, who single-handedly saved my breastfeeding career by telling me one quiet, sunny Saturday on the ward that I was ready to exclusively breastfeed. No more feeding every three hours by the clock, no more reporting to the nurses and no more being asked ‘how much do you think she’s had, so I know how much formula to top up with?’ which is about the most stressful question it is possible to ask a new breastfeeding Mama. Breastfeeding is no joke, and this vote of confidence was so timely, so needed and so helpful.

  • Of course, this was all a minuscule price to pay for Mabli’s health. Despite being very unlucky that she got sick, my overriding feeling is that we were very very lucky: that she was treated so quickly, that we were in a hospital despite the home birth, that she was a good birth weight, and ultimately, that we didn’t have to decide whether or not to get her breathing checked whilst at home, on our own and exhausted with an hours-old baby.

  • We celebrated her first birthday this summer, and she is a smiley, sociable and curious one year old, with no lasting effects from the infection.

  • I am not an expert on GBS but wanted to share our story to spread awareness about how this infection can affect babies.

  • Here’s what the NHS says on GBS: https://www.nhs.uk/conditions/group-b-strep/

  • Here’s a charity campaigning to spread awareness of the issues surrounding GBS: https://gbss.org.uk/about/who-we-are/why-gbss-exists/
  • I remain a massive advocate of home births, and found this group very supportive: http://hackneyhomebirth.tumblr.com as well as the Hackney Homebirth Team.

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