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Do you have options if you have tested positive for Group B Strep in pregnancy? Below is a table with information from the CDC and what the CDC recommends regarding Group B Strep in pregnancy. Also, included are alternative treatments, natural remedies before labor begins and options for what to do about your Group B Strep during labor. None of the alternative or natural remedies have been scientifically proven. The alternatives are commonly used by some home birth midwives and by some pregnant women who are allergic to particular antibiotics or believe strongly in natural remedies for Group B Strep. Others have used the natural remedies and alternatives for Group B Strep in pregnancy because they feel strongly against the overuse of antibiotics and the harm the overuse may be causing.

This information is not a prescription for your individual case. All information should be thoroughly researched by you, the reader, and consult with your licensed care provider.

Group B Streptococcus CDC Recommends Alternative Treatments Prior to labor Nutritional

This is NOT a Prescription for your particular case. You should contact your care provider

Alternative Treatments

In Labor

Group B (GBS) is a type of bacteria that can cause illness in people of all ages. In newborns, GBS is a major cause of meningitis, pneumonia, and sepsis (CDC 1996; CDC 2005; CDC 2009).Group B strep lives in the intestines and migrates down to the rectum, vagina, and urinary tract. (Johri et al. 2006). Women can test positive for GBS temporarily, on-and-off, or persistently (CDC 2010) The “universal approach.” Screen all pregnant women at 35-37 weeks and treat everyone who is positive with antibiotics during labor (this is the method that is currently used in the U.S.)

The“risk-based approach.” Treat laboring women with antibiotics if they have one or more of these risk factors: GBS in the urine at any point in pregnancy, previously gave birth to an infant with early GBS infection, goes into labor at less than 37 weeks, has a fever during labor, or water has been broken for more than 18 hours (this is the method that is currently used in the United Kingdom)

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm?s_cid=rr5910a1_w

Lavender essential oil (therapeutic grade) – 2-3 drops in a 25cc syringe applied vaginally as a shallow wash

 

Re-test in two weeks if time allows

 

This is NOT a Prescription for your particular case. You should contact your care provider

Grapefruit Seed Extract (GSE) – orally, liquid or tablets, 10-20 drops or 1-2 tablets and 1 tablet vaginally at bedtime (do not use liquid in the vagina, only tablets!)

 

Increase probiotic (fermented) foods in the diet (miso, tempeh, yogurt, sauerkraut, etc)

 

Chlorohexidine – 3 oz  diluted in 1 liter of water, administer a shallow douche every 6 hours in labor.

This is NOT a Prescription for your particular case. You should contact your care provider

Premature Rupture of Membranes (before labor begins) Options For Waiting To Go To Your Birth Place Options Nutritional Options In Labor
CDC recommends that antibiotics be given every 4 hours, starting more than 4 hours before birth. Many women who have an allergy to penicllin can take Cefazolin instead. One advantage to Cefazolin is that (like penicillin) it crosses the placenta and reaches the fetus’s bloodstream http://evidencebasedbirth.com/groupbstrep/  Go to birthplace as soon as water breaks to start antibiotics.

 

Wait until you’re in active labor because First time moms were reported the first stage of labor lasts about 6-12 hours from the time they are four centimeters, average was 7.7 hours. The longer labors were just over 17 hours. Second (or more) time moms reported average in older data was 5.6 hours. On the long end, second moms were near the 14 hour mark. This is based on data from the1960s http://pregnancy.about.com/od/laborbasics/f/lengthoflabor.htm .

 

Chlorhexadine (aka Hibiclens) is a topical disinfectant that kills bacteria on contact. It binds easily to the skin and mucous membranes. In the vagina, the anti-GBS effects of chlorhexadine last from 3-6 hours.  

 

probiotics (lactobacilli) In several studies, researchers found that the lactobacilli strongly inhibited the growth of GBS by increasing the acidity of the environment. (Acikgov, 2005– article in Turkish; Zarate, 2006). Ampicillin,Erythromycin, or Clindamycin (CDC)  – Administered IV every 4 hours from onset of labor or rupture of membranes until delivery

Maternal IV may be continued until 3 postpartum doses are given, providing maternal temperature is normal (AF)

Antibiotics, Oral – (Not considered standard of care due to inadequate absorption during labor)

 

This is NOT a Prescription for your particular case. You should contact your care provider or an experienced naturopath or midwife for your particular case. This is a list of OPTIONS in general: Group Beta-strep Treatment Options Handout
Available Treatment Options:
Prevention / Non-Antibiotic Prenatal

  • Homeopathic Streptococcinum
  • Naturopathic herbal suppositories (Midwife Medicinals) – 1 nightly x 14 days
  • Increased Vitamin C
  • 500mg Bioflavinoids (to increase strength of amniotic sac)
  • Echinacea tincture orally (is specific to staph and strep infections)
  • Herbal Peri Rinse (Midwife Medicinals) or make your own Echinacea vaginal wash – administer as a shallow vaginal douche with bulb syringe 1-2x’s daily
    • (infusion – 6 bags of Echinacea tea or 6 droppers full of Echinacea tincture to 1 quart boiling water, steep for 10 hours)
    • Add Propolis tincture – 40 drops and garlic oil – 5 drops
  • After shallow douching follow with acidophilus vaginally
  • Propolis tincture orally 15 – 20
  • Grapefruit seed extract 20 drops in citrus juice two times daily or 1-2 tablets and 1 tablet vaginally at bedtime (do not use liquid in the vagina, only tablets!)
  • Red Lapacho (Pau d’ arco) tea – 2 or more times daily or as desired
  • Treating partner (as above)
  • Lavender essential oil (therapeutic grade) – 2-3 drops in a 25cc syringe applied vaginally as a shallow wash
  • Increase probiotic (fermented) foods in the diet (miso, tempeh, yogurt, sauerkraut, etc)
  • Re-test in two weeks if time allows

Newborn Treatment

  • Careful observation of respirations, heart rate, temperature, nursing, tense fontanels, leg stiffness and alertness of baby.
  • In both early (mean age 20 hours) and late (mean age 24 days) onset GGBS, intensive IV antibiotic therapy with ampicillin or penicillin is recommended for 10 – 14 days (AF)
  • Antibiotics IV – Penicillin, Gentamycin within 1 – 2 hours after birth, in healthy babies, has been shown to be effective in preventing infection, however, up to 2/3 of sick newborns are born with well established infections.  (This treatment is not effective for babies weighing less than 4lb. 7oz. (2,000 g).
  • Echinacea tincture prophylactically to a healthy newborn: 1 drop of tincture per 5 pounds of body weight every 3 hours.(AF)

What are the risks of treating with antibiotics?

  • Allergic reaction
  • Thrush/yeast infection

http://www.cdc.gov/groupbstrep/index.html

What are the risks of treating with herbs/non-allopathic measures?

  • Allergic reaction

Resources:http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm?s_cid=rr5910a1_w

http://pregnancy.about.com/od/laborbasics/f/lengthoflabor.htm

http://evidencebasedbirth.com/groupbstrep/

Christa Novelli
Mothering Magazine, Issue 121, Nov/Dec 2003

http://www.homebirth.org.uk/gbs.htm

http://www.mayoclinic.org/tests-procedures/group-b-strep-test/basics/definition/prc-20014969