Why There Needs to be More Awareness of Group B Strep
Group B Strep.
It’s one of those words I remembered hearing during my first pregnancy but it wasn’t ever something I asked more about and it certainly wasn’t something that was ever explained to me. As that pregnancy was straightforward I had no concerns that the next would be any different… I couldn’t have been more wrong.
There were these small differences. My sickness being worse than the first time around, feeling far more tired and drained plus I was often very breathless but I put most of this down to the fact that I was that little bit older and that I was running around after a three-year-old. Which is what all the medical professionals said too… ‘You’re doing too much, slow down a bit, rest more’.
However, one evening, at 24 weeks gestation, I was napping on the sofa when I suddenly woke and had a huge urge to go to the toilet. After I’d been I went to pull my knickers up but I noticed they were covered with blood. My first thought was that this was it, I was losing the baby I had so desperately wanted. Panic washed over me. I phoned the hospital and on their instruction, I took myself straight up there. I was assessed and was simply told that it was a very small bleed and these things can happen. I was sent home and told to keep an eye and return if it occurred again.
A few days later the same thing happened again. It was the same time of day and, again, I had been feeling utterly exhausted– as I had been a lot more lately. I rang the hospital to let them know but as it was exactly the same as before I decided to remain at home to watch for any changes. Needless to say, nothing happened and there was no more bleeding.
A few more days passed and a trip to the toilet led me to realise that I had lost my mucus plug. I was only 26 weeks pregnant and very aware that the loss of the plug is usually followed by the arrival of a baby! I contacted my midwife who wasn’t very concerned at all. She asked if there had been more bleeding, which there hadn’t been and my waters hadn’t broken either. I was told that it was also something that could just happen.
As the weeks passed I was seeing more and more mucus-like discharge in my knickers which varied in its colour and consistency (sorry for the detail but I feel it is important to cover everything). I repeatedly asked the midwives about it and I was told it was normal over and over. Yet, I wasn’t a first time Mum and I hadn’t experienced any of this when I was carrying Jake. There were no bleeds, no unusual discharge, no smell and my plug remained intact until the night before labour. Now, I feel this point is also important because had this been my first pregnancy I would have taken their word for all of this and just carried on as I was. However, feeling that I was still far too tired, I was breathless and nobody knew why plus with the fact that I wasn’t quite right down below, I pushed for tests to be carried out.
They took a swab at the hospital which was then sent off for analysis and a day or so later I received a phone call from a midwife who sounded concerned. It turned out that I had tested positive for Group B Strep (GBS).
She explained that it is a bacterial infection which is usually found in the gut and those who have it don’t even realise they do because it usually doesn’t cause them any issues. I was told that I would need to go into hospital as soon as labour started to ensure that I received IV antibiotics as soon as possible which would protect my baby. She also said she would send me some information in the post as well as a sticker to go on the front page of my notes. That was it. The extent of the information I was provided regarding this infection and no, no follow up appointments or checks were made.
However, during my own research, I discovered that 1 in 4 women have Group B Strep in their vagina and if they are pregnant it can be passed to the baby during the birth (if it is vaginal and they are out of their sac). It is dangerous to a baby as the infection can enter their body via their nose and mouth leading to respiratory issues, meningitis or pneumonia. It is also linked to miscarriage, stillbirths, the breaking of waters and premature births, although not one person told me this. There is no treatment for it at the time because even though these may treat it completely at the time, it could return later in the pregnancy and you wouldn’t know as they won’t test for it again which is why the only course of action is to provide IV antibiotics as soon as labour begins in order to protect the baby.
I was told that it was symptomless. I do not personally agree with this. I am adamant that my exhaustion and breathlessness were both caused by this infection as were the bleeds and loss of my mucus plug. What other explanation was there? I was also told that it wouldn’t affect my pregnancy, another ‘fact’ which I do not agree with.
Here is why…
There go my waters
In week 30 of my pregnancy, I was standing in the kitchen when I thought ‘uh-oh, I’ve just wet myself!’ Which was very unusual for me. I went to the toilet and sorted myself out only for it to happen again approximately 10 minutes later. At this point, I told my husband that I thought my waters had broken, although we were both unsure because I wasn’t very far gone. I spent the evening waiting for something to happen but everything seemed normal so I went to bed. At 2 am I woke to find that the bed was soaked. We phoned the labour line who urged us to get to hospital to be checked. I was sure that labour was going to start shortly…
By the time we had a babysitter (family are amazing at 3 am, aren’t they?!) and made it to the hospital nothing was happening, thankfully. The midwife carried out a simple swab test to see if my membranes had broken and sure enough, it was.
They kept me in hospital for a few days for monitoring, to begin antibiotics to protect the baby and to administer steroids to develop my baby’s lungs in case he came prematurely. With no signs of labour, I was discharged (with my waters still leaking) but was told to take it very easy and not do anything that could start things moving… easier said than done with an active 3-year-old at home!
I kept a close eye on the amount I was losing but there was no ignoring the fact that I soaked the kitchen floor one Saturday morning. Another trip to the hospital, more checks and yet again I was sent home and told to rest. I went back in for a scan the following week to check how much amniotic fluid the baby had around him– it wasn’t much and my bump had visibly decreased in size. I was monitored with the CTG, had my blood pressure taken, temperature checked and all seemed well with the baby so I was told to wait until Thursday when I could see my consultant and he would then make the decision about when I would need to be induced as I wouldn’t be able to carry him to full-term.
Well, I didn’t quite get that far… the following day I woke aching, shaky and feeling generally unwell. I took myself back to the hospital and asked to be checked. After 7 hours I was finally told I was being admitted as they believed I had some sort of infection, most probably urine. Throughout the day I’d felt as though I’d been having contractions but these weren’t displaying as ‘usual contraction pains’ so I was reassured they weren’t. I was taken upstairs to a room at 7:15pm where labour was finally recognised by a midwife and my baby made a swift arrival into the world at 9:36pm. He was exactly 8 weeks early.
As he was whisked away to the neonatal unit I was also kept in to be checked. My blood results came back shockingly high in infection markers which meant I had to be given 4 IV drips containing antibiotics to combat it. We soon realised that the baby had to make his exit in order to survive as my womb was no longer safe for him.
And this is where everything points back to Group B Strep. Not only did I have symptoms, I then went on to have two bleeds, premature rupturing of the membranes (PPROM) which led to an infection and premature birth.
And yet, we still do not routinely screen for this infection here in the UK.
“GBS is recognised to cause preterm delivery, maternal infections, stillbirths and late miscarriages; preterm babies are known to be at particular risk of GBS infection as their immune systems are not as well developed.”
The reason they don’t screen?
The NHS list reasons such as costs, that most babies do not contract it, that it may do more harm than good to swab a pregnant woman and as too many antibiotics are already taken each year, they would be adding to the resistant problem.
I understand all of these points, I really do, BUT having just experienced a very difficult pregnancy, a worrying one, a stressful one and then coping with everything that comes with having a premature baby, I have been on an emotional rollercoaster that I wouldn’t want to happen to other women, yet I know it will.
I truly believe that this infection needs to be taken much more seriously than it is at the moment and that pregnant women need to be given sufficient information on this subject as soon as they attend their first midwife appointment, including what to look out for, encouraging them to seek medical advice if they see particular changes and a detailed booklet about Group B Strep and what it may mean for them and their baby.
William on his due date
My story has a happy ending but there are many others that don’t. Group B Strep needs more awareness, it needs to be discussed and we need to prevent further deaths, disabilities and prematurity.
On average in the UK, at least
two babies a day develop a group B Strep infection
one baby a week dies from their GBS infection, and
one baby a week survives with long-term disabilities – physical, mental or both.
Have you ever heard of Group B Strep? Did you have it in your pregnancy? Do you think we need better screening programmes?
I’d love to hear from you and if you would like to see the test made routine here in the UK, GBSS (Group B Strep Support) have a petition running at the moment which you can sign here.
If you need support regarding any of the health issues I have talked about you can find plenty within the highlighted links in this post as well as more blogs on this website. Please feel free to message me at any time too.
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4 thoughts on “Why There Needs to be More Awareness of Group B Strep”
Yes it needs to be checked! I had my first in the US and at expecting my second in the UK. I enquired about my swab (having recalled from my previous pregnancy) and was told it isn’t necessary. I insisted I wanted it so was told I could arrange to have it privately done. I agree that all expecting mums should be swabbed. Even if most don’t have it, to miss the few that do and have a poor outcome is wrong. It is a simple swab and the cost of that swab is most certainly cheaper than antibiotics and later emergent care.
It just seems that here they are very laid back about it all whereas other countries treat it far more seriously. It needs to change.
I’m 20 weeks and have had a urine culture come back positive for GBS. I’ve simply been told “it’s nothing to worry about” and I’ll have IV antibiotics at the start of labour to protect the baby. This is my first pregnancy; I’d never heard of this before and I’m glad I’ve started reading around the topic – I’m symptom-free so far but I’ll definitely be asking more questions.
If it doesn’t affect you that’s great but if you start to see anything unusual definitely let your midwife know. Hopefully it will all be ok and as they know you can get your antibiotics. As I say in the post, I would never have realised that heavy discharge was an issue if I hadn’t already had a baby so it’s a case of looking for these new things. Good luck with the rest of your pregnancy xx