Why We Need to Be Talking About Group B Strep
By Emma Reed
Group B Strep was one of those words I had remembered hearing during my first pregnancy but it wasn’t ever something I looked into and it certainly wasn’t something that was ever explained to me. As that pregnancy was straightforward I had no concerns that my most recent one would be any different… I couldn’t have been more wrong.
I had noticed small differences such as my sickness being worse than the first time around, feeling more tired and drained and quite often very breathless but I put most of this down to the fact that I was that little bit older, that it could possibly be a girl (a difference in hormones) and that I was running around after a three-year-old.
One evening (at week 24) I was napping on the sofa and felt 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 in blood. My first thought was that this was it, I was losing the baby I had so desperately wanted and panic came over me. I phoned the hospital and took myself straight up there. However, my worries were soon washed away as the bleeding hadn’t continued and the midwife told me that some women do have unexplained bleeding, perhaps from the cervix as it comes under pressure from the growing baby. I went away relieved but wary.
A few days later the same thing happened again. It was the same time of day and, again, I had been feeling utterly exhausted. 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.
The bleeding continued
A few more days passed and a trip to the toilet led to me 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, to my surprise, wasn’t at all concerned. She asked if there had been more bleeding, which there hadn’t been and my waters hadn’t broken either. Apparently, the plug can go sooner but it can also grow back so it isn’t always something to worry about.
As the weeks passed I was seeing more mucus-like discharge in my knickers which varied in 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, in my first pregnancy, I had never experienced any of this. I had no bleeds, no unusual discharge, no smell and my plug only came away before labour began. 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 and the fact I wasn’t quite right down below, I decided to push them to do tests.
They agreed to do a swab at the hospital and it was sent off for analysis. 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. As I mentioned before, I had heard of it but really had no clue what it was, what it meant for me and my baby and why I had it.
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 any issues. However, 1 in 4 women have it in their vagina and if they are pregnant it can be passed to the baby during labour as they pass through the birth canal. It is dangerous to a baby as the infection can enter their body via their nose and mouth which can lead to respiratory issues, meningitis or pneumonia. It is also linked to miscarriage and stillbirths. There is no treatment for it at the time because it may go with antibiotics but it could return later in the pregnancy and you wouldn’t know as they don’t test for it again. The only course of action is to provide IV antibiotics as soon as labour begins in order to protect the baby.
“Overall, even with current prevention strategies, approximately 1 in every 1,000 babies born in the UK develops group B Strep infection.”
Group B Strep Support Website
I was told that it was symptomless… this I do not personally agree with and I am adamant that my exhaustion and breathlessness were both caused by this infection. I was also told that it wouldn’t affect my pregnancy, another ‘fact’ which I do not agree with. And you will see why…
In week 30 of my pregnancy, I was standing in the kitchen talking to my husband 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 about 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. Nothing else came during the rest of the evening but I went to bed with a pad in just in case. At 2 am I woke. The bed was soaked. We raced to the hospital expecting labour to shortly follow. The midwife carried out a simple swab test to see if it was my membranes and sure enough, it was.
I was kept in hospital for a few days to be monitored, to begin antibiotics to protect the baby and to have steroids to develop the baby’s lungs in case he came prematurely. With no signs of labour, I was discharged but was told to take it very easy and not do anything that could start things moving!
It wasn’t easy to deal with
It was tough. Having a very active three-year-old, having to take him to pre-school and activities, worrying about the baby I was carrying and being checked 3 times a week by the hospital all wore me out. My waters continued to leak but thankfully they weren’t gushing. However, one Saturday morning I reached up for something in the kitchen and the floor was suddenly covered in fluid. Another trip to the hospital found everything was still ok and again I was sent home. On the Monday I went back in for a scan 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 on the CTG, had my blood pressure taken, temperature checked and all seemed well with him still so I was told to wait until Thursday when I could see the consultant. He would then make a decision about when I would need to be induced as the baby could not go to full term.
And then he arrived!
Well, I didn’t quite get that far because the following day I woke aching, shaky and feeling generally unwell. I took myself back to the hospital (my second home it would seem!) 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. 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 at 9:36pm. He was 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 the problem. We soon realised that the baby had to make his exit in order to survive.
And this is where everything points back to Group B Strep. Not only did I have symptoms, I then went on to have bleeds, premature rupturing of the membranes which then led to an infection which led to a premature birth. And yet we 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.”
Why the NHS don’t screen for GBS
The reason they don’t screen? The NHS give reasons such as costs, most babies do not contract it, 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 number of people who are becoming resistant to them.
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 having my tiny baby taken away from me as soon as he was born and him having to spend 3 weeks in neonatal care has all been one of the worst and most emotional times of my life. I am so incredibly grateful that he is here safe, GBS free, and for all the work that the medical staff did to save him but as I sit and write this he has still not even reached his due date and I know that there could still be further issues from being born so soon.
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 certain changes and a detailed leaflet/booklet about Group B Strep and what it may mean for them.
But more importantly, I think that more needs to be done about Group B Strep and that routine screening needs to be reconsidered by our NHS. Find out more about GBS by going to http://gbss.org.uk/.