What is GBS?
Group B Strep (GBS) is anaerobic bacteria that is usually found in the digestive tract. In 10-30% of pregnant women, it can colonize or grow in the vagina.

Why is GBS a concern during pregnancy?
Most women carrying GBS will have no symptoms. Carrying GBS is not harmful to you, but there is a small chance it can affect your baby around the time of birth.

How will I know if I have GBS?
GBS is detected by doing a vaginal swab and running a culture.  The recommendation is to test between 36 to 38 weeks gestation.

If I test positive for GBS, will I still have GBS when my baby is born?
GBS is transient so your status can change.  Up to 33% of women who test positive at 36 weeks may be negative at birth, and up to 10% of women who test negative at 36 weeks may be positive at birth. Without doing a rapid test (which is not the standard of care in the US), GBS status at the time of birth is unknown. For the clients I serve who test positive at 36 weeks, they have the option to repeat the test to see if their status has changed.  

What are the risks of GBS to my baby?
GBS can occasionally cause serious infection in newborns. Many babies come into contact with group B Strep during labor or around birth, and the vast majority will not become ill. Of Moms who test positive for GBS and choose not to have antibiotic treatment, up to 2% of babies born will develop a GBS infection. For Moms who test positive and choose to have antibiotic treatment, the risk of baby being infected drops down to .2 to .4%  If the GBS infection is not treated, babies can become seriously ill. With prompt treatment, most babies will make a full recovery, a small number of babies who are infected die. Early detection of GBS disease is vital so treatment can be started as soon as possible.

The two main types of GBS disease in newborns are:

• Early-onset GBS disease: Occurs within the first week of life and is more common. This is what GBS testing is focusing on preventing.
• Late-onset GBS Disease:Occurs 1 week to 3 months after birth and is less common.

How many babies die from early onset GBS disease?
Two to three babies (4 to 6%) out of 50 babies with early onset GBS disease will die.

What are the symptoms of early-onset GBS infection in newborns?

• Being floppy and unresponsive
• Grunting when breathing, or working hard to breathe when you look at their chest or tummy
• A high or low temperature
• Very fast or slow heart rate
• Very fast or slow breathing
• Crying and inconsolable

The overwhelming majority of babies with early-onset GBS disease are diagnosed within the first hour after birth, which indicates the baby was most likely infected before birth.

What is the treatment for GBS infection in babies?
The treatment for GBS infection in babies depends on the severity of the infection. Antibiotics are the main treatment for GBS infection. Antibiotics do not discriminate between strains of bacteria, so if you get IV antibiotics during labor, or your baby is given antibiotics after birth, I recommend taking probiotics to rebuild a healthy microbiome.

In Summary:
While the risk is low of a newborn getting a GBS infection, there is a risk and I want clients to be aware of that. I don't want any client to have a baby who gets GBS disease. I cannot provide antibiotic therapy, so if that is desired, we will work to transfer care for a hospital birth. I trust that clients are capable of weighing the risks and benefits and making the decision they are comfortable with and is best for their family. I will monitor baby for signs of GBS infection and make sure the client knows what to look for and how to access help if baby needs it.







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Can we talk? I think there's a myth that anything that comes up during pregnancy is because of being pregnant or should be handled by your maternity care provider. Pregnancy can bring some typical complaints and discomfort, but not everything that happens during pregnancy is because of being pregnant. Sometimes pregnant women can get sick and it has nothing to do with being pregnant.

My focus and expertise is on pregnancy, labor, birth and postpartum, so everything pregnancy and birth related. As a CPM in Kansas, I have to rely on holistic remedies to bring relief or resolve something. I cannot prescribe medications even if they are necessary to treat an illness that pops up during pregnancy.

If I have a client who has a urinary tract infection that is not resolving with herbal remedies, I will ask them to see their regular doctor. If a am working with a client who has extreme morning sickness that natural treatments aren't able to make manageable, I will encourage her to see a doctor. I have asked a client with heat exhaustion to see the doctor.  She needed IV fluids right away. I have had a client seek care with medical professionals who learned her symptoms were caused by food poisoning. Both these clients needed more help than I could provide. I do not take it lightly that I am asking someone to see a doctor.  If I am asking it is because I'm concerned that something is going on that needs more help than I can offer.

I am thankful that we have doctors, and can avail ourselves of their expertise when needed. I also appreciate when clients understand that we need more help and are willing to see their doctor. Not everything that happens during pregnancy is related to the pregnancy, and sometimes medical help is necessary.
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The wonder, and joy of feeling the first little flutters that you are sure is baby moving around is incomparable. It is amazing to have that intimate connection to your baby!

Just as we are all different, when baby movements can be felt will be different for each mother, and for each pregnancy.  Some Moms are so in tune with their body that they can feel the flutters around 14 weeks, and rarely, even earlier.  Other Moms may not notice the movements until 20 weeks or a little later, especially if the placenta is implanted on the front of the uterus. At first they feel like little flutters but as baby grows and gets stronger the flutters are replaced by kicks and punches. Once baby gets even bigger, those movements change to more rolling, nudging movements because there isn't room for baby to punch or kick as much.

Early in pregnancy, there may be days when you may not feel much movement from baby. This is normal.  As pregnancy progresses, baby's movements become more noticeable. Around 28 weeks gestation, babies have settled into a predictable movement pattern. I encourage clients to become familiar with this pattern.  

It is pretty common for baby to move more at night when you are laying down. As pregnancy progresses, it is my opinion that baby has more room when you are laying down compared to when you are standing or sitting so that is why they tend to be more active.  

Baby can be affected by how Mom is feeling. If Mom is dehydrated, or has a cold or other illness, baby's movements may be a little less or subdued. I have worked with mothers who just needed to eat, and then baby was ready to dance a jig. Sometimes Mom is up and busy and doesn't notice movements but when she slows down and focuses on baby, the movements are noticeable.
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Baby's movements can give insight into how baby is doing in utero, so it is important to pay attention to them. Changes in baby's movement pattern might mean something is happening that we need to check on, usually with an ultrasound. Significant changes in baby's movement pattern can indicate baby may need help to prevent a stillbirth, so get to know baby's movement pattern well. 

Sleep. We all need it and most of us would benefit from better sleep or more sleep. During pregnancy, getting good sleep or enough sleep can be challenging.  

Pregnancy can create new issues with sleeping. Trying to get comfortable, having to get up to go to the bathroom, having vivid dreams, and not being able to fall asleep again if waking up are common issues that can interfere with sleep during pregnancy.

Getting comfortable can be a challenge, especially if you are used to sleeping on your back. Pillows can be your best friend in this situation. Putting a pillow under a hip just enough to tilt you off your back can help in early pregnancy.  As your baby grows, having a pillow tucked behind your back, one between your knees, and one to support your belly may help you with being comfortable. I am a huge fan of the pregnancy pillows that surround you, almost like a nest. As pregnancy progresses, you might need more pillows for more support, or you might want your partner to tuck you into bed, helping get the pillows just right to let you sleep in comfort and bliss.

Vivid dreams can be something else that interferes with sleep. These dreams can be weird, intense or scary.  It seems like the mind goes into overdrive as you sleep, and you just don't feel as rested as you would with more normal dreams. Catnip tea, or Valerian tea are options to help you quiet your mind and let you have more restful dreams. Have a cup shortly before you go to bed.

If you are waking up often, or having a hard time getting to sleep in the first place, it might be time to add a snack to your bedtime routine. Sometimes your blood sugar can drop low enough that your body just isn't happy and it will wake you up or keep you awake. I recommend a protein rich snack such as nuts, cheese, or jerky before bed. If you fall asleep easily enough but can't get to sleep after waking up to go to the bathroom in the middle of the night, try adding in a small protein rich snack while you are up.

In the last trimester, many mothers can sleep but it is often interrupted by having to go to the bathroom multiple times in the night. Baby might be low enough to use your bladder as a pillow which means there's just less capacity in there. My suggestion for this situation is to set a cut off time for hydrating and focus on getting all your hydration in before that cut off time. Usually 2 hours before bed is plenty of time. Just make sure to start hydrating again as soon as you wake up for the day.

Hopefully, these ideas will having you sleeping through your pregnancy like a baby!