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Written by

Roxanne Albert, BSN, RNC-OB

Group B Strep in Pregnancy: What a Positive Test Means

  • Medical, Pregnancy

Table of Contents

Welcome to the MamasteFit Blog! I’m Roxanne, a labor and delivery nurse and student midwife, and I’m going to be breaking down everything you need to know about group B strep in pregnancy, also called GBS or group beta streptococcus. You may be wondering why we test for GBS during pregnancy and if you’re positive, what that means for your birth and for your baby. Let’s dive right in!

What is Group B Strep in Pregnancy?

Group B Streptococcus (GBS) is a common bacterium found in the digestive and lower reproductive tracts of about 25% of adults. While it’s typically harmless to adults, it can pose risks during childbirth if passed to the baby, potentially leading to Early Onset GBS Disease. This condition can cause serious complications like pneumonia, meningitis, or even sepsis in newborns, particularly because their immune systems are still developing.

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The GBS Test

Testing for GBS usually occurs between 36 and 37 weeks of pregnancy. The test involves a quick swab of the vaginal and rectal areas, with results available within 48 hours. If the bacteria are present, the result will be positive. GBS can also be detected earlier in pregnancy through urine tests.

It’s worth noting that GBS colonization is transient, meaning it can come and go. Testing close to delivery helps provide the most accurate risk assessment for your baby.

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What If You’re GBS Positive?

A positive GBS test means your care team will likely recommend antibiotics during labor, specifically penicillin administered every four hours through an IV. This approach significantly reduces the risk of passing GBS to your baby. For individuals allergic to penicillin, alternative antibiotics are available based on sensitivity testing.

Without treatment, the risk of GBS transmission is 1-2 in 1,000 births. With antibiotics, this risk drops dramatically to 0.22 in 1,000 births. While the chance of transmission is already low, the potential severity of GBS Disease in newborns makes this a crucial conversation to have with your healthcare provider.

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Alternatives to Antibiotics

For those who prefer to avoid antibiotics, alternative options include:

  • Chlorhexidine Wipes: These can reduce GBS colonization during labor.
  • Probiotics or Garlic Treatments: Some anecdotal evidence suggests these may help prevent GBS colonization during pregnancy.
  • Enhanced Monitoring Post-Birth: Babies born to untreated GBS-positive mothers can be closely monitored for signs of illness in the first 48 hours.

 

Discuss these options with your provider to determine the best approach for your birth plan.

Recognizing GBS in Newborns

Early detection is vital. Symptoms of Early Onset GBS Disease often appear within the first hour of life but can also develop up to 48 hours after birth. Watch for:

  • Increased heart and respiratory rates.
  • Signs of respiratory distress (e.g., nasal flaring, grunting, or ribcage retractions).
  • Lethargy, poor feeding, or irritability.
  • Temperature instability.

 

If your baby shows any of these symptoms, prompt medical attention is crucial.

Making an Informed Decision

While GBS is rare, its potential consequences are significant. Understanding your options and the associated risks empowers you to make the best choice for your family.

For more information, check out Evidence Based Birth’s GBS article.

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Frequently Asked Questions

What causes strep B during pregnancy?
Group B strep isn't caused by anything you did — it's a common bacterium that naturally lives in the digestive and lower reproductive tracts of about 25% of adults. Colonization is also transient, meaning it can come and go on its own. It's typically harmless to adults; the reason we pay attention during pregnancy is the small chance of passing it to baby during birth.
How to reduce GBS in pregnancy?
Some families explore probiotics or garlic treatments during pregnancy, though the evidence for these is anecdotal, and chlorhexidine wipes may help reduce GBS colonization during labor. The most well-supported approach for a positive result is IV antibiotics during labor, which drops the transmission risk from 1–2 in 1,000 births to 0.22 in 1,000. Discuss these options with your provider to find the best approach for your birth plan.
What does it mean if my group B strep test is positive?
A positive result means the GBS bacteria were present on your swab — not that you or baby are sick. Your care team will likely recommend IV antibiotics (usually penicillin, given every four hours) during labor, which significantly reduces the chance of passing GBS to baby. If you're allergic to penicillin, alternative antibiotics are available based on sensitivity testing.
How is a strep B test performed during pregnancy?
The GBS test is a quick swab of the vaginal and rectal areas, usually done between 36 and 37 weeks of pregnancy, with results back within about 48 hours. GBS can also show up earlier in pregnancy through urine tests. Because colonization is transient, testing close to delivery gives the most accurate picture of risk for baby.
Can GBS in pregnancy go away on its own?
Yes — GBS colonization is transient, meaning it can come and go on its own. That's exactly why the test is done between 36 and 37 weeks: testing close to delivery provides the most accurate risk assessment for your birth. A positive result earlier in pregnancy doesn't necessarily mean you'll still be colonized at delivery, which is worth discussing with your provider.