The Business of Being Born Message Board

Q: Does having a positive GBS (Group Beta Strep) rule out having a homebirth? If so, is there anything one can do to change that positive to a negative?

A: GBS can be treated at home, in the same way that it is treated in the hospital, which is by giving antibiotics intravenously according to protocols dictated by the Center for Disease Control. However as most of my moms would rather avoid an I.V. if possible, I have developed a protocol to be used at home that I think is superior to the methods used in hospital and allows for adequate treatment without an I.V. I have used this protocol now for 12 years without fail. I screen all of my patients at 35-37 weeks as recommended by the CDC. I screen differently than most practitioners who just identify if GBS is present. I have the lab do a culture and sensitivity, which means that if GBS is present, all of the antibiotics that can treat it will be listed. If this isn’t done, you can’t be sure that the gold standard antibiotic, penicillin, will even treat it. After that I determine a relevant treatment, as derived from the list. One of the antibiotics that usually works is available in a vaginal cream which can eliminate the need for an I.V. After we do the treatment, we conduct a test of cure to make sure that we did in fact eliminate the GBS. It is important to make sure that the GBS does not return.A reculture is done to make sure that the GBS does not return. There are many other methods that some midwives are comfortable with. Some of them involve vaginal and perineal washes with hibiclens, or vaginal suppositories with tea tree oil. I choose not to comment on these methods, as I have found a method that I feel offers minimal intervention with maximum safety. There are also some simple things you can do that could make your body over time, less likely to have GBS in the future.

Cara Muhlhahn, CNM
Cara Muhlhahn Midwifery, New York