GBS-positive During Pregnancy: 3 Steps to Reduce Risks
Group B streptococcal infections during pregnancy can lead to complications. If there is additional risk, we recommend antibiotics during delivery. We do this, for example, when GBS has been found in your urine during this pregnancy, if you previously had a baby with GBS disease, in case of fever during delivery, with premature birth (before 37 weeks), or if your membranes have been ruptured for a long time (usually >18 hours).
In that case, you will deliver in the hospital. You will receive an IV with antibiotics: we start as soon as contractions begin or your membranes rupture and repeat this every 4 hours until birth. In the Haaglanden hospitals, you can often deliver with your own midwife; the nurse or gynecologist arranges the IV and medication. Be sure to also take a look at our final weeks page 37-42 Weeks.
Are you allergic to penicillin? Then we will discuss in advance with the hospital which alternative is suitable (based on the test results). We will clearly document this in your file.
What is GBS?
GBS stands for group B streptococcus, a bacterium that many people unknowingly carry in their intestines and sometimes also in the vagina. Being GBS-positive is not an STI and you usually notice nothing: no itching, no pain, no abnormal discharge. Carrying GBS can come and go during pregnancy. For you, it is usually harmless, but during delivery the bacterium can sometimes be transmitted to your baby. This can cause an infection in a small percentage of newborns (such as pneumonia or bloodstream infection). With antibiotics during delivery, we significantly reduce this risk. Outside of delivery, treatment is usually not necessary, except when GBS in the urine causes a bladder infection.
The Risks of GBS
GBS is usually harmless for you, but in rare cases the bacterium can cause an infection in your baby. This happens mainly in the first week after birth (so-called ‘early-onset’), sometimes later in the first three months (‘late-onset’). Without antibiotics during delivery when there are risk factors, this chance is higher. A GBS infection can manifest as blood poisoning (sepsis), pneumonia, or meningitis. After birth, watch for signs such as lethargy, poor feeding, rapid or grunting breathing, a grayish color, fever, or low temperature. If you see this, call your midwife or the hospital immediately.
The good news: with quick recognition and treatment, most babies recover completely. For you as a mother, GBS without treatment can sometimes cause a bladder infection, and after delivery a uterine or wound infection (for example after a cesarean section). Therefore, we recommend antibiotics during delivery when there is reason to do so according to policy; this way you significantly reduce the risk for your baby and also minimize your own chance of complications.
Care for your Baby after Birth
After birth, we monitor your baby extra carefully. What we do exactly depends on the overall picture: was your baby born on time or prematurely, how are the temperature and breathing, and when and for how long did you receive antibiotics? Based on this, we decide whether your baby will be observed on the ward for a while. If everything looks good and the preventive antibiotics were given on time, you can usually go home with clear instructions on what to watch for. In case of doubt or if your baby has symptoms, the pediatrician can quickly assess your baby.
What Can You Do Yourself?
- Call immediately at the start of delivery or when your membranes rupture and you are GBS-positive, even at night. Then we will arrange when to go to the birth center and start the antibiotics.
- Document your allergies (e.g., penicillin) and previous experiences in your birth plan and discuss this with us during check-ups.
- Watch your baby during the postpartum period: drowsiness, grunting/rapid breathing, temperature (too high/too low), poor feeding, grayish color → call immediately. Our maternity care assistants also monitor this closely.
The Hague Agreements (VSVs the Hague and Surrounding Areas)
In The Hague, the birth care teams (VSVs, such as HMC and Haga Juliana Birth Center) work with the same clear agreements, based on the national guideline (NVK/NVOG/KNOV).
If you have additional risk of GBS transmission, we give antibiotics during delivery: we start as soon as your contractions begin or your membranes rupture and repeat every 4 hours. You will receive clear instructions on what to watch for in your baby. Practical matters may vary slightly per hospital (for example, ward or discharge criteria), but the policy is the same everywhere. We document your personal plan in advance in your file, so everyone knows what to do and the best care can be provided.
Do you have doubts when your delivery starts or with ruptured membranes and you are GBS-positive? Call us immediately, so we can start the antibiotics on time.
Frequently Asked Questions
Is GBS an STI or "Contagious Disease" for My Environment?
No. Being GBS-positive (or carrier of the GBS virus) is part of the normal flora of many people and has nothing to do with sexual transmission. We are concerned about contact during birth and the risk for newborns.
May I Deliver in a Bath or Shower with GBS?
Often yes, as long as we can ensure timely start of antibiotics and there are no other medical reasons to advise against it. We coordinate this in advance with the hospital team.
Can I Have a Home Birth if I Am GBS-positive?
Home birth is sometimes possible if you are GBS-positive, but we usually recommend the hospital if you need antibiotics during delivery. In the hospital, we can give the antibiotics through an IV and monitor your baby closely. In The Hague hospitals, you can deliver with your own midwife.
What are the Symptoms of GBS?
In pregnant women, GBS carriage is usually without symptoms. If there are symptoms, it often involves a
