By now, you will have had many pregnancy appointments. There is one more test that will be offered to you between the 35th and 37th week of pregnancy, and which are not covered by public health insurance.
Midwife Amelie Suermann will tell us all about the test for B Streptococcus (GBS).
Amelie is a Berlin-based midwife with a Master of Science degree in Global Health. She works as one of the English-speaking midwives at Praxis Hebammenzeit in Friedrichshain. Amelie has a young daughter and is about to become a mom for the second time!
B Streptococcus (GBS)
Group B streptococcus (GBS) are a bacteria that may naturally occur in the intestinal flora. They usually settle in the anal area and can migrate to the vagina and urinary tract. In German, they are called Gruppe-B-Streptokokken.
It is estimated that about 18% of pregnant people are carriers of GBS. There are no symptoms in most people that carry GBS and usually no illness is caused by it in people with healthy immune systems.
However, if GBS is transmitted to the infant during birth, there is a 1-2% chance that the baby may develop GBS disease. This is a serious infection that usually requires the baby to be hospitalized in the NICU and be treated with antibiotics.
To avoid the colonization of the baby with GBS and to lower the risk of GBS disease, it is recommended that pregnant GBS carriers are treated with antibiotics during labor. If the birthing person with GBS is treated with antibiotics during labor at least 4 hours before birth, the baby’s odds of developing GBS disease drop from 1% to about 0.2%.
Therefore, you may be offered a test between the 35th and 37th week of pregnancy to screen for GBS. This is done by a gynecologist or midwife who takes a swab from the vaginal and anal areas.
If you test positive for GBS, it will be noted in your Mutterpass and the recommended place of birth would be a hospital. Current guidelines recommend administering IV antibiotics during labor as a prophylaxis for GBS disease for GBS carriers, starting with the onset of regular contractions or after your water breaks. If you decide against testing for GBS, you are usually only offered antibiotics after your waters have broken for an extended period of time or if you develop signs of infection.
Testing for GBS is not mandatory. On the one hand, opting out of testing may avoid the unnecessary use of antibiotics during labor as the baby’s risk of developing GBS disease is only 1-2% in a positive result.
On the other hand, testing and the administration of antibiotics have proven to significantly reduce the risk for GBS disease in infants and GBS disease remains one of the main causes of severe infections in the newborn period. With this information in mind, you can discuss the topic with your care provider and make an informed decision.
If there is a suspicion of a possible B streptococcus infection, every insurance company will cover the costs of the test. Otherwise, you will pay for this privately (approx. €30-50).
Additional source: Frauenärzte im Netz: Ringelröteln in der Schwangerschaft
