Let’s talk about your vaginal microbiome! While the gut microbiome has become a wildly trendy topic in recent years, the vaginal microbiota needs some catch-up. There’s lots to discuss about vaginal microbes, and we will. Right now this post is for you if you are pregnant or trying to conceive, and want to prevent or reverse a Group B Strept (GBS) positive test.
Who should care about GBS?
All pregnant women! GBS “colonization” is common, 1 in 3-4 women test positive. By the way, GBS is a normal bacteria that can live in your gut, bladder, or vagina, and is fine in tiny amounts. It is not fine if it over-populates during pregnancy, as your baby has a 50% chance of contracting it during delivery. 1 in 200 cases results in serious consequences for the infected baby, including meningitis, sepsis, pneumonia, or stillbirth!
If you test positive with a swab between week 35-37 of your pregnancy, in the U.S. and Canada you are advised to take IV antibiotics during labor. This lower the chances that your baby will contract GBS disease to 1 in 4000.
So since IV antibiotics lower the serious risks for your baby, why would you choose not to take them? In fact, 20-30% of women in developed countries get IV antibiotics during labor. Let’s explore the cons of antibiotics…
Why try to avoid IV antibiotics during labor?
The concerns here are the same as with antibiotics in general:
- Do they wipe out your beneficial bacteria for you and your baby?
- Will the antibiotics cause yeast overgrowth for you and your baby?
- How well do you tolerate antibiotics?
Some women want to reduce medical interventions during delivery, and let birth be as natural as possible. For home births, IV antibiotics are not always available.
What do we know?
GBS antibiotics, like all antibiotics, have a collateral effect on your beneficial bacteria. Therefore, the microbial seeding your baby gets during a vaginal birth is altered. So far, the limited research shows that in the short-term (up to 12 weeks), your baby will have fewer beneficial microbes and more undesirable ones. There is a delay for your baby in assembling his or her permanent (adult) bacteria populations. The longer your labor, and the more time on antibiotics, the longer delay your baby will have in assembling an optimal microbiota.
We also know that antibiotics during labor increase risks for candida overgrowth for mama and baby. This can cause sore nipples, thrush in the baby’s mouth, and difficulty with breast-feeding.
What can we guess?
We do not know the long-term effects of IV antibiotics on your baby’s microbiota. However, we do have evidence that C-section births, which also result in an altered microbiota, may have long-term effects. C-section births are correlated with increased rates of asthma, allergies, celiac disease, type 1 diabetes, and obesity. So, theoretically, because of an early altered microbiota, GBS-antibiotic babies may have similar long-term risks.*
Since long-term effects are unknown, why not be far more judicial in the use of antibiotics? A person’s permanent microbiota imprint is assembled in the first 3 years of life. Therefore, it simply makes sense to try to prevent interfering with this, if at all possible. And fortunately there are ways to do this!
*Let’s be clear that there are ways to boost baby’s microbiome in the case of needed antibiotics or C-section births:
- Breast-feeding helps baby recover a healthy microbiome.
- Oral probiotics for the newborn are another great option.
What can you do to prevent or reverse a GBS positive test?
Preventing GBS in advance is hands-down the best approach to avoid a positive test and potential antibiotics. It would be very difficult to decline antibiotics in a hospital setting, and most women wouldn’t want to take this risk anyway.
Prevention is all about optimizing your vaginal microbiome. Do this before getting pregnant if you can – especially if you get frequent vaginal bacterial infections or have genital herpes or another STD. You and your baby will benefit in ways beyond simply preventing GBS. You’ll seed your newborn with a better microbiome and thus a better immune system and metabolism.
What kind of flora does your vagina need?
Contrary to the gut microbiome, your vaginal flora should NOT be diverse! In fact, lactobacillus should be the dominant species. (The four dominant species are lactobacillus crispatus, iners, jensenii, and gasserii). Lactobacilli produce lactic acid, which keeps your vaginal pH an optimal 4 -4.5. GBS cannot live at this pH – they need a more alkaline environment.
Lactobacilli provide many other anti-GBS byproducts, and in the right numbers they provide good crowd control. A big part of GBS prevention, and treatment, is cultivating more lactobacilli. This is built into the following strategies..
Steps to prevent GBS
- Test your vaginal pH with home test strips like these. If it’s higher than 4.5, move to step 2. If it’s between 3.5 and 4.5, move to step 3.
- Use vitamin C in the form of ascorbic acid suppositories to lower your pH – so that GBS cannot survive. Use readymade suppositories or make your own, and use 1 per day for 6 days. Afterward keep testing pH and repeat if it drifts above 4.5. In addition, do step #3…
- Take oral probiotics shown to reduce, displace, or erradicate GBS. These strains are Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14. Take 2 caps orally every day, starting with your GBS positive test and continue until delivery. Better yet, start 4 weeks before your GBS test, and also insert one capsule vaginally (ok to do with the vitamin C suppository in step #2) at night.
You can ask for another GBS swab before delivery. There is also a rapid test you can do while in early labor. This test is actually more accurate, and cheaper than adminitering IV antibioics! However it’s not commonly used yet, and may not be possilbe to do at a home birth.
2. Take lactoferrin, an ideal source of iron in pregnancy AND decreases GBS levels. 1 capsule twice daily orally, and 1 cap vaginally at night. Brands:
3. Insert allicin, from garlic. Insert 1 gelcap or 1/2 fresh garlic clove (must be cut or pierced for allicin to release) every night for 4 weeks, then once every 3 days the rest of pregnancy. Allicin brand:
- Design’s For Health Allicin (prick the gelcap before insertion)
4. Wash with thyme tea. Brew thyme tea, and use as a vaginal wash instead of soap.
There are additional home remedies, for more complex cases, or if the above don’t work for you. Happy vaginal microbes!
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