As we approach International Prenatal Infection Prevention Month in February, we teamed up with Count the Kicks, a fellow charity we highly respect, to provide information aimed at educating and empowering mums to be.
Let us first remember and review that group B Streptococcus (GBS) is a natural and normal bacterium that colonises 20-30% of all adults (men and women) without symptoms or side-effects. It is usually found in the intestines as part of your normal gut flora. It can also found in the vagina living as a ‘commensal’ – an organism which lives in or on another without causing any harm. It is not a sexually transmitted disease and simply carrying GBS does not require treatment of the woman or of her partner. While this bacterium is normal and natural and does not require treatment on its own, in pregnancy it deserves more notice. There is a risk, if Mum is a carrier, of passing it on around labour, potentially leading to group B Strep infection in her baby. Group B Strep is the most common cause of life-threatening infection in newborn babies and of meningitis in babies up to three months. At least 500 babies a year in the UK become infected. One in 10 sick babies die, one in 20 survivors suffer long term problems, and five in 10 survivors of group B Strep meningitis suffer long-term mental and physical problems including cerebral palsy. Prevention is better than cure.
Even though routine antenatal screening for group B Strep is not recommended by the UK National Screening Committee nor the Royal College of Gynaecologists and Obstetricians, this does not mean that you can’t still ask to be tested. The two most common tests are the conventional NHS test and the ECM test. The ECM test is considered the ‘gold standard’ for detecting group B Strep carriage. The conventional NHS test will miss up to half of the women carrying GBS when the swabs are taken. If your NHS Trust does not provide ECM testing, you can order an at-home test pack from private labs for around £35. To support February’s Prenatal Infection Prevention Month, The Doctors Laboratory (TDL) is offering the ECM test for group B Strep for £29. Tel: 0207 307 7373 tdlpathology.com/
Thirty five to 37 weeks of pregnancy is suggested for testing, as the result of an ECM test done then has shown to be a highly predictive indicator of whether you will be carrying for the next five weeks when you’re most likely to go into labour. Please feel free to call us at 01444 416176 or visit our website (www.gbss.org.uk) for more information on where you can get the ECM test. UK guidelines recommend that, if you have had any positive GBS test result (from the vagina, rectum or urine) during your current pregnancy, you should be offered intravenous antibiotics from the onset of labour and then at intervals until delivery.
Luckily, the contribution of group B Strep to prenatal infection is fairly small. We would be remiss however if we didn’t point out that GBS is one of a number of bacteria found in the vagina that can cause infection in a baby while still in the womb, which can result in late miscarriage, stillbirth or a baby born very poorly indeed. However, thankfully these complications are not common and are usually caused by a variety of factors other than group B Strep, for example, genetic defects, gynaecological problems, other infections, etc.
Count the Kicks
Let’s focus now then on getting to know your baby, their patterns and movements in utero and how to ‘count the kicks.’ Most mums first begin to notice their baby stirrings around 18-20 weeks, but of course every woman and every pregnancy is different so it may be a bit later for some. *If you haven’t felt any movement by 24 weeks then contact your midwife to arrange an ultrasound to make sure all is okay.
The motion and movements may feel like kicks, flips, turns, and/or swooshes. (hiccups are not classified as movements) You can easily start to recognise your baby’s pattern by keeping a log of their activity, from when you feel first movement (say at 20 weeks) and then every few days. In the very beginning, the movements may seem a bit all over the map but you will soon discover your little one’s modus operandi. There is no set normal. Like we said, each mum, pregnancy and baby are different. Each baby’s pattern will vary…i.e. times of day when they’re particularly active and for how long. Baby generally won’t move during their sleep periods, and as you begin to learn when those might be you could sneak in a nap yourself! Just like there is no set normal for movement, there is also no set number of kicks you should be counting…there is no quota. “There is a common misconception that you should be feeling 10 kicks over a set period, this is no longer recommended as all babies are different…Baby’s movements can vary from 4 to 100 every hour so counting to 10 kicks would be irrelevant for most of the population.” – Countthekicks.org.uk. If you haven’t felt your baby move by 24 weeks, contact your midwife to arrange an ultrasound. There is a fabulous week by week guide on their website.
When to Call the Midwife
The N.I.C.E. Guidelines suggest “Any changes in fetal movements should be reported to a midwife or healthcare professional for further assessment”. The following is the list from Count the Kicks. If you can check the box next to one or more of these, then call your midwife.
•If you notice a change in your baby’s normal movement pattern
•If you have any itching or a rash
•If you have a temperature or fever
•If you have any pain including headaches
•If your vision becomes blurred or you see colours or patches
•If your hands or feet become swollen or painful
•If you have any fluid loss or bleeding
•If you have pain passing urine
•If you have a “bad feeling” or feel uneasy in any way
Remember too that even if you’re still unsure or just have a strange feeling, go ahead and call your midwife! Never go to sleep ignoring a change in your baby’s movement. That’s what your midwife is there for, so you are not wasting anyone’s time.
Knowledge is power, and the more parents-to-be can educate themselves the more empowered they feel. As we’ve covered above, just because group B Strep testing is not routine practice does not mean you can’t still ask for an ECM test or order one privately. If you test positive in your current pregnancy then UK guidelines state you automatically should be offered the option of antibiotics during labour. Also, tracking your cheeky little monkey’s movements and learning their definition of ‘normal’ will also empower you as a mum before they even arrive…safely and healthily!
For any further questions or concerns, please feel to contact either:
• Group B Strep Support | 01444 416176 | firstname.lastname@example.org
•Count the Kicks | 07961383699 | email@example.com