Group B Strep in Pregnancy: What You Need to Know About GBS Testing

Pregnancy comes with so many new terms, acronyms, and decisions—and one that often pops up late in the third trimester is Group B Strep (GBS) testing in pregnancy. If you’re between 35–37 weeks pregnant, chances are your provider will bring up this test and recommend a quick swab to check for the presence of GBS bacteria.

But what does this test really mean? How does it impact your labor and delivery choices? And most importantly—how can you feel confident making decisions about your own birth?

As a birth doula in Michiana (Northern Indiana & Southwest Michigan as well as Virtual Services), my focus is on empowering you through evidence, advocacy, and education. So let’s break it down!

What Is Group B Strep in Pregnancy?

Group B Streptococcus (GBS) is a type of bacteria that can naturally live in the digestive tract, vagina, or rectum. For most people, it’s harmless and doesn’t cause any symptoms. But during labor, GBS can sometimes be passed to the baby, and in rare cases, it can lead to infections like sepsis, pneumonia, or meningitis in newborns.

Because of this, many providers recommend routine GBS testing during pregnancy. This is typical across midwifery practices as well as OBGYNS, though the approach and emphasis to testing may slightly differ.

How GBS Testing Works

Between 35 and 37 weeks, your provider typically performs a vaginal and rectal swab. You can decline Group B Step testing, as with any procedure, however, I recommend asking your provider some more questions and knowing the full scope of you risk before doing so. It’s a quick test and you can ask your provider to do it yourself. Results usually come back within a few days.

• If negative: No antibiotics are usually recommended during labor.

• If positive: Standard protocol is to receive IV antibiotics during labor, usually every 4 hours until birth.

This is where informed choice comes in: while antibiotics can greatly reduce the risk of early-onset Group B Strep infection in babies, they also have potential downsides like disrupting the vaginal microbiome or limiting your mobility during labor. Ultimately, it is important to have all the information in order to make the right choice for yourself.

Evidence on GBS and Newborn Risk

The CDC and ACOG recommend universal screening at 35–37 weeks, followed by antibiotics during labor if positive. Studies show this reduces the risk of early-onset GBS disease in newborns by around 80%.

However, not all countries follow this universal approach. Some use a risk-based strategy—giving antibiotics only if risk factors are present (such as prolonged rupture of membranes, fever in labor, or history of a previous baby with GBS disease).

This tells us one important thing: there is more than one evidence-based way to approach GBS in pregnancy.

What Group B Step Results Could Mean for Your Birth

If you test positive for Group B Strep in pregnancy, here are some things to consider:

• Hospital Protocols: Most hospitals in the Michiana area follow CDC guidelines, which recommend IV antibiotics during labor. However, hospital policy is not the law and you ALWAYS have the right to accept or decline an intervention. This is where advocacy is key!

• Birth Center or Home Birth Options: Some midwives offer alternatives like risk-based screening or natural remedies to support microbiome balance.

• Mobility in Labor: Receiving antibiotics often means you’re connected to an IV, which may limit movement—though you can advocate for wireless monitoring, frequent position changes, and mobility-friendly IV setups.

• Water Birth: Some facilities restrict water birth for Group B Strep-positive clients, while others allow it. This is an important conversation to have with your provider early on so you know what your options would be if you testing positive.

  
  

Advocacy and Decision-Making

Here’s what I want every pregnant woman in Michiana to know: you are the decision-maker in your birth.

Testing is optional. Antibiotics are optional. Interventions are optional. Your care provider may recommend them—and you deserve to know the evidence, benefits, and risks so you can make the decision that feels right for you.

That’s where advocacy tools come in. In my Birth Advocacy Toolkit, I walk you through how to have these conversations with confidence, ask the right questions, and keep your values at the center of your care.

Your Sneak Peak at the Birth Advocacy Toolkit

Bringing It Back to You

At the end of the day, Group B Strep in pregnancy is one small piece of a much bigger picture. What matters most is that you feel informed, empowered, and respected in your choices.

Maybe you’ll choose antibiotics. Maybe you’ll take a risk-based approach. Maybe you’ll decline testing altogether. What matters is that it’s your birth, your baby, your decision.

Ready to Feel Confident in Your Birth Choices?

If you’re pregnant in Cass, Michigan, South Bend, Mishawaka, or the greater Michiana area, I’d love to support you. My work as a birth doula and pregnancy coach is rooted in advocacy, education, and unwavering support for your vision of birth.

✨ Grab your Birth Advocacy Toolkit today for less than the price of two lattes. It is jammed packed with more evidence-based guidance, real-life roleplay scripts for navigating conversations with your provider so you never are at a loss for words, and even a BONUS partner guide for your go-to birth buddy.

💬 Then, let’s connect.

Book your consult to learn more about my birth doula packages and pregnancy coaching support. Together, we’ll build the confidence and clarity you need to have the empowered birth you deserve.

References

• American College of Obstetricians and Gynecologists (ACOG). (2020). Prevention of Group B Streptococcal Early-Onset Disease in Newborns. Committee Opinion No. 797.

• Centers for Disease Control and Prevention (CDC). (2020). Group B Strep (GBS). Retrieved from https://www.cdc.gov/groupbstrep/index.html

• Verani, J. R., McGee, L., & Schrag, S. J. (2010). Prevention of perinatal group B streptococcal disease: revised guidelines from CDC, 2010. MMWR Recommendations and Reports, 59(RR-10), 1–36.