Caesarean sections are not recommended as a means of preventing group B Strep infection in babies since they reduce but don’t eliminate the risk and they pose their own risks for Mums and babies.
When you’re having a planned Caesarean section (before waters break and before labour starts), you should be offered board-spectrum intravenous antibiotics at the time of the operation – these are effective against a wide range of bacteria, including group B Strep. In this situation, our Medical Advisory Panel’s view is that additional antibiotics specifically against GBS infection developing in your newborn baby are not recommended. When a planned Caesarean section takes place before waters break or labour starts, the risk of the baby developing group B Strep infection is so low that additional antibiotics specifically against GBS infection are not recommended.
The chance of a baby developing a GBS infection both before labour starts and before the waters have broken is very small. And for this to be happening just as you are about to have an elective Caesarean section is even smaller. Our Medical Advisory Panel has carefully considered the evidence, looking at the balance of the potential risks and the potential benefits of having additional antibiotics at that point and don’t recommend it.
If you are having a Caesarean section, our medical panel’s recommendations with regard to GBS are as follows:
Elective Caesareans If a baby is at higher risk of developing GBS infection and the mother is having an elective Caesarean AND is in labour OR her waters have broken, the mother should be offered the recommended intravenous antibiotics as soon as possible after the start of labour or waters breaking. The baby would only need intravenous antibiotics against GBS infection if born preterm or if there are signs of possible infection in either the mother or the baby
Emergency Caesareans If a woman carries GBS or has previously had a baby infected with GBS and needs an emergency Caesarean, she should be treated as for an elective Caesarean – no intravenous antibiotics are indicated against GBS unless she is in labour or her waters are broken. If she is in labour, she should be treated as for a normal labour up until the time when an emergency Caesarean section becomes necessary, when she should be delivered immediately.
For more information about the latest clinical guidelines on preventing group B Strep infection in babies, plus our new leaflet, visit www.gbss.org.uk/RCOG from which you can read and download both.
Every pregnancy is different. Please discuss your individual circumstances with your consultant and explain your concerns, so you can work together on a plan that you’re all happy with. We at GBSS can only provide general information, we can’t give medical advice.