Understanding Group B Strep and Placenta Encapsulation
What is Group B Strep?
GBS (Group B Strep) is a bacteria that's found in the gastrointestinal tract and genital tract. Estimates say that about 38% of adult humans are colonized with GBS bacteria.
Why are pregnant people tested for GBS?
Pregnant folks are tested around week 36 of their pregnancy to see how much GBS bacteria is hanging out in the birth canal. Providers want to know if mom is colonized, because if she is, it's possible the GBS bacteria could pass to her baby.
Babies, of course, are more susceptible to illness because they're born with immature immune systems that don't kick in fully until about 2-3 months out, so we need to be extra careful with them.
When a certain level of bacteria is reached, the pregnant person is considered "colonized". Being colonized is NOT the same as having an active infection... it just means that you are carrying the bacteria. Statistics show that about 20-40% of pregnant people are carrying GBS bacteria.
Important Note About Breastfeeding
Pregnant folks can pass GBS to their babies during the birth process but are still encouraged to breastfeed. GBS can show up in mother's milk, yet has never been reported to be risky. In fact, people are encouraged to breastfeed even when they have tested positive.
Testing Approaches
Universal Precautions (US Method)
Here in the US, they use universal precautions. That means that all people are tested between 35-37 weeks of their pregnancies and if they test positive for colonization (meaning there are enough bacteria present to register), they are treated with antibiotics during labor.
Something to consider is that the presence of GBS bacteria can fluctuate, so someone could test positive at 35 weeks and then negative at 37.
Risk-Based Method (Other Countries)
In many other countries, they use the risk-based method and only treat people with antibiotics during labor if one or more of these symptoms is present:
GBS in urine at any time during pregnancy
A previous birth in which the infant had a GBS infectionIf labor occurs before 37 weeks (because heavy colonization in the genital tract can cause preterm labor)
A fever during labor
If the birthing person's water has been broken for longer than 18 hours
The 2016 Oregon Incident
With work such as this, when one thing goes wrong, the entire industry is effected.
First, I want to be clear that I have processed hundred of GBS placentas without concern. None of my clients, GBS-positive or otherwise, have gotten sick from ingesting their placentas. None of their babies have gotten sick, either.
Most care providers have "allowed" their "patients" to have their own placentas without batting an eye when they've tested positive for GBS.
So the question is, why do some care providers discourage moms from consuming their placentas if they test positive for GBS while others see no risk? I'll go out on a limb and say it's mostly bias and personal opinion, but there is this one incident in 2016 when was an infant in Oregon who became infected with GBS. Twice.
The Incident Details
The first evidence of GBS infection came just hours after birth. The baby was treated for GBS with antibiotics at the hospital and sent home healthy.
Mom's placenta hadn't even left the hospital baby was already showing signs of infection.
Five days after being sent home healthy, the infant showed signs of illness again.
The baby was admitted to a different hospital, diagnosed with late-onset GBS infection, treated with antibiotics, and then sent home healthy.
The infant RECOVERED and, contrary to what many providers are telling their patients, the baby did not die. There is not a single documented case of anyone ever dying due to placenta pills.
Testing Results
The mother of this baby was tested for GBS at 37 weeks and her results were negative. Read that again: when this mom brought her baby home form the hospital in 2016, she had not tested positive for GBS.
Her breast milk was tested and GBS bacteria was not found in her breast milk. So there is no evidence that the infection actually came from mom.
Other family members were not tested.
Mom's placenta pills were tested and did in fact test positive for GBS, so it is possible that she was positive at the time of birth, but since her results were negative, she was not treated with antibiotics.
Analyzing the Possibilities
But how likely is it that mom’s consumption of her placenta pills caused the reinfection in her infant?
If the pills were the carrier, it’s highly unlikely that the GBS bacteria would survive the stomach acid in mom's gut. And since mom's breast milk tested negative, how would she even have passed it to her baby? If she had enough GBS in her system to pass on to her baby, then her breast milk levels would have been high enough to test positive.
Some other possible scenarios are that one of the family members was colonized and possibly took the pills from the jar and passed them to mom after not washing their hands after using the restroom (WASH YOUR HANDS, PEOPLE).
Even in the CDC article, it is stated that "transmission from other colonized family members could not be ruled out."
Another possibility is that the infection never cleared after the first round of antibiotics.
The point is that we have no evidence that this mom passed the infection to her baby through her placenta pills or otherwise.
Unfortunately, there are so many possibilities here. And in all cases, late-onset GBS infection is very difficult to trace.
There were so many variables that it's impossible to know with certainty what caused this infant to get sick. People understandably want answers when things go wrong, so I’m guessing that blaming placenta encapsulation was just fast and easy.
Expert Medical Opinion
Dr. Genevieve Buser, who is an infectious disease/pediatric specialist and the lead on this investigation stated that she "is not necessarily recommending against placenta encapsulation".
Dr. Buser, by the way, was one of the doctors who treated the infected infant and one of the lead authors of that CDC article. So if even SHE is not making a blanket statement that placenta consumption for moms who test positive for GBS is dangerous, then why are so many doctors scaring their clients with misinformation? Do they know more than this lead doctor at the CDC?
I think not.
Safety Protocols and Evidence
But let's just say HYPOTHETICALLY that the pills were to blame in this case. How can I be so confident when I tell my clients that their care provider is uninformed and delving out inaccurate info?
First, GBS bacteria thrive in moist heat and cannot survive the encapsulation process when the placenta is processed according to safety protocols.
I process all of my placentas using the warmed preparation method, meaning that all placentas are steamed gently prior to dehydration. However, for people who have tested positive for GBS, I steam those placentas until they reach an internal temperature of 165 degrees.
Additionally, all placentas are dehydrated at a temperature of 165 until every single piece is completely devoid of moisture, which typically takes about 12 hours.
So EVEN IF (in this ONE case from 2016), the cause of infection was the placenta pills (and I'm not saying it was), that simply means that the encapsulator who processed this placenta into capsules did not follow industry-wide safety protocols.
Please note that this incident from 2016 was the ONE AND ONLY time that there was any correlation between a baby getting sick and placenta encapsulation.
This is a single incident – NOT A STUDY – and it had never happened before this, and has not happened since.
CORRELATION IS NOT CAUSATION
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4037808/https://www.marchofdimes.org/complications/group-b-strep-infection.aspxhttps://www.unlv.edu/news/article/study-maternal-placenta-consumption-causes-no-harm-newborns
About the Author
Tiff D’Amico is a certified placenta encapsulation specialist serving families throughout New Jersey, Philadelphia, and Delaware. She’s on a mission to keep more placentas out of the trash and instead turns placentas into pills for moms to take throughout their postpartum period to help boost their postpartum mood, energy, milk supply, and recovery.
Learn more about her services at www.theplacentagirl.com
