Sometimes I get discouraged.
This blog rests on the premise that anyone is capable of learning the basics of science, medicine and logic and using that knowledge to see through the quacktivist claims of the purveyors of pseudoscience. But then I read about the pure idiocy spewed forth on a topic like Group B Strep and I wonder if that is an over-optimistic sentiment.
How could anyone be stupid enough to believe that washing your vagina out with soap will prevent neonatal meningitis or pneumonia? (Feminist Breeder, I’m thinking of you, among others.)
Let’s step back for a moment and consider what you ought to know before you can make an informed decision to decline antibiotics for Group B Strep (GBS) and to substitute washing the vagina with Hibiclens (chlorhexidine) instead.
1. How does GBS hurt babies?
2. What are the chances of a baby contracting GBS?
3. What is the neonatal death rate of GBS?
4. How does IV antibiotics change the risk of a baby contracting and dying of GBS?
5. Has Hibiclens been shown to be as effective as IV antibiotics?
The latest information on Group B Strep can be found in the Prevention of Early Onset Group B Streptococcal Disease in Newborns published in the April edition of the journal Obstetrics and Gynecology.
1. How does GBS hurt babies?
Group B streptococci … emerged as an important cause of perinatal morbidity and mortality in the 1970s. Between 10% and 30% of pregnant women are colonized with GBS in the vagina or rectum… Invasive group B streptococcal disease in the newborn is characterized primarily by sepsis and pneumonia, or, less frequently, meningitis.
2. What are the chances of a baby contracting GBS?
For the past 30 years, GBS has been the most common cause of neonatal sepsis. The actual incidence is 1.7/1000 live births (approximately 7200 cases per year).
3. What is the neonatal death rate of GBS?
More than 15% of affected infants will die (approximately 1080 deaths).
4. How does IV antibiotics change the risk of a baby contracting and dying of GBS?
Since the early 1990s, national guidelines have resulted in an 80% decrease in the incidence of early-onset group B streptococcal sepsis, from 1.7 cases to less than 0.4 cases per 1,000 live births.
5. Has any other treatment been shown in large clinical trials to be as effective as IV antibiotics?
No, absolutely not.
In fact, large scale studies done the use of Hibiclens in low resources settings where IV antibiotics are unavailable show that it is in INEFFECTIVE in preventing neonatal group B strep sepsis. For example:
… We performed a placebo-controlled, randomized trial of chlorhexidine vaginal and neonatal wipes to reduce neonatal sepsis and mortality in three hospitals in Pakistan….
RESULTS: From 2005 to 2008, 5,008 laboring women and their neonates were randomly assigned to receive either chlorhexidine wipes (n=2,505) or wipes with a saline placebo (n=2,503). The primary outcome was similar in the chlorhexidine and control groups (3.1% compared with 3.4%; relative risk 0.91, 95% confidence interval 0.67–1.24) as was the composite rate of neonatal sepsis or 28-day perinatal mortality (3.8% compared with 3.9%, relative risk 0.96, 95% confidence interval 0.73–1.27)…
CONCLUSION: Using maternal chlorhexidine vaginal wipes during labor and neonatal chlorhexidine wipes does not reduce maternal and perinatal mortality or neonatal sepsis…
What is Hibiclens anyway?
The active ingredient in Hibiclens is chlorhexidine gluconate also known as (1,1′-hexamethylene bis [5-(p-chlorophenyl) biguanide]di-D-gluconate). According to the FDA:
… adequate and well-controlled studies in pregnant women have not been done. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
And:
It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised …
Why are homebirth and natural childbirth advocates washing the vagina out with Hibiclens instead of using IV antibiotics?
It certainly can’t be because it works, since large scale studies show that it doesn’t.
It certainly can’t be because it doesn’t matter since GBS is the leading infectious cause of newborn death.
It certainly can’t be because IV antibiotics don’t work since they have reduced neonatal GBS deaths by 80%.
It certainly can’t be because Hibiclens [chlorhexidine gluconate also known as (1,1′-hexamethylene bis [5-(p-chlorophenyl) biguanide]di-D-gluconate)] is “natural.”
So why do women like The Feminist Reader wash their vaginas out with soap to prevent their babies from dying of Group B strep pneumonia or meningitis?
Because it fulfills the MOST important criteria for an NCB “treatment”; it is a form of ignorant, immature, self absorbed defiance of authority. And if that isn’t a good enough reason for NCB advocates to risk killing their babies, what is?
