GBS is a global concern
In 2015, approximately 200,000 cases of early-onset GBS occurred worldwide. Around 150,000 fetal and neonatal deaths occur every year around the world as a result of group B strep (combined stillbirth, early-onset, and late-onset). The largest concentration of these GBS-related infant deaths is in Africa. This worldwide problem is of particular concern in countries with limited resources, where preventative intravenous antibiotics are not readily accessible to prevent infection during birth.
When compared to other developed nations, maternal healthcare in the U.S. lags behind. For example, according to ProPublica, the U.S. has the highest maternal mortality rates when compared to other developed countries. This international disparity of care is compounded for black mothers in the U.S., who must also face systemic racism when receiving healthcare.
Healthcare providers can help
Healthcare providers are on the front line of this issue, and a concerted effort can make a big difference in reducing the prevalence of GBS infections for WOC and their babies. Since current clinical practices to prevent GBS transmission and infection focus on identifying women at the highest risk of colonization and/or transmission of GBS, pregnancy-related healthcare professionals must be aware of additional risk factors such as race and/or ethnicity.
The racial inequalities in maternal healthcare in general are systemic, therefore there are some influences outside the control of the healthcare professionals. The health facility and healthcare provider don’t have control over community, family, or the system at large. That being said, here are some ways that healthcare workers can work to reduce the incidence of GBS infections as they are influenced by racial inequality.
- Maintain consistent quality of care from one patient to the next. Work to overcome internal biases.
- Be aware of racial and socioeconomic risk factors for GBS (and other pregnancy complications), and screen for GBS accordingly.
- Make GBS screenings more comfortable and accessible. Self-administered screenings have been found to be just as diagnostically accurate, and they tend to be preferred by patients.
- Encourage your pregnant patients to include a midwife or a doula in their pregnancy care team. These pregnancy professionals act as a bridge between doctor and patient to help put them in charge of their own pregnancy and to provide educational and cultural resources.
Summary
The racial inequality present in regard to early-onset GBS is just one symptom of a greater issue where mothers of color don’t get the same quality of care as their white counterparts. This issue is of special concern in the U.S. where prenatal healthcare lags behind that of other developed nations. The majority of these infections and deaths are avoidable, and healthcare workers can make a difference in preventing them.
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