Are Antibiotics Over-Prescribed in Pregnancy and Labor?

Obstetricians routinely prescribe antibiotics to pregnant women. But is it necessary, and more importantly, is it harmful to mother and baby?

Conventional medicine touts the benefits of antibiotic use but what is severely under-discussed are the risks antibiotics are having on us individually and on us as a collective society.

Worldwide, the overuse and overprescription of antibiotics has created superbugs which are strains of bacteria that are resistant to the antibiotics we have available today. This antibiotic resistance has been designated as a worldwide threat with no new antibiotics on the horizon. In January 2022, the Lancet published an article estimating that antibiotic resistant bacteria killed 1.2 million people. Not only are doctors overprescribing antibiotics, but we are also exposed to antibiotics through our food and water systems. 

This overzealous use of antibiotics (and other medications) by pregnant mothers and in turn their babies is not only often unnecessary, but causing harmful long term effects.  

Antibiotics kill the “bad” bacteria that is contributing to the “infection” or “illness”, but they also kill the good bacteria. Gut health has been a popular buzz phrase in the health community for the past few years, but for good reason: Our gut health is vital to our overall health. In fact, nearly 2500 years ago Hippocrates stated, “All disease begins in the gut.” 

The diversity of your gut microbiome (or bacteria that make up your gut) is crucial in setting the stage for your immune system, your mood, your hormones, and so much more. Negative effects of overexposure of antibiotics in children include asthma, allergies, neurological disorders, obesity, gut issues, eczema, food sensitivities, and more. 

The first 1,000 days of life from conception to age two is considered a crucial time frame in development and nourishment of the gut microbiome. Antibiotics in this stage can have long-lasting impacts on the intestinal ecosystem and its many functions—FOR LIFE. 

Why Are Antibiotics Prescribed During Pregnancy? 

The United States has a problem with irresponsibly overprescribing antibiotics, often taking a “one-size-fits-all” approach to healthcare. This especially applies to American obstetrics. During pregnancy, antibiotics may be prescribed for bacterial illnesses, urinary tract infections, ruptured amniotic sacs during labor, and Group B strep (GBS). 

GBS is one of the routine screenings that takes place in the third trimester—typically around weeks 36-38 of pregnancy. Regardless of whether or not you exhibit symptoms, if tested as GBS positive, it is standard protocol for the mother to receive at least two rounds of IV antibiotics during labor, namely Penicillin. The antibiotics are given every four hours. Some OBs also screen for GBS in early pregnancy and will prescribe an oral antibiotic to be taken in first trimester while still advising the intravenous antibiotics through labor as well. 

In addition, ACOG recommends that any mother who has tested positive for GBS with one pregnancy be treated for GBS in subsequent pregnancies regardless of whether they test negative or positive. 

Alternatively, in countries with much better birth outcomes than the U.S., a mother would only be treated with antibiotics during labor if she presents with one of several criteria including fever or premature rupture of membranes. This approach is known as the “risk based approach.” The haphazard approach taken by American OBs is severely compromising the gut microbiome in the name of preventing infection. There may be a time and a place for antibiotics, but prescribing to every woman and infant as a precaution is ignorant at best, and vastly harmful at worst. 

Infants and Antibiotic Eye Ointment 

Even if mothers make it through pregnancy and labor without the use of antibiotics, erythromycin (antibiotic eye ointment) is wiped over baby’s eyes within minutes of being born. The rationale behind this routine intervention is to prevent babies from getting neonatal infections as a result of gonorrhea being passed from mother to baby. However mothers are screened for sexually transmitted diseases in early pregnancy so if there is no infection present, there should be no antibiotics needed. Some conventional medical providers believe eyes are like “open wounds” at birth and susceptible to boogey man bacteria ready to invade the baby’s system. This is simple not the case. 

Germ Theory vs. Terrain Theory in Birth 

Modern medicine is based upon germ theory. Under this theory, which was founded in the 1800s by Louis Pasteur, microorganisms are the cause of disease. Thus, finding ways to kill these microorganisms is the solution to avoiding illness— whether that’s through antibiotics, hand sanitizer, or antibacterial cleaning solutions. 

An alternative theory is the terrain theory which was founded by Claude Bernard, a friend of Louis Pasteur’s. Rather than pointing to microorganisms as the direct cause of disease, terrain theory emphasizes the role of the terrain (or body) in disease. Under this theory, the terrain is the major determinant in how the body responds when “unfavorable” bacteria are introduced. 

The terrain theory better explains why some people get sick and others don’t when introduced to the same illness. Germ theory places little to no responsibility on an individual’s health choices and views exposure to microorganisms as an attack on the body over which we have little to no control. A perpetuation of the victim consciousness model, that we are powerless and susceptible to attack at any moment. Germ theory is focused solely on finding ways to kill an organism, rather than on ways we can nurture our terrain in order to avoid or minimize illness. Terrain theory rightly focuses on the body’s inner environment to make it inhospitable to “harmful” bacteria, “viruses”, and parasites. 

Advocating For Yourself Starts During Pregnancy 

Advocating for the health of your baby begins before your baby is brought earthside. If faced with these hurdles and decisions without support or prior knowledge, many mothers unknowingly follow what their provider deems necessary without considering the potential risks or alternatives. 

This is one reason why I created the Uncovering Birth Masterclass. In this course, I will not only help you gain a deeper understanding of birth, but also help you learn how to navigate your choices, learn about the best ways to support yourself nutritionally for a healthier pregnancy, give you tools for clear communication with your medical providers, and so much more. The class is a self-directed module with added doula support so that you can work through it at your own pace. If you feel you need a more intimate approach, the masterclass is also offered as a one-on-one session. 

Are you processing birth trauma or looking for more comprehensive support? Schedule a bespoke prenatal consultation or one-on-one birth trauma processing session to help you navigate your thoughts and experience so that you can come back as a more empowered and healed you.