Strep B screening: weighing human and financial costs in childbirth

Streptococcus B is a bacteria carried by 20-25% of adults in the UK, typically in the gut or vagina, which is rarely dangerous and largely asymptomatic. It does not often result in illness or infection, but the risk arises during pregnancy where a woman can transmit the bacteria to her baby as it passes down the vaginal birth canal. A baby born by caesarean section is at lower risk.

The human and financial cost of failure to diagnose and treat

A settlement of £35 million was agreed in January 2025 to compensate a child and provide some semblance of a life for that family after their baby was left severely brain-damaged after NHS staff failed to treat the common infection when she was born.

The infant has cerebral palsy and a payment goes some way to safeguard their future. I haven’t seen a copy of the breakdown, but it is reported in the press that the infant will require 2:1 care. Based on experience, that infant will probably require a house, aids and equipment, a deputy to manage the money, therapy and specialist transport and other bespoke assistance to meet her significant needs and ensure she will be cared for even after her family has passed. It assumes a reasonable life expectancy.

When you weigh up the cost of compensation, not to mention the legal fees and the human impact, you question why the NHS does not adopt the approach taken by so many developed countries that routinely test for Streptococcus B.

The Background

This multimillion-pound payout was made by the Great Western Hospital Trust in Swindon, which admitted that they failed to recognise and treat the infant and her mother for the Group B Streptococcus (GBS) bacteria despite clear warning signs, such as the mother having a high temperature.

Had she been treated with antibiotics during pregnancy, the infant would have been born intact.  Instead, she wasn’t tested for Strep B despite the existence of a temperature and other red flag signs.

The baby wasn’t given antibiotics intravenously immediately after birth.  It was not until 16 hours later that antibiotics were administered, and only after the newborn developed a fever, blotches on her skin and deteriorated. It was too little, too late and she developed Sepsis and Streptococcus B-related meningitis, leaving her severely brain-damaged.

The Current Situation - UK Screening Policy

UK National Screening Committee does not recommend universal screening for GBS in pregnancy

• Many women carry the bacteria and most deliver babies without developing an infection.

• Screening women late in pregnancy cannot accurately predict which babies will develop GBS infection.

• No screening test is entirely accurate. Between 17% and 25% of women who have a positive swab at 35-37 weeks of gestation will be GBS negative at delivery.

• Between 5% and 7% of women who are GBS negative at 35-37 weeks of gestation will be GBS positive at delivery.

• Many of the babies who are severely affected from GBS infection are born prematurely, before the suggested time for screening.

• Giving all carriers of GBS IAP would mean that a very large number of women would receive treatment they do not need; this may increase adverse outcomes to mother and baby.

A spokesman for the Department of Health and Social Care said

“while there is currently insufficient evidence that the benefits of routine screening of women for group B strep infections could outweigh potential harms, an ongoing clinical trial is exploring the issue”

By the end of summer 2025, there ought to be results published relating to a trial of 320,000 women at 71 hospitals in preventing Streptococcus B infections in babies.

The GPS 3 trial, funded by the National Institute for Health Research, has been tasked to compare the effectiveness of the existing risk based approach in the UK, where women are selected for testing based on a history of Strep B infection, fever during labour or other factors – with a lab based test at 35-37 weeks of pregnancy, and a ‘bedside test’ at the start of labour.

Such a test, if rolled out, is likely to cost £15.00 per patient.

Reasons for Litigation

• Failure to treat GBS bacteriuria.

• Failure to provide an information leaflet.

• Failure to recognise increased risk from previous pregnancy.

• Failure to provide antenatal screening for women with GCS in a previous pregnancy or IAP.

• Failure to document the need for IAP.

• Failure to commence IAP.

• Failure to recognise and treat sepsis in labour.

• Failure to give antibiotics to preterm labour < 37 weeks.

Guidance for GBS infection and potential for harm

• All pregnant women are provided with an information leaflet.

• Carriers of GBS in previous pregnancy offered BS-specific (ECM) testing for GBS late in the current pregnancy.

• Women are offered intravenous antibiotics in labour where:

• Established preterm labour (before 37 weeks of pregnancy) offered antibiotic prophylaxis.

• GBS detected in current pregnancy.

• GBS was detected in the previous pregnancy and the baby was healthy, and mum has not had a negative ECM test in the current pregnancy.

• Previous baby developed a GBS infection.

• Fever in labour of 38°C or higher.

• Clindamycin is not recommended in penicillin-allergic women as UK resistance rate is high.

It would seem sensible to empower women to spot the signs of fever and infection during pregnancy and arm them with the tools to advocate for intervention. As with all scenarios that involve harm to a baby, it is our strong view that prevention is better than cure. The argument is that routine testing in other countries does prevent most infections and would ease long-term pressure on the NHS.

How Forbes Solicitors Can Help You

At Forbes Solicitors, we are committed to raising awareness of the ongoing crisis within the maternity care sector of the NHS. We encourage those impacted by these failures to share their experiences; your voice matters. Telling these stories is crucial in driving the reforms necessary to prevent future harm. We stand with each family seeking answers. If you need support or want to understand your options, call us in confidence on 0800 037 4625.