Deconstructing Dissonance: Ontario Midwifery Clients Speak about Their Experiences of Testing Group B Streptococcus–Positive

Mary Sharpe, RM, PhD; Kristen Dennis, RM; Elizabeth C. Cates, RM, PhD; Sophia Kehler, BA; and Kory McGrath

ABSTRACT
Group B streptococcus (GBS) is a bacterium commonly found in the vaginal flora and is usually of no consequence to women. However, vertical transmission of GBS to the baby during pregnancy and/or birth can lead to GBS-associated disease, a leading cause of neonatal morbidity and mortality in Canada and throughout the world. Screening for GBS at 35–37 weeks’ gestation and administration of intrapartum antibiotic prophylaxis for colonized women has become standard practice; however, there is little research surrounding clients’ experiences, knowledge, and perceptions of both the test and of testing positive for the bacteria. This phenomenological study used semi-structured interviews guided by open-ended questions to explore the experiences of six midwifery clients in southern Ontario who tested GBS-positive in 2009. Transcribed interviews were analyzed using grounded theory to identify key themes. The diagnosis sharply affected women’s experiences during pregnancy and labour and often led to dissonance for them regarding questions of risk, health, the concept of normal, the midwifery model, their birth plans, and the competence of their midwife. The themes are discussed in terms of their relevance to midwifery practice.

KEYWORDS
midwifery, group B streptococcus, prenatal screening, pregnant women’s experiences, qualitative research

This article has been peer reviewed.