Why You Might Need Antibiotics in Labor

Couple at the hospital in labor

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Antibiotics are known to fight off infection. Sometimes you need these powerful medications in your labor and delivery experience. Here are some of the reasons that you may need antibiotics during your delivery:

Group B Strep (GBS)

You will most likely be tested for Group B Strep at the end of your pregnancy, typically between weeks 34-36. If you are positive for GBS during that test you will most like receive antibiotics in labor via your IV or saline lock. You may also be given antibiotics if you have given birth to a baby who contracted GBS.

Prophylactic for Just in Case

In some birth situation, you may be given antibiotics just in case, an example might be for a cesarean section or c-section. Since the risk of infection is increased due to the nature of surgical birth, an antibiotic is given to help prevent that infection. There may be other reasons that you need antibiotics as well, talk to your doctor or midwife for a discussion given your personal medical history.

It was once proposed that all women be given antibiotics at the end of their pregnancy to prevent some types of infections. There is no data showing this is beneficial and may actually cause harm, so this is not what we mean with prophylactic. It is also not beneficial to give antibiotics to every mother before breaking her water to try to prevent chorioamnionitis. 

Preterm Labor

If you are in preterm labor, it may be caused by an infection. Because of this fact, using antibiotics may stop your labor or at least help with the infection. Even if you are unable to stop the labor, you can help reduce the risks of infection to you.

Your Water Has Been Broken for a Certain Length of Time

Typically antibiotics are given after 18 hours of your membranes (water) being ruptured to try to prevent a uterine infection or chorioamnionitis (an infection of the amniotic sac) if your Group B Strep status is unknown. This may be sooner or later depending on your hospital or practitioner's protocol. This is true if your water broke on its own or if it was done as a way to induce labor or speed labor up.

Running a Fever

If you are running a fever in labor, they may give you antibiotics, even before they know why you are running a fever, to try to prevent transmission of whatever you may have to the baby. This depends on your medical history and the protocol at your place of birth and with your practitioners.

A Word About Mitral Valve Prolapse (MVP)

It used to be that if you had a mitral valve prolapse (MVP) you would be asked to do prophylactic antibiotics to prevent heart problems. It was also used in cases of rheumatic heart disease. This is no longer considered the protocol.

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  • Ray A, Ray S. Cochrane Database Syst Rev. 2014 Oct 1;10:CD010626. doi: 10.1002/14651858.CD010626.pub2. Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant.
  • Thinkhamrop J, Hofmeyr GJ, Adetoro O, Lumbiganon P, Ota E. Cochrane Database Syst Rev. 2015 Jun 20;6: CD002250. doi: 10.1002/14651858.CD002250.pub3. Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity.

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.