I’ve spent 36 years as a birth activist and this book brings me joy. That’s not because I have a particular need to know about Group B Strep (although this book is my go-to when I do), but because this small volume is such an excellent example of exactly what any woman needs to be fully informed and to make her own decisions. We talk about putting the woman at the centre of the decision-making process but those are empty words if women don’t have access to balanced, thorough and clear information. This is exactly what Sara Wickham’s updated book provides. It’s also interesting.
Starting with a brief ‘introduction to human- bacteria relationships’ and going onto one of the most through expositions on the virtues and dangers of screening I have ever seen, Sara then talks about every aspect of this complex subject from the perspective of her knowledge of what women need to know and regularly ask her. One of her special talents is explaining and discussing risk. We are all too often simply told that a course of action is risky, but of course we need to know how risky, and what the risks are of alternative actions or of doing nothing.
I was very struck two years ago when I was diagnosed with breast cancer and discussed risk with my oncologist. I actually burst out laughing when I asked her about the risk of dying if I didn’t have particular treatment and she said airily about one in three. Being so used to discussions within maternity of risks based on one in thousands I had to very quickly change my mindset: risk is clearly very much based on context. Sara gives us the figures we need to wrestle with these kinds of choices and to put them into context.
As human beings we often have difficulties with computing risk and weighing up different courses of action. The narrative that says that Group B Strep is dangerous, infected babies can die, antibiotics can prevent and solve this and so every pregnant woman should be screened is a simple and compelling one. It becomes much less compelling when the damage caused by potentially giving antibiotics to huge numbers of women for a risk of a rare occurrence is taken into account. Group B Strep Explained enables women to weigh up the evidence in a complex situation and work out their own decision based on their individual circumstances. It is also a help for health professionals and policy makers in giving advice and recommendations so that they can as accurately as possible lay out the advantages and disadvantages of possible screening and treatment.
Books like this one are a necessary and crucial resource that helps to make it possible to implement our current maternity strategy and highlight women’s autonomy.