If a mother is positive for GBS at the time of delivery and is untreated the baby has a 1 in 200 chance of contracting GBS. For some that seems like a rare complication, for others that might seem like the odds are too high. I believe that parents need full informed choice. To say GBS is "rare and treatable" is not full informed choice. Like I said, for some the risk would make them call it rare, for others it would not be. And treatable, yes it is, IF and when it is caught early and in time. Some of the first signs of GBS in a newborn are lethargy, poor feeding, etc. That can be confused with many other things. If a mother calls a provider and says her baby is having issues, and they look in her chart and it shows that she was GBS negative (because she purposely skewed the test results) GBS will not be the first thing on their minds, and they might not think about it until other options have been tried and failed. By then it is harder to treat...
The false negative for GBS swabs at 36 weeks are 4%. There is no false positive. So yes, not 100% accurate, but it's the best we have to go by. I will reiterate that it is vitally important for a mama and her provider to know if she is a GBS carrier at the time of birth. This is regardless of if she chooses antibiotic treatment or not.
I am a midwife and I teach an alternative pharmacology course at the local midwifery school. We talk a lot about alternative treatment for GBS. I believe that there should be choice for a mama other than abx in labor as well. There are many alternative protocols that can be used (not studied, but anecdotal). Usually they start at 37 weeks and continue daily until labor. They usually involve garlic and herbal suppositories (every day, not just one day to fool a test) and an oral tea blend. IMO, a vaginal rinse at the time of labor will do little. And also the risks of any vaginal douching during labor (Hibiclens, tea tree, whatever, are not recommended for GBS. It can push the small amount bacteria that it doesn't kill further up towards the cervix (and baby). Vaginal washes of any kind are especially contraindicated if the membranes have ruptured, which sometimes they do very early in labor. Then what would you do?
Also, finally, let me say that I do NOT think that GBS positive status should in any way rule out VBAC. That is ludicrous and I would personally fight tooth and nail for anyone that tried to argue it. It is not a contraindication for normal vaginal delivery and VBAC mamas have no higher risk of transmission than any other vaginal birthing mama.
I wouldn't normally post but one of the few things that really irks me on MDC is the mention that the GBS swab is something that needs to be "beaten". It's just a tool to help a mama and her provider make an informed decision.