Group B strep and antibiotics in labour

[Toomanytoomany]

I found out at my 28 week check up that a swab they did at 10 weeks showed I was positive for group B strep (nice of them to let me know - they told me all my tests came back normal!).

I am looking into my options as the hospital's policy is, as everywhere, to administer IV antibiotics four hourly once labour begins.

If I can avoid it I want to do this, as I don't want to be hooked up to an IV (I need to pee every ten minutes when I'm in labour and dragging the IV around is a pain in the butt, and I don't like how it restricts my free movement.) I also have two children who are allergic to various antibiotics and have other issues, I have one child who has had major gut problems through her life from overuse of antibiotics during her first of life, and I am concerned about my baby developing penicillin-resistant bacteria such as resitant e-coli.

The other issue is, my pro dromal labours last a long time - up to a week - and there's no way of judging "the start" of my labour, and I can see immense pressure on me for labour augmentation, and the resultant risks to me and the baby involved in that.

I also get thrush every time I have antibiotics, and I don't want thrush on a healing perineum!!!!

I'm considering a compromise position - that I will consent to IV antibiotics if my waters have been broken for twelve hours, or I go into labour before 37 weeks, or I develop a fever before or during labour. After looking up the incidence and risks of streptococcal sepsis for neonates, this is a significant set of clinical risks which contribute markedly to the 0.2% chance of the baby becoming infected by GBS.

In the meantime I'm embarking on a course of garlic, grapefruit seed extract and probiotics to improve my internal flora and hopefully reduce the colonisation so that it's negative at my 36 week screening anyway.

Does this seem reasonable? Has anyone else dealt with these issues outside the normal protocols? Does anyone have any research beyond the inadequate cochrane review and the health service propaganda to help me make a truly informed decision? Given how bureaucratic and process driven the hospital is, I am anticipating a fight if I insist on treatment outside the norm.

[Oorki Galoorki]

i think you are up for a fight just simply because "its not how we do it"......
but it seems like a great plan
i might recomend they check it again at around the 37 week mark(it comes and goes) so you might not have a positive reading by then with all the natural products you are using.

[Schmickers]

I think that sounds like a sensible plan. You are basically exploring the difference between treating based on risk factors (prolonged rupture of membranes, fever, etc.) and treating based on pathology; if you'd like, I have a link somewhere to an Australian study that compared the two and found that neither strategy better than the other. Might be useful to have at your next appointment.

We had a positive swab for GBS when we were pregnant with Olivia; we did many of the things you are doing with probiotics, and we also had a douche prepared by our naturopath, can't remembe exactly what was in it, but I'm sure there was garlic. We were negative on our second swab.

[diannescruffy]

Hope it all works out well for you and your next swab will come back negative. Obviously different hospitals have different policies, I was positive with two of my pregnancies and neither time had an IV thankfully. I was given an injection at a certain time during my labour and that was it.
Good luck with it all.

Regards,
Dianne

[Kazmar]

Hope it all works out for you! Just thought Id let you know. I had this IV. I found it made no difference to the birth. In my birth plan I wanted NO needles what so ever, is a massive fear of mine. But I knew it would help so much If you do have to take the IV dont stress. As I said it made no difference to Annabelle's birth

[Toomanytoomany]

Hope it all works out for you! Just thought Id let you know. I had this IV. I found it made no difference to the birth. In my birth plan I wanted NO needles what so ever, is a massive fear of mine. But I knew it would help so much If you do have to take the IV dont stress. As I said it made no difference to Annabelle's birth

I've had IVs too for four of my other deliveries - that is the least of my concerns but I do know that I don't like them. My major concerns are to do with the impact of large doses of antibiotics on the baby and me, and weighing that up against the actual risk.

Thanks for the good wishes, everyone.

[Toomanytoomany]

if you'd like, I have a link somewhere to an Australian study that compared the two and found that neither strategy better than the other.

Yes please - I would like to have any info at my fingertips that is available! The only Cochrane Review info available was pretty brief. I also note that the studies in favour of the routine administration of a/biotics are based on poor samples - and there doesn't seem to be much info on the instance of checking for resistant bacteria and other types of sepsis in neonates. It's like, "We can test for this one, so this one's the bogeyman!" when of course it isn't as straightforward as that, is it?

[Tegam]

I tested positive for my 1st. Had the AB but delivered too soon so they had no affect.

I tested positive for my 2nd. New baby was going to come too quick so said no to AB in hospital. Labour was 2hrs so i was right, the AB need over 4 hrs to work...

Didnt both getting tested for baby number 3 as i was guessing i would be positive. I had done my research and was happy that i knew the pros and cons well enough to make this decision....

I cant remember where my research is, ill have a look for you

but i do remember that in one of the studies it suggested that the babies that do get GBS from their mothers are the ones that are put under undue stress at the time of birth, eg. being made cold in a operating theatre, or being "Checked" by the Dr. Weighed on those horrible scales or even given needles........

So they suggested that skin to skin, 1st bf and the deley of "checks" and weighs.....

Something for you to think about...

Also i have to say that there are some people that think that i took an risk by not taking the AB.....Well i have nursed VERY sick babies and i have watched some die of it - yes scary - BUT if we added up all the risks then we wouldnt get pregnant... There is no possible way to take all the risks out of babies and births..... And Like you AB have their own risks, All of my children are yet to have AB so why would i want to introduce them to them when they are so young....

Also the AB can be administered in one go so while you how have to have the needle in you shouldnt have to have a pole?????

[Toomanytoomany]

Milly thank you for that, it is very helpful. It's funny - I'd been feeling this pregnancy that the skin to skin thing after birth was feeling much more important to me than it has done before.

I have shortish labours, too, four to six hours, and as quick as two hours, so I doubt they'd have much opportunity to get them in before the baby was born.

I am assuming about the pole - they can just have a bung in and not the other apparatus? That would be good to know if the other risks are present and I do agree to have them.

[Mazmay]

I'm in the same situation, due at the end of this month with our second and having our baby at Box Hill. I have already stated on my file that i will refuse the IV Antibiotics if my waters have not broken etc as i also think that AB given to a newborn unnecisarily is wrong as both myself and my daughter have had problems with AB's and i dont want this to effect my babys developing immume system. There is a 1 hour test for GBS that can be used in labour(unlike the standard 48hr culture one) but i'm havng fun trying to get my hands on one as the hospital dont have them but are willing to undertake the test during labour if i can source one for myself its called "ne IDI-Strep". You might like to look into it also.
The thing i don't like about this diagnosis is that its an infection that can come and go so i may not even have the infection at the time of labour. My midwife said that if i dont have the AB they will give the baby a heel ***** test after 6hours to test for a developing infection and then take action if required, my midwife also said that i will have a fight on my hands with the doctors about refusing the AB and said the way around this is to come in to hospital as late as possible or when my waters break, to have written on my birth plan that i understand and accept the risks involved by not have the AB and to be well informed.
i will add that my hubby wants me to have the AB's and i'm so unsure what to do that its keeping awake at night.
Good Luck and keep us updated!

[Toomanytoomany]

I'm in the same situation, due at the end of this month with our second and having our baby at Box Hill. I have already stated on my file that i will refuse the IV Antibiotics if my waters have not broken etc as i also think that AB given to a newborn unnecisarily is wrong as both myself and my daughter have had problems with AB's and i dont want this to effect my babys developing immume system.

Yes, thank you - too often this is just written off as a selfish decision on behalf of a woman who might simply not want a needle... I've had IVs many many times and that is not the uppermost concern for me. Dosing myself and my baby with unnecessary antibiotics, and all the concomitant risks that entails is my major concern!

I had my last dd at Box Hill - I didn't like the medicos but the middies were fantastic. I hope you have a good experience!

[Toomanytoomany]

I'm in the same situation, due at the end of this month with our second and having our baby at Box Hill. I have already stated on my file that i will refuse the IV Antibiotics if my waters have not broken etc as i also think that AB given to a newborn unnecisarily is wrong as both myself and my daughter have had problems with AB's and i dont want this to effect my babys developing immume system.

Yes, thank you - too often this is just written off as a selfish decision on behalf of a woman who might simply not want a needle... I've had IVs many many times and that is not the uppermost concern for me. Dosing myself and my baby with unnecessary antibiotics, and all the concomitant risks that entails is my major concern!

I had my last dd at Box Hill - I didn't like the medicos but the middies were fantastic. I hope you have a good experience!

[Jas]

Sorry TMTM...I'm about to steal your thread a little!!

I have been tested this pregnancy and it came back neg however my 1st pregnancy i was tested positive and apparently the policy of my hospital is if you have ever tested positive they will give you the ab's durning labour. This seems silly to me because who knows if i had of been tested a day earlier or later with DS1 then the test may have shown a neg result and they would never have known, if a previous pos test (21months ago) is enough to treat this time y not just treat everyone...that's what I would do if I was to work with that logic.

Anyway I asked the midwife what would happen if i didn't want the ab's and she said I shouldn't have to fight TOO much and the fact i tested neg this time will help but basically I'm looking for some facts on the risks of strep b and likelyhood etc and also the risks and likelyhood with having the ab's administered.

I will also ask at my next appt about the process of having the ab's etc

I would also be very interested to hear ppl's thoughts or experiences with this policy. What I don't understand is why I had to get my bits out to be tested if their policy is to treat anyway lol! Woukd especially love professional opinions on this too if ur around Smickers or Neil?

[satya]

I was never tested for it so I'll never know if I had it but my son had suspected sepsis & spent 5 days in special care because with a big board strapped to his arm to get the antibiotics into him. If I'd been asked I would've said yes to the antibiotics during the labour (17 hours & ventousse delivery) & may just have avoided the trauma we went through whilst he was in special care (that's a story for another time).

[Jas]

Satya,

Thanks for sharing your story, I am sorry you had that scn was included in it (the 19 approx hrs Noah was in there for was more than enough for a lifetime for me) It is great to hear different experiences.

So did they know that this was due to him being affected by gbs or was it just basically the most obvious option?