GBS + (is it irresponsible to do nothing?)

[scarletjane]

I am 38 weeks and planning a home water birth. I opted to do the test because i thought that in case of transport, it would be nice to have a negative test to show the hospital so that i wouldn't get talked into antibiotics unnecessarily (this happened to a friend b/cus they claimed there wasn't enough time to wait for her results to come back). But... the test was positive at 36 weeks.

My midwives have given me all of the requisite information and it is ultimately up to me to decide. I am not interested in doing the IV antibiotics, but I am considering doing the Hiba-cleanse (i think it's done externally hourly) but am even contemplating not doing that. My concern is that there is so much flora that the baby is intended to be exposed to during the birth and I feel uncomfortable messing with that. I just wanted as few interventions as possible. And yet I want to be prudent because my baby's health is my top priority obviously.

Though this doesn't really matter because i know GBS can come and go, I tested negative a couple of months ago when they tested for yeast and simultaneously ran it for GBS (though this negative test was only done vaginally and the 36 week one was also rectal).

Thoughts?

ETA: this was a swab test, not a urine test

[Plummeting]

I know that some people choose to ignore the labs unless their membranes are ruptured for over 18 hours or they develop a fever. I don't know what the stats are on the safety of doing so, but I do know some do it. Good luck finding a suitable solution!

[emnic77]

With DS, I tested positive and refused antibiotics (hospital birth). I did rinse with hibiclens before I went to the hospital, and I went late because my midwife told me that if I showed up too late, there wouldn't be enough time for the antibiotics to work and that the hospital would give me less hassle for refusing them (which I had no issues with them being icky about).

I tested at 36 weeks, started on grapefruit seed extract in my juice every day, ate two grapefruits a day, basically just stepped up my vitamin C intake...I already ate a ton of garlic but I stepped that up as well. I had DS at 41+ weeks, so he wasn't premature, and my water didn't break until his head was born, so I was not concerned with the risk factor at all.

If I were in preterm labor and my water was broken for a couple days, I maybe would choose differently, but this time around for my homebirth I am not even testing, and not doing anything, except staying on top of vitamin C and D (and if I end up transferring, I will be treated as GBS+ no matter if I test now or not because I already tested positive once, and around here "once positive always positive" from what I was told by my old hospital midwives).

[crittersmom]

I tested + for my 3rd birth at 36 weeks.Because I have fast labors and knew this one would also be fast I knew I wouldn't get the ABX in time even if the DRs tried to use the every labor is different line.I loaded up on garlic and kefir and yogurt to get as much good bacteria and natural antibodies in.i also did not allow anymore vaginal exams because I didn't want an oops I accidently swept you or broke your water or anymore chances of bacteria getting where it shouldn't be.I had DD 7 minutes after I arrived and 50 minutes after my water broke and neither of us had fevers.I twas very obvious she was fine in the first 24 hours but they made her stay for 3 days afterwards taking her temp every hour since I didn't get the ABX in time.I did buy the hibiclens and had it ready but just didn't have the time to use it.

[sostinkinhappy]

I tend to err on the side of caution with GBS, simply because we had a friend whose baby died of a GBS infection he got from mama during birth. I don't know the exact stats, but what we learned is that while it is uncommon for babies to contract GBS during birth, the ones that do don't fair very well.

That being said, I was GBS+ with my last baby but my bags of waters remained intact until after birth & I was only in labor for about a half an hour. In fact, they didn't even have time to hang the bag of antibiotics before he was born! I have read that the hiba-cleanse protocol is effective and had I known about it at the time, I probably would have gone with that as it is a minimally invasive procedure & is really just applied externally, much like a peri-wash would be done.

[CorasMama]

Yeah, it's not super common for it to pass to the baby, but since A) you can't tell right away if the baby has contracted it, and B) those who do contract it get really sick, I would at least do the hibiclens.

[Suzannah]

What is GBS? Any info on this?

[FoxintheSnow]

Originally Posted by sostinkinhappy

I tend to err on the side of caution with GBS, simply because we had a friend whose baby died of a GBS infection he got from mama during birth. I don't know the exact stats, but what we learned is that while it is uncommon for babies to contract GBS during birth, the ones that do don't fair very well.

That being said, I was GBS+ with my last baby but my bags of waters remained intact until after birth & I was only in labor for about a half an hour. In fact, they didn't even have time to hang the bag of antibiotics before he was born! I have read that the hiba-cleanse protocol is effective and had I known about it at the time, I probably would have gone with that as it is a minimally invasive procedure & is really just applied externally, much like a peri-wash would be done.

Same here, very sad!!! I think it's very risky to do nothing.

Originally Posted by Suzannah

What is GBS? Any info on this?

Group B Strep

[iamkari88]

with my first i tested positive and recieved the iv in the delivery room. with my 2nd they didnt even test me. they just went ahead and treated me. with my third they didnt test me or treat me for it. i dont know what they plan on doing this time around. i think you should go with your gut instincts on this one.

[emnic77]

GBS can come and go. You could test negative at 36 weeks and be positive at delivery and never know it, which puts you at the same amount of risk as testing positive at 36 weeks and doing nothing. Unless they test at delivery, IMO, it's pointless.

[gardenmommy]

I've only been tested for one pregnancy. All my other babies were born at home, and my MWs have never made an issue of it. They have all made sure I knew what signs to look for, of course, should the baby become ill. However, since your results can change from one day to the next, I feel like the test doesn't really provide a really good answer one way or the other. If I had been tested, and it was +, I would do what PPs have done: lots and lots of probiotics (kefir, yogurt, Primal Defense), garlic (and maybe garlic suppositories), grapefruit seed extract, etc. All of those are good ways to keep the bacteria balanced in your system, without the side effects of abx. I would also not allow any internal exams, and be super careful about hygiene, esp. if my water broke early on in labor.

[klocke]

I tested positive for it with my first birth (hospital) and had to do IV antibiotics. 2nd birth they didn't even test they just automatically gave me IV antibiotics. 3rd birth was at home and after talking to my midwife I decided to not test at all and we just went ahead and put some Hibi Cleanse in birth pool. The US is the only country that routinely screens for GBS. I say if your water has not been broke for an extended period of time and you don't have a fever then you should be fine. I know in my personal case the antibiotics caused a lot of trouble and actually affected my 1st borns health for 4 months after he was born.

[scarletjane]

Thanks to everyone who replied. Your thoughts have all been really helpful. I'm going to discuss it further with my midwives and read more of the research.

[thefragile7393]

Here's my experiences--1st birth at a FSBC and I tested positive for GBS. At the time I didn't know that it could come and go, so I was told that I would need IV antibiotics 4 hours before birth. Well I got there at 9 cm and there was no time for an IV, though they did try with a portable IV machine. WHy...I don't know, it's not like it would have gotten to the baby in time. DS was fine. Mine was also a waterbirth with waters broken while in the water.

#2....honestly we just never got around to doing the test. Did a homebirth and mw had me do hibiclens for a while before the due date, and we were planning on testing but dd came at 38 weeks and we never got around to it. SHe too had no complications. Do as much research as you can I guess and look at your own risk factors, if any. If we go through a 3rd I doubt I'll test again.

[Sweetiemommy]

My midwives are okay with swabbing only the vagina when they test. The bacteria is often found in the rectum only and if you test both at the same time, how does one know where the bacteria is living? The theory is that GBS can transfer from rectum to vagina, but honestly, if you test the vagina and it comes back negative, I would just maintain excellent hygiene and not worry about it.

[~Christina~]

Had I tested positive I would have refused the antibiotics unless there were other risk factors presenting (PROM, fever, premature baby). With my son I had an extremely resistant case of thrush that ruined our nursing relationship. I feel that my accepting a high dose of antibiotics would have been more risky for causing all the good bacteria to be killed than my baby actually contracting GBS. Like someone said, just b/c you test neg or pos one day doesn't mean it's the same at delivery.

[Becken]

I tested positive with DD and had to have penicillin during labor. My labor was so fast that they only got through one round (and man, that stupid IV was more painful than anything else! It BURNED in my veins!). My waters never broke - my midwife stripped them (against my birthplan, dammit) when I was complete.

I think that those antibiotics were just another straw on the camel's back that was DD's terrible food sensitivities. I've spent this current pregnancy cultivating my gut health with extreme care. I have a midwife who will do hibiclens if I'm positive (I think I find out tomorrow, actually!), and we won't worry about it beyond that.

I think it's worth testing because there are body-friendly ways to help prevent the infection of the babe, which is potentially fatal and almost always lands them in the hospital. I wouldn't mess around with it.

[Plummeting]

Originally Posted by Becken

I think it's worth testing because there are body-friendly ways to help prevent the infection of the babe, which is potentially fatal and almost always lands them in the hospital. I wouldn't mess around with it.

My plan is probably like yours this time. I'm going to test, then do what I can to prevent infection of the baby w/o abx if I'm positive. I haven't seen convincing data that treating with IV abx during labor actually reduces mortality. I've seen it reduces GBS infections, but then there are increases in treatment-resistant E. coli infections and other bacterial infections. It seems like it might be trading one problem for another.

The thing I haven't been able to find (admittedly I have not looked a lot just yet) is whether or not the increase in E. coli and other infections makes up for the decrease in GBS infections, or whether there's still an overall gain.

OP, you might be interested in reading this abstract: http://www.ncbi.nlm.nih.gov/pubmed/9790363

[sostinkinhappy]

Originally Posted by Becken

I think it's worth testing because there are body-friendly ways to help prevent the infection of the babe, which is potentially fatal and almost always lands them in the hospital. I wouldn't mess around with it.

^^^Yeah, what she said.^^^

If I had to do it all over again, this is the approach I would have taken. Find out one way or the other & if it turned up + then use non-ABX approaches to treating & monitoring the situation.

[Tulafina]

I tested + with my first and decided to get the abx... I really didn't want abx during labor especially because I'm very allergic to penicillin and the other abx of their choosing doesn't work very well on me but the OB I had at the time really pushed me to do it…I gave in. The only thing was when I went into labour I totally forgot about it and ended up getting to the hospital at 9cm dilated ..they freaked out on me and gave me an iv and abx anyway and he was born 25 mins later(water broke as I started pushing and he was born 25 mins later). I swear the abx really messed with my son and I...we both had thrush for 6 weeks. They also ended up keeping him for 5 days in the NICU to monitor him-nothing was wrong.

I tested + for GBS at 36weeks with DS2. I was with a MW this time and she left it up to me whether I wanted abx or not. So I did a tonne of research and started the following things:
Double dose of probiotics daily
Clove of garlic inserted vaginally every night for a week
I washed myself with hydrogen peroxide 3x a day for a week

I then went back and got retested and was - for GBS. I continued doing the treatments for the duration of my pregnancy(went to 5 days past EDD) and just scaled it down a bit. I still took massive amounts of probiotics, but did the internal garlic just 2x a week, and washed 1x a day with HP. I had a 1.5 hour labour(total time), water broke at 10cm, and I pushed him out 11 mins later. I wasn't worried about it at all the second time around.

HTH,
Julie