GBS guidelines?

[Magali]

I am reading thru the guidelines for GBS treatment in Canada. If a mama is + she gets antibiotics when water breaks or at the start of labor. If mama's status isn't known, it is recommended to give abx if water is broken for 18 hours, maternal fever, or labor starts before 37 weeks. What I don't understand is why there is a difference? Why are there certain criteria for unknown, but standard abx for + even if none of the "risk" factors (fever etc...) are involved?

[triscuitsmom]

The idea being I think (or at least IME) that people who are declining the test aren't wanting to risk prophylactic antibiotics so they give guidelines for when it would be a "good idea" to have the antibiotics anyway. Since not just GBS can cause infections, other bacteria can and do as well the idea is that with risk factors (water breaking, fever etc) that any of those bacteria have a higher chance of causing an infection that could pass to baby.

I would think that the vast majority of people who have the test (either because they don't know they have the option not to or because they feel it is the right decision after weighing the information) are wanting (or at least not declining) the antibiotics if they are positive because of the risks.

As always you can refuse both the test and the antibiotics no matter what your risk factors or lack of risk factors.

[MegBoz]

I was + & was conflicted on it since I had my doula saying, and I quote, "Oh, I'm not worried about GBS." (Like, decline ABTs & don't worry.) While the CNMs are saying it's a CDC recommendation & baby could die!!!!!

So DH had the BRILLIANT idea to see how they do it in other countries (ya know, the ones with decent maternity care?) In the UK, they don't even routinely test for it! If you do get tested, they don't recommend ABTs unless you have 2 or more risk factors. Then you get ABTs. A positive swab is only 1 risk factor.

Those other factors increase the risk of baby getting GBS, so if your status is unknown, they give ABTs when the other risk factors arise.

Next time around, I'll probably get tested, but do hibiclens vaginal washes instead (kinda silly to send ABTs around my (and baby's) bloodstreams when it's only in the specific locale of the vagina that we need to kill bacteria! & that has been shown to be effective too, with out the awful side effects.

[Magali]

Originally Posted by MegBoz

Those other factors increase the risk of baby getting GBS, so if your status is unknown, they give ABTs when the other risk factors arise.

See that's what I don't understand. If no risk factors arise during my labor, and my ONLY risk factor is the + swab, then why are they going to give me the anitobiotics? It seems like overkill, seeing as a status unknown could very well be positive, and the recommendations are different for positive and unknown.


triscuitsmom, I like what you said about being able to refuse the test or the abx. I am birthing in a hospital with a Dr. and I am SURE they would make it damn hard to do either.

[triscuitsmom]

Originally Posted by Magali

triscuitsmom, I like what you said about being able to refuse the test or the abx. I am birthing in a hospital with a Dr. and I am SURE they would make it damn hard to do either.

FWIW I've had both of my boys in the hospital. Different hospitals, both in Ontario. I did have midwives for my prenatal care both times, but both times was a transfer of care in the end to OBs for all of my labour and delivery.

The first time I had not done the test so my status was unknown. Noone batted an eye at me refusing antibiotics. I had no other risk factors though. My water was only broken for about 12 hours before he was born (and it broke on it's own 36 hours into labour).

The second time I had done the test and was negative only 5 days before my water broke. When I had him it was Day 3 after my water had been broken and I'd been in the hospital for 18 hours at that point and still no antibiotics. They wanted to start them as soon as I arrived because it was (well) over 18 hours, but I declined and said that I would reconsider if my temp went up. It went against policy but in the end it is your choice and it really wasn't that big a deal to decline and totally worth it for me. No thrush to upset the balance of our breastfeeding relationship. (I ended up battling thrush for ages after my first was born and I got IV antibiotics while still in the hospital for another complication that came up after he was delivered).

[Magali]

Thank you for sharing .