How could this happen in a homebirth?

[JFTB1177]

Let me preface this by saying I had a homebirth (not just a homebirth but a HBAC!) last year that was very successful. While I had a difficult labor, in the end baby and I were perfectly healthy and right now my beautiful 14-month-old is running around next to me. Would I suggest homebirth to other women? Absolutely!!!! Esp to those who really want a VBAC and don't think they'd have as much of a chance at a hospital (like me).

Besides wanting the VBAC, another major reason I chose HB was because of some of the horror stories I saw on tv aboout women who had C-sections and got Strep infections and ended up losing all of their limbs (there are two I can think of off-hand, one in FL and one who was on Oprah). These stories horrified me and I felt like I was keeping myself safe from any such disaster (even though those sort of things are rare).

Well... I came across this article on AOL last week. Same thing happened to a mom who had a homebirth (was her 3rd child)! How does this happen to someone who has not had a C-section??? I wrote my doula and shared the article but she didn't know what to tell me. We will start ttc our 3rd child before long and now I can't get this out of my head... can someone here who knows a lot about this stuff please tell me how this happens to someone who has a perfect HB?

http://www.aolnews.com/nation/articl...limbs/19478121

[JFTB1177]

No one???
Please understand I am not putting down HB at ALL! I did have a successful HB and recommend it to almost any woman as an option. I am SUCH a worrier by nature and just want to know how something like that can happen in a HB where the mom is not being cut (as in a c/s) and is not being exposed to dangerous germs (like in a hospital)? I just want to know how this happened so I can prevent it from happening to me in a future birth, that's all...

Thanks! Please someone, bite!

[Baby_Cakes]

Hmm. The only thing I can think -- and the article doesn't mention if she had a birth attendant -- is that someone involved in the birth had strep A and somehow passed it, maybe through an internal exam?

I'm guessing no midwife came to check on the mom a few days after the birth either?

That's a horrible story, but honestly I think that is incredibly, incredibly rare and doesn't dissuade me from wanting to homebirth at all. It's like a one in a bajillion chance of getting that sick, you know?

[JFTB1177]

Originally Posted by Baby_Cakes

Hmm. The only thing I can think -- and the article doesn't mention if she had a birth attendant -- is that someone involved in the birth had strep A and somehow passed it, maybe through an internal exam?

I'm guessing no midwife came to check on the mom a few days after the birth either?

That's a horrible story, but honestly I think that is incredibly, incredibly rare and doesn't dissuade me from wanting to homebirth at all. It's like a one in a bajillion chance of getting that sick, you know?

Hey Carrie, thanks for biting!
I understand what happened to this lady had nothing whatsoever to do with her HB and that it is extremely rare, but I have OCD and I am paranoid that every worst situation will happen to me! lol ugh.

So you think maybe the strep A could have gotten inside of her *down there*, and because she was giving birth it made it's way inside her uterus, etc and spread that way???

I have no idea if she was checked up on afterwards...

[Turquesa]

Originally Posted by JFTB1177

No one???

Patience, my OCD friend! Only 26 minutes lapsed between your first two posts! I'm used to waiting hours to get responses....and I'm no stranger to OCD!

From what I am reading:

Severe, sometimes life-threatening, GAS disease may occur when bacteria get into parts of the body where bacteria usually are not found, such as the blood, muscle, or the lungs. These infections are termed "invasive GAS disease."

Honestly, I cannot see how you would be safer from this condition in the more germ-infested setting of a hospital.

Near the end of both of my pregnancies, I started reading stories of all of the birth rarities and freaking myself out. These anxieties are normal. Have you processed these concerns with your MW?

[onlyboys]

I do think it's one of those one in a million chance sorts of things. There is a much greater chance of getting an infectious disease in a place like the hospital, which sees many more infectious and unfamiliar agents hanging around.

As for the WAY someone would get Strep A: anytime you introduce someone's hands or instruments into the birth canal, you run the risk of getting an infection. If the woman had a tear (or more rarely, an episiotomy) that needed repair, the first level of the body's protective mechanisms have been breached, which makes getting an infection more likely. So, if the midwife's gloves were contaminated, or her sterile field wasn't perfect, then there's a chance of infection getting into her body.

Minimizing the contact that other people have with the inside of your body, the less chance of obtaining an infectious disease.

[JFTB1177]

Originally Posted by Turquesa

Patience, my OCD friend! Only 26 minutes lapsed between your first two posts! I'm used to waiting hours to get responses....and I'm no stranger to OCD!

HAHAHAHAHAHAHAHAHA! LMAO!

I know, I should learn some patience... when I get in these panicky states it's hard though!

I will definitely bring these concerns up to my MW. I just wanted to ask on here first before bothering her with my ridiculous concerns when she's such a busy person lol.

[JFTB1177]

Thanks onlyboys, that makes sense! Yikes I had 2 tears that didn't heal and my MW ended up using a silver (is it nitrate?) stick to heal them so I wouldn't get an infection.

I hate worrying about everything!!

[Climbergirl]

OMG! How absolutely scary! For me, I had a c-section and had trouble breathing 4 days later when the nurse said (yes, really) "you are in a hospital and probably caught a cold". Nice. They discharged me.

The next day, I was back in the ER diagnosed with pneumonia, septasemia, and early cardiac failure. They have no idea "why" but I have a few guesses (may the major surgery I had 5 days prior???). I was told I was 12 hours from a vent and the ICU and stayed in the hospital for 5 more days. It was scary to see how fast things went very very downhill.

I used to work for a biomedial company and did work on cleanrooms (testing, etc.). The OR was horrifying to me. It would not have passed the requirements we had for our room that had the least restrictions and I was being CUT OPEN right there. The nurse had hair out of cap. ARGH.

I should probably warn my midwife about my previous knowledge of sterile fields so she can be forewarned I may be a little OCD about it now!

[JFTB1177]

OMG Climber girl!!!! Thank GOD you are okay!!!! Whew! Do you think immediate attention is what helped? Do you have any lasting effects?

I don't want to cause anyone else to freak out about this... I understand it's rare and even more rare at home (but like I said, I really do have OCD.) I did have 2 tears from my HBAC which took more than a month to heal (were still open wounds until my MW burned then closed with silver nitrate), and I never got an infection. So I don't want to cause you concern, Climber. I don't want my OCD to rub off on anyone else... ugh

[mediumcrunch]

The homebirth mom in TX that had Group A strep has a blog, well her husband does. She just got home a few days ago.
If I am reading right, the theory was that she was already colonized and she ended up with a uterine infection that spread....I think.

http://katyupdate.wordpress.com/

[*MamaJen*]

I really recommend reading that blog -- it does answer a lot of those questions. But in general, this isn't an infection that was caused by a homebirth. It's incredibly rare anywhere, but even rarer to contract at home. It's not something you need to worry about.

[JFTB1177]

Thanks guys- I did read some of the blog. I am still a bit confused though- the husband said that none of the docs know why or how it happened... when you say it was colonized does that mean the Strep was living on something in their home and then somehow made it into her during the birth process?

[paquerette]

I think it means that she had the group A strep vaginally colonized. Group B is commonly test for, but I don't think anyone tests for A, so I think this must be very rare indeed.

[Climbergirl]

Originally Posted by JFTB1177

OMG Climber girl!!!! Thank GOD you are okay!!!! Whew! Do you think immediate attention is what helped? Do you have any lasting effects?

So I don't want to cause you concern, Climber. I don't want my OCD to rub off on anyone else... ugh

Oh, you haven't caused me concern! I will be more careful about exams and what not due to what happened to me. I honestly have WAY too much knowledge about cleanliness and how germs move around cleanrooms. It makes me a little crazy.

I don't feel that I got immediate attention since I was discharged after saying I had a hard time breathing that morning. They also would not believe me that my blood pressure was a little high for me because most people would love a reading that is too high for me. I got tired of trying to explain this to people who obviously did not care, and I decided that it probably had to do with the fact that I just had a baby. Now I know!

At this point, there is no long lasting effects. My thyroid started pooping out, but that has happened to my sister as well as a lot of people in my family. I had a lot of thrush issues due to the antibiotics (and yeast infections - a lot of them - for almost 2 years) as well as a long time in getting DS to the breast, but we did it. Well, there is one long lasting effect, I am a LOT more healthy because I want to BE healthy and stick around for these cute little ones.

[veggiemomNYC]

I recently had a successful homebirth with strep G. This is also very rare. I most likely caught it from the community around me, definitely not my home. Prior to giving birth I was on clindamycin, both oral and vaginal, for about a month to make sure it was gone.

What happened to this woman was so scary. I wonder if she did the strep test. A good strep test colonizes for all versions of strep. Definitely worth doing.

[JFTB1177]

Thanks for explaining, Paquerette!

Climbergirl, I just noticed you're in Gaithersburg!! I live in Damascus, we moved here 2 years ago from Rockville! :-) Btw, there is no way I could know about those "cleanrooms", I would probably not sleep at night. lol

Veggiemom- I never heard of Strep G! That's good to know the strep culture checks for all types... the lady's husband said she was tested for strep and it was neg- is that possible? I'm glad everything turned out well for you!

[turnquia]

JFTB- Unfortunately infections like that there is no cause for them 99% of the time.

Its like necrotizing fascitis. Sometimes it just happens. Its super rare, and very lethal if not caught early.

Unfortunately for the mom in the article, she just was one of the unlucky that became susceptible to the infection. Strep is very common and a lot of times on our skin. It sometimes for some people goes wild.

Its amazing she is alive, so kudos to that mama. We are far more likely to be seriously injured or die in car accident than have anything like this happen to us.

[kittywitty]

That is soooooo rare I have never even heard of it. I certainly would worry more about getting struck by lightning than I would about this. The end is always anxiety filled. Hang in there!

[limette]

I have no answers but this isn't the first case. This is the third time I've read about it happening in the past two years. The other two were hospital births, I think one was a c-section. I think one was in Florida.