All Women Need Antibiotics One Hour Before Cesarean Delivery

[MountainMamaGC]

I read this today and I dont know if I agree with this. I didnt have antibiotics with my first and I healed up beautifully. I also think this will affect the future health of the babies as they are now finding that bacteria does play a role in their immune system developing properly.

http://www.medicalnewstoday.com/articles/198701.php

All pregnant women should be given antibiotics before having a cesarean delivery to help prevent infections, according to new recommendations issued today by The American College of Obstetricians and Gynecologists. The College says that the antibiotics should be given within one hour of the start of surgery for maximum effectiveness.

[kitkat5505]

Hm, I didn't get antibiotics with either of mine and had no problems with either.

[ASusan]

I was going to post the to the allergies forum. Many women suspect antibiotic use (during c-sect, for example) has contributed to problems with gut flora and that, in turn, creates problems for food intolerances.

did they look for outcomes further down the road, after the newborn stage?

[cappuccinosmom]

Does it occur to them that antibiotic overuse is a danger in itself? It won't wipe out all infections. It might prevent a few infections from beginning but it will also play a role in resistant strains developing.

[WaitingForKiddos]

Interesting. I didn't have any antibiotics with my cesarean and I'm healing very well, and I'm typically infection-prone.

I wonder if the need for this is dependent upon closure type, the dr's skill, and the hospital's aftercare. My doctor is highly skilled, considered one of the best ob's in the area (and also has the lowest cesarean rates). He closes with sutures, cuts and sews with the idea a vbac will be the next birth, and the aftercare is very hands-off.

Given that many cesareans aren't planned (and even my planned cesarean turned crash) there ought to be a good comparison avaliable in a few years of this implimation to see what the real outcome difference is.

[AFWife]

Originally Posted by cappuccinosmom

Does it occur to them that antibiotic overuse is a danger in itself? It won't wipe out all infections. It might prevent a few infections from beginning but it will also play a role in resistant strains developing.

This. MRSA is already a huge risk when you WALK INTO the hospital (add in an open wound??) I think that using MORE antibiotics will only make it worse and up the risk. I mean, if you give antibiotics and kill off the weaker bacteria (not to mention your good bacteria!) before the surgery even starts aren't you setting women up for nastier infections?

[harli]

This is a prophylactic treatment used to prevent infections from happening in the first place. It's commonly done in planned surgeries. Not that I agree with it but it probably won't leave the women open for new nastier infections like AFwife mentioned. The idea is that you have a ton of good bacteria (or should) with possibly some bad bacteria that is introduced when the surgeon doesn't wash his hands or equipment as well as he should. So you put the antibiotics in there and kill off some of your good bacteria but you also kill off the few bad bacteria quickly before they have a chance to colonize. Usually antibiotic use only leaves you open for worse infections when you've been on them a while and almost all of your good bacteria is gone.

That said I don't agree with this practice unless your talking about someone who is already sick who is going in for surgery. But for an otherwise healthy mom who needs a c-section I don't think it's necessary.

This is probably an attempt to bring down the maternal mortality rate. If I remember right infections from c-sections is a pretty common problem for women who undergo them.

I also bet that it is going to be used by doc's to push scheduled c-sections more rather then just waiting for labor to begin on it's own. After all if labor begins on it's own they won't have time to get the recommended 1 hour of antibiotics in.

[womenswisdom]

Are you all sure you didn't have any antibiotics? I just always assumed that I'd had some, since I had major abdominal surgery, yk? They can give you one injection that is effective for 7-10 days, so is it possible you got that and didn't know?

ETA: yeah, I just googled "antibiotic standard cesarean" and there is a ton of information about the standard of care being a prophylactic antibiotic during surgery.

[LizD]

I would also guess that if you had a cesarean section, antibiotics were most definitely a part of your care. They're not something you need to consent to on an individual basis, just part of standard orders, especially for major abdominal surgery. Things like that are pushed right through your IV with your fluids.

[WaitingForKiddos]

Totally 100% sure I didn't have antibiotics.

[LizD]

If you didn't have antibiotics during surgery, that's very unusual. They're a standard addition to IV fluid for surgery, emergent and non-emergent, along with the anesthesia and sedation, Zofran for nausea, Reglan for heartburn, Pepcid, etc etc. There's a whole lot of drugs that are part of standard surgical orders that patients are not asked about and rarely see the orders for. *Most* people having abdominal surgery -or any surgery- in the United States right now are going to have a cocktail of all kinds of standard drugs for surgery including prophylactic antibiotics, especially now that hospitals are concerned with MRSA and VRE and other nosocomial infections.

What's interesting about this topic is the new recommendation that they be given at least an hour ahead of time when possible, especially in light of the other news stories about the differences in bacterial colonization of infants depending on delivery route.

[MountainMamaGC]

I am allergic to so many antibiotics and so I know they did not give me any. We didnt want to risk any more antibiotic allergies.

[*farmergirl*]

Ah that must be why. I think generally once you say no allergies they feel free to give whatever. My first was an emergency so they hit me with them afterward. My second was planned an they gave me antibiotics before the surgery but they didn't tell me! It wasn't until I said something to a nurse that she said I'd already been given them. I wasn't happy with that at all. I think it had a hand in my ds having a yeast diaper rash. I'm not allergic but I have Crohn's and things like antibiotics and Ibuprofen reek havoc on my system. I did convince them not to give me the Ibuprofen but I couldn't convince them to let me keep my piercing in - I have 23-mainly in my ears- it took me a half hour to get them all out!

[Climbergirl]

I am pretty sure I had some during my c-section. I should check my records just to be sure.

However, the septasemia, early cardiac failure, and pneumonia 5 days post op, is where I got a whole load of them. In several varieties, and IV form (then pills later). I still don't think my gut is completely healed and any antibiotics give me bad yeast infections now (worse than before). DS has the same reaction too (but I did not nurse him during the heavy antibiotics time frame, so I wonder where that came from).

I hate antibiotics. I know they save lives, but I hate taking them and avoid at all costs.

[BetsyS]

I had them with all 3 c-sections (one emergent, 2 planned). Like someone said, the only way that I knew I was getting them is that they double checked about allergies (I'm allergic to something related to the antibiotic they gave, but that particular antibiotic is fine). And, my babies #1 and #3 both got yeast diaper rashes, which I think was related.

[AllyRae]

I had a planned c-section at a major university hospital and I never once got antibiotics that I was told about (I have allergies to several kinds of antibiotics, so they would have had to run it by me to let me know what one they were going to try)... (The baby ended up with thrush somehow anyhow, but all of my kids got thrush whether they were exposed to antibiotics or not. She also has food allergies. So that theory didn't work for her I guess....)

[AlexisT]

I had abx with my section. Wasn't given an hour ahead of time--couldn't have been, my section was emergent. They already knew I didn't have allergies so I was never asked any more questions.

[AlexisT]

I also just read the NICE guideline for CS (I gave birth in the UK) and this is what it says:

"In the UK 85% of surgeons usually administer prophylactic antibiotics, 12% do so if other factors are present and 3% rarely use them.306 [evidence level 3]"

and

"Women having a CS should be offered prophylactic antibiotics, such as a single dose of first generation cephalosporin or ampicillin, to reduce the risk of postoperative infections (such as endometritis, urinary tract and wound infection), which occurs in about 8% of women who have had a CS."

[harli]

This is not talking about giving antibiotics during c-section or after. This new guideline is talking about giving antibiotics within the hour before delivery. Before most of the c-section Mama's probably did have antibiotics but now c-section Mama's will get them before delivery. Just wanted to point that out.

[MountainMamaGC]

Originally Posted by *farmergirl*

Ah that must be why. I think generally once you say no allergies they feel free to give whatever. My first was an emergency so they hit me with them afterward. My second was planned an they gave me antibiotics before the surgery but they didn't tell me! It wasn't until I said something to a nurse that she said I'd already been given them. I wasn't happy with that at all. I think it had a hand in my ds having a yeast diaper rash. I'm not allergic but I have Crohn's and things like antibiotics and Ibuprofen reek havoc on my system. I did convince them not to give me the Ibuprofen but I couldn't convince them to let me keep my piercing in - I have 23-mainly in my ears- it took me a half hour to get them all out!

I have crohns too and I am prone to fistulas which is why I have to have a c-section. I wish I would have said no to the advil. I think it helped bring me out of a 4 year remission. I did heal beautifully though even though I was abx free. I will decline abx when I have another baby.