GBS and Homebirth

[liberal_chick]

Hi all. I'm hoping I can get some assistance with an issue that's popped up for me here in the 11th hour of my pregnancy. I have an appt with my MW later today and will be asking her as well, but I wanted to go ahead and get my feelers out here b/c I know there are a plethora of info and experiences floating around.

My MW doesn't test for GBS but I just had a nagging feeling about it so I went to an OB to be swabbed. I've never swabbed positive before, but I did this time.

What is the general protocol for testing GBS positive and having a homebirth?

Additionally, I've had 3 UTIs this pregnancy with the last being a week ago. I'm set to finish out a round of Keflex tomorrow (I fought off the other two with cranberry and tons of water, but didn't want to take the time to do that this time so I decided to see my GP for the abx). Abx give me a yeast infection 98% of the time, so I also just finished out some OTC yeast stuff. I'm pretty sure that I've had a mild yeast infection for quite a bit of this pregnancy, but I was keeping it in check with probiotics. The abx made it flare up enough that I practically ran for the OTC stuff in the store.

I say all that to basically ask: A) could the mild yeast have affected the GBS test at the OB's office? and B) will the round of abx I'm on now have an affect on my GBS status?

TIA!

[babyjelly]

No, the yeast would not have affected the swab. Yeast and GBS are two different organisms, and the swab looks specifically for GBS.
As for the current abx, while Keflex is not generally the drug given for GBS, I would think tha it probably would have done the trick. You may want to be reswabbed.
"General protocol" differs depending on provider...for my previous birth, I would have been given IV abx in labor at home. My current MW generally does not treat unless there are risk factors (prolonged ROM, fever, etc.) but will do a Hibiclense wash if the mama prefers.
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[liberal_chick]

My MW is unlicensed, so there is no option for abx in labor. I also kind of "burned a bridge" with the OB that did my swab, so there is no re-swabbing.

My MW said that she's going to do the hibiclense wash every two hours and I'm comfortable with that.

[Lady Lilya]

Good. I saw the thread title and wanted to make sure that you knew about hibiclense. I saw statistics, and it appears to be more effective than ABX. And much safer too.

[wiggles06]

Garilc to treat GBS

I did the garlic therapy my last pregnancy and it worked. Here is the info on the protocol:

http://www.gentlebirth.org/archives/gbsCohain.html


http://www.midwiferytoday.com/articles/garlic.asp

Hope this helps.

[lilsamsmom07]

Hey girls! New to the website so bare with me. I need to vent a bit so here goes.  20 wks preg, been planning a homebirth since before conception in a state where its not accepted.  First preg  had no problems, great efficient birth, etc, but upon going to see my previous care provider for initial lab work, with this pregnancy found out I'm GBS+., and it's in my urinary tract.  Never had a UTI in my life,but suffered from occasional to frequent yeast infections.  I understand these two play off each other as they interfere with the body's natural flora.  So I've been on a candida diet for eight days now!  I've always considered myself a pretty healthy eater. Eating fresh, organic, and unprocessed foods, I drink water 90% of the time.  BUT of how I love my carbs, and sweets too!  I love all fruits and indulged in them daily. Coincidentally my last yeast infection was after a long weekend splurge on chocolate cake.  YET, NO more til this baby is healthy and perfect and on the outside of my body.  I'm determined to rid my body of this by improving my immune system, through diet and supplements, and hope to retest before the baby comes to find out I have at least only low levels of GBS. This whole thing is really messing with my focus on the normalcy of birth and mental ability to trust my body.  I don't want to risk my baby's well being.  I want to be certain hibiclense is equally effective as antibiotics. My midwives instills confidence, I just need more...   

[JamieCatheryn]

Here you go: http://www.ncbi.nlm.nih.gov/pubmed/12375548?dopt=Abstract

[~Adorkable~]

i keep being very surprised that so many folks seem so casually OK with using Hibiclense in the vaginal area around birth time when the FDA and Hibiclense website talk so clearly that it can lead to blindness and deafness if eyes or ears are exposed to it?

i certainly get that GBS needs to be dealt with in some way, but Hibiclense is not just a soap, its a very very strong chemical with known issues. i have brought this up before and folks seem so blase about it, am i the only one? i used to work in a field that at one point used hibiclense and stopped using it nationally because of the warnings and risks, so maybe I'm more spooked?

[babymango]

Adorkable; Thanks for pointing this out.  There was somethng that was making me feel uncomfortable about the hibiclense and I couldnt put my finger on it.  It is a harsh chemical, many websites that discuss it mention the need to keep it away from mucus membranes: eyes, nose and *genitals*!

After reading more about it, im not sure whether im more scared of the antibiotics or the hibiclense!  (not saying the abx are harmless, im just saying it doesnt sound like hibiclense is perfect either)

[3xMama]

Wow, thanks for posting that Adorkable! I had seen it listed many times on here before and was thinking of getting some since I'm GBS+. But after doing a little research, I think I'll stear clear of this. One of its main uses is as a surgical scrub and I'm not sure I want something that strong in my girly parts. I'll stick with garlic, thank you!!

[~Adorkable~]

yeah i fully understand that something needs to be done and something that we know will work. there actually is other surgical scrubs that are rated for mucosa membranes and have similar effectiveness. the one that used to be my go-to is not currently being made, but i have a email to a good friend of mine that works closely with this type of skin cleaners still and is up on current chemicals.

i will let you know as soon as i hear what the current mucosa compatible one is. 

with Hibiclense i have two issues

the first is that it is not rated for mucous membranes and yes that can be mitigated somewhat with diluting and single use, but i have heard of folks using it for many days, and this just seems like a bad idea knowing how much this kills off EVERYTHING in the area, these are supposed to be one time kill all chemicals.

the other issues is even bigger, maybe i don't understand, if you were to use use this after your water broke, it could lead to a baby getting exposed to it and it is a huge no-no to get this stuff near ears or eyes, with that being the first thing that comes down the vaginal canal, i don't think i want the stuff lining mine! as many down sides as ABX have, i think this is a clearer more immediate issue.

Now sometimes ABX are just not an option with a home birth, that is why i will be looking into a safer broad spectrum antimicrobial to have at hand rather than Chlorhexidine the active ingredient in Hibiclense

[MegBoz]

Yeah, there is no "protocol" so far as I know. My MW says she doesn't like to do IV ABTs at home because of the risk of anaphalytic shock (lol, oh the irony - the treatment is riskier than the disease!) She'll do hibicleans if we want, but she said she's had great results with mamas eating fermented foods & testing negative. She said maybe only 10% test positive, and then she has a protocol to help clear it up (I believe garlic is included). So she's rarely had anyone re-test negative the 2nd time in the past 10 years or so.

I was thinking that if I test +, I personally will only bother with hibicleans if I end up with a 2nd risk factor - listed below - like ROM for 18+ hours. If I end up with prematurity, I'd birth in the hospital anyway & maybe accept IV ABTs. I don't want vaginal exams anyway & my 2nd stage should be short, so my risks are already low. 2nd stage was 45 min with DS - my first - so likely to be quite a bit shorter with my 2nd baby.

http://www.babycentre.co.uk/pregnancy/antenatalhealth/physicalhealth/groupbstrep/

The Royal College of Obstetricians and Gynaecologists has identified a number of factors that help to predict whether your baby is more likely to develop a GBS infection (RCOG 2003:3-6).

These include, if:
• you go into labour prematurely (before 37 weeks of pregnancy)

• your waters break 18 hours or more before you have your baby

• you have a raised temperature (38 degrees C / 100 degrees F or higher) during labour

• you have previously had a baby infected with GBS

• GBS has been found in your urine during this pregnancy

I hadn't heard about blindness & deafness from hibicleans!! I thought it was somewhat common in Europe. I believe I've read of positive results from studies in the US too. I just have to say that logically hibicleans makes so much sense. The GBS bacteria are living in the vagina (& possibly rectum) & they are harmless to the mother, but may have an adverse affect for the baby - so it makes sense to me to use an anti-bacterial wash that kills bacteria only in that location. I've joked that IV ABTs are like taking a sledge hammer to kill an ant... you will indeed kill the bug you intended to kill, but you're going to do quite a bit of collateral damage - and there's a smarter way to go about it! I've read side-effects are about 10% - and that includes thrush - which can kill a breastfeeding relationship! A very significant risk, IMO. My doula had a nasty itchy rash lasting 3 whole months that she attributes to her IV ABTs. & of course there are those risks of ABT-resistant infections that can be fatal, such as e.coli, but the risk of that isn't nearly so high as the 10% risk of other side effects.

[lovebeingamomma]

I've never heard of a case of blindness or deafness from hibiclens, any evidence of this happening?  Just because it states it as a possible side effect doesn't mean it ever happens, unless perhaps the dose was given in higher concentrate then should be used?  With an estimated 10 moms a year dying from severe allergic reaction to IV ABX, and a whole range of other possible side effects, I'm going with the hibiclens.

[carriebft]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386993/

this is a good read on this topic. seems to be a theoretical risk with no science back up really...there are many studies using this solution and none have reported adverse events outside of contact dermatitis in premature infants (and a very very small number of those)