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Group B strep

post #1 of 26
Thread Starter 

So I will probably need to be tested next week and was thinking about refusing testing. I tested positive with my second, but had him outside the US and they don't treat routinely. Had my third without testing--so that's two for me who most likely had a chance of infection and didn't get it. From what I have read, if you test positive once and don't do anything major to treat (which I haven't) you are likely to be positive again.

 

My thoughts are that I would rather avoid an antibiotic IV draw out once I am in labor (assuming I don't have any special risk factors that increase transmital), as I tend to have a 1-2 days of really mild "false" labor and then 3-4 hours of actual labor starting VERY slowly and rapidly ending in OMG we need to get to the hospital as I need to push NOW.

 

For background: With my second I went to the hospital as I had a "back ache for two days" and my water had broken 12 hours earlier but was not dialated at all. Cut to a poorly translated umm OK to take a drug that has been outlawed in the US to "get labor started" and I was pushing alone in the labor room two hours before I was scheduled to be checked again to see if I might want an epidural. (In my defense my husband was out of town, so I had an acquaintance take me to the hospital)

 

I thought the speed of the labor was due to the drug, but with my third I had light contractions for twelve hours, then a break for the day only to wake up at midnight with those light pains again. I went downstairs and worked for a few hours then got in the bath to relax before going back to bed and almost didn't get out again! Somehow I managed to get back upstairs and wake my husband up and went thru transition in the car and had to be dragged up two flights of stairs to push baby out. We were in the hospital less the 30 minutes before he was born.

 

So I think I should count on a fast birth once things actually start to happen. :-) If it's not insanely rushed I will actually be glad, but am planning for another speedy quick one.

 

 

I find labor, mostly the crazy rush to the hospital, kind of traumatic and am thinking that if they just don't know if I am positive maybe I won't have to go thru the whole "hold baby in for a few hours while the meds start to work" fiasco I have heard other friends who have had babies in the US go thru. Or maybe I should just get tested and then plan on refusing treatment? 

 

Any thoughts on what may go over better, and what are you ladies planning on?

post #2 of 26

For some reason, I'm completely convinced I'll be positive for GBS (I was negative with my first pregnancy), and I have been internet/MDC searching for options if I am positive.  I have my swab today.  I can see, Sarafi, why you don't want it at all, and it makes perfect sense.  I'm going ahead with the test, but am interested in hearing experiences with being positive and accepting or refusing any sort of treatments.  I really do not want IV antibiotics during labor (I'm having a hospital birth, so I'll have to have concrete plans before labor if I am positive).  Thanks for all your insight into GBS, which is about that time for all of us here in July DDC.

post #3 of 26

I'm still waiting on my result since it took longer at the lab than expected. I've tested negative the last two times. It's one of the few tests I don't have a problem doing because if I end up transferring to the hospital I don't want to automatically be assumed as positive and have that to deal with. If I were to test positive, I'd increase my chances of being negative at birth by following the recommended holistic treatments like increased vitamin C, probiotics, garlic, bee propolis. grapefruit seed extract, echinacea, etc. I would also do Hibiclens vaginal flushing during labor as an alternative to antibiotics to reduce the chances of spreading it to the baby.

post #4 of 26

I was strep B positive with my first baby and got the antibiotics when pushing him out in the hospital.  I got there ready to push and think they gave me the antiobiotics at the very end.  He ended up with minor food allergies (that he basically outgrew at 3) that may or may not have been caused by the antibiotics.

 

This time I want to be negative so I don't have to deal with any of that (but tested positive for it in my urine at my 10 week prenatal visit then negative for it in my urine at my 20 week visit) so I have been taking tons of probiotics - drinking miso soup, eating yogurt and taking different brands of a good quality probiotic my whole pregnancy- and the past 3-4 weeks or so I have been doing sitz baths with either green tea (make a cup of tea and pour it in the contraption they sent me home with after baby #1 filled with warm water the rest of the way) or 1/4 cup of bragg's apple cider vinegar (got the apple cider vinegar idea from online research and the green tea from my acupunturist) every other day.  I also stopped wearing underware at night and try to air out as much during the day as possible too!  While soaking I also keep telling my body that the GBS is not welcome and needs to leave me alone (strong believer in the mind body connection)!

 

My test is next Monday and I plan to shower, then soak in the apple cider vinegar and dry off real well with a freshly laundered in hot hot water towel and then go to the appointment without underware.

 

If I do test positive I am going to talk to my midwives (birth in a hospital) about refusing treatment.  My doula sent me this information about it to help with my argument (last time my water broke 3 hours before he was born and he was 8 days late- both low risk according to this article).

"Interestingly, the Cochrane Collection reviewed the evidence in 2009 and recommended no treatment for GBS in labor in low-risk situations.  You may want to discuss your baby’s risk with the midwives, and whether they still recommend treatment in your situation if you test positive.

http://www2.cochrane.org/reviews/en/ab007467.html "

 

However, I also want to leave the hospital ASAP after delivering this time and don't want my refusing of antibiotics in labor to prevent the pediatrician from releasing the baby so I have to be mindful of that too (which is why I am thinking very positive about testing neg. this time).

 

Time to go soak and make some miso soup!

 

Melistar- where in NJ are you birthing?  I am at Morristown Mem. Hospital with Avalon midwives and have the same due date 7/7 as you do!

 

 

 

post #5 of 26

I was GBS positive with my first and am again this time as well.  I refused treatment at the hospital with the first and will again this time.  My midwives were super supportive and respected my decision, however the hospital did have special treatment rules for observation post birth, which are the same whether your status is unknown or you refuse.  The baby and I were required to stay an extra 24 hours at the hospital (or two nights) and I had to bring baby in to the Dr, two days after we left the hospital for a checkup.  Overall I was very happy I made the choice to not have the IV.  So my personal opinion is whether you test or not try to discuss openly with your Doc or midwife, you might be pleasantly surprised.

post #6 of 26

Thank you for all the helpful info on GBS.  I'll find out Thursday at my next dr appt whether I tested positive.  If so, I am going to see if my doc is amenable to allowing me to retest after trying some home remedies.  Or, if that's not possible (for practical--I go into labor--or insurance reasons), whether they'd be amenable to alternative therapies during delivery.  It's worth asking, like goster said!

 

(PS - Nightswimming, I sent you a private message re my location on NJ--I'm in South Jersey. Unforutately, we don't have many birthing center options in my area (I meant midwife friendly hospitals with natural birthing assitive ammenities, like balls and tubs, etc.  I know there are more options like that in the northern part of the state).  I do, however, have a brand new hospital with all private rooms, so that's at least something....no roommate from hell like last time.)


Edited by melinstar - 6/13/11 at 11:32am
post #7 of 26

I am going for my GBS test in about 20 minutes..soaking in apple cider vinegar/water sitz bath as we speak.  Wish me luck!

post #8 of 26

Good luck! 

post #9 of 26

I did this tests today- first time after 5 babies but MW likes to do this test because in the event of a transfer the hospital will hold your baby for 3 days while they test the baby so she feels it's easier to have a sheet with results in case. Her protocol is hibiclens wiping every 4 hours in labor- one can birth where they want (water, land etc;) she doesn't care. I hope mine is negative though.

post #10 of 26

I just read a study that showed the Hibiclens wipes were not as effective as the internal wash for treats GBS.  Just a FYI.

 

post #11 of 26

Okay- what is the internal protocol? Now I'm worried I will  have a positive test!

post #12 of 26
Quote:
Originally Posted by greenmama66 View Post

Okay- what is the internal protocol? Now I'm worried I will  have a positive test!


yeahthat.gif
post #13 of 26

Well my test was negative so I don't have to do anything out of ordinary in labor, I asked my midwife about internal protocol and she's never heard of it.

post #14 of 26

I don't know if my worrying about this test conjured the devil, but I tested positive.  I asked the doc about alternate treatments, whether I could retest in two weeks, and if I refused IV abx at birth, whether I and/or the baby would have to extend our hospital stay.  She looked at me like I had two heads, I got the feeling no one had ever questioned her on this issue before, and she kind of was perplexed about my questions.  (Like, regarding the retesting, after she said GBS is transitory, she then said that they rely upon 36 week swab, so even if I were negative at 38 or 39 weeks, it wouldn't matter--they'd still treat.  But, then I said, if I had been negative at 36, there was still a chance I could have it at 38, or 40, but I wouldn't be treated because I had been negative at 36.  And, if I retested at 38 or 39 weeks and was negative, why would I need IV abx then?  She had no answers....)  She did say that neither I nor the baby would have an extended hospital stay if I refused IV abx, but that they would have me "sign something" and tell me to look for the signs for all the horrific things that could happen to my baby if I refused abx.

 

Related to Nightswimming's comment about allergies....anecdotally, that's added to two women I know who had IV abx for positive GPS, and they both had to eliminate diary & soy from their diets while nursing.  Coincidence?

 

At my OB practice, there are 5 docs, and it's luck of the draw who delivers you.  I'm going to ask about GBS at my following appts with other docs to get their take on the issue.

 

 

post #15 of 26

Sorry to hear that Melinstar (and sorry I never PM'ed you back...really bad about that!).  Try going to your next appointment with a print out of the Cochrane report I posted:

"Interestingly, the Cochrane Collection reviewed the evidence in 2009 and recommended no treatment for GBS in labor in low-risk situations.  You may want to discuss your baby’s risk with the midwives, and whether they still recommend treatment in your situation if you test positive.

http://www2.cochrane.org/reviews/en/ab007467.html "

 

I will say that my son did outgrow all of his food allergies and extra probiotics at birth might have helped him even with the antibiotics.  I am still not convinced though that I got the antibiotics soon enough before he was born to even make a difference though (although my memory about that could be really off) so what was the point.  I hate treatments just because it has always been done that way even though it makes no sense.

 

Good questions that you asked your Dr. that she had probably never thought about before- she is just used to following protocol.  That is why it is our jobs as moms and dads to question the protocols - we have that right and we do owe it to our babies/families!

 

I go for my appointment this afternoon with the test results...Keeping my fingers crossed I am negative.

post #16 of 26

I'm planning a home birth.  I tested GBS positive and my midwife gave me the option of antibiotics or the internal hibiclens protocol.  The info sheet she gave me describes the protocol this way:

 

Use Hibiclens (Chlorhexidine) vaginal wash at the onset of labor or at rupture of membranes, whichever comes first.

 

Method:

 

  • Fill your peribottle first almost to the top, leaving about 1/2 inch.  Add 2 Tbsp Hibiclens (4% chlorhexidine solution).
  • You may be most comfortable in a squatting or a sitting position (even on the toilet) or lying down with your hips slightly elevated.
  • Use the entire amount for each application.
  • Slowly instill the solution into the vagina under very gentle pressure.

 

After the first vaginal wash, you should rinse with the Hibiclens solution after using the bathroom each time for the duration of your labor.

 

Hope that helps! :)

post #17 of 26
The CDC has new recommendations that were out in 2010, which is a little newer than the Cochrane report and those are the recommendations our peds use. Not to say one is better than the other at. all (I tend to trust Cochrane more than the CDC, just fwiw imo). It's the pediatricians that really control the time frame of stay after delivery with regard to GBS pos. So i would contact them instead of the OB. the GBS isn't a problem for you, just the baby. With DS I delivered in the hospital and was GBS pos and stayed 48hrs so they could observe baby longer. They did blood cultures on babe a couple hours after delivery. The GBS prophylaxis is helpful in reducing early onset GBS infections but not for late onset (which can occur quite late, like months, afterwards).

ETA- i only had to stay longer because I went too fast to get 2 doses in. If I would have gotten both doses in time then I wouldve been able to go at 24 hrs. the goal is to get at least 2 doses in with the second finishing at least 30 mins prior to delivery.

ALSO, anyone who tests positive and is penicillin allergic... be sure to make sure they do a susceptibility report on your test. GBS is pretty much universally susceptible to pcn but if you're allergic it is not always susceptible to the alternatives. I had a mama last week that needed Vancomycin because she was allergic to pcn and it was resistant to the other standard second choices.
Edited by mamahen2coop - 6/20/11 at 6:31pm
post #18 of 26

Thanks for that information Mamahen2coop.  Unfortunately I was positive...really bummed about it because I do not want to antibiotics and do not want to stay in the hospital for 48 hours (I actually want to leave asap).  The pediatrician I use would support me on this but he doesn't have hospital privledges where I am delivering so my baby will be seeing another ped. that the midwives recommend.  Should I contact that pediatrician to talk about it? 

 

Any ideas on how to not get the antibiotics and not stay for 48 hours?  I am only planning to refuse the antibiotics if I get to the hospital ready to push and my water breaks towards the end like it did last time.

 

Do you by any chance have a link to the cdc info?  I will be looking for it as well.

 

Thanks.

post #19 of 26

I tested positive as well.  FML.  I swear everything that could go wrong with this pregnancy will. 

post #20 of 26
Quote:
Originally Posted by Nightswimming View Post

Thanks for that information Mamahen2coop.  Unfortunately I was positive...really bummed about it because I do not want to antibiotics and do not want to stay in the hospital for 48 hours (I actually want to leave asap).  The pediatrician I use would support me on this but he doesn't have hospital privledges where I am delivering so my baby will be seeing another ped. that the midwives recommend.  Should I contact that pediatrician to talk about it? 

 

Any ideas on how to not get the antibiotics and not stay for 48 hours?  I am only planning to refuse the antibiotics if I get to the hospital ready to push and my water breaks towards the end like it did last time.

 

Do you by any chance have a link to the cdc info?  I will be looking for it as well.

 

Thanks.


You can always leave AMA (against medical advice). they cant FORCE you to stay. and maybe the protocols are different at other hospitals.

Here are a couple links to the CDC. I deleted the stuff our PNP sent to us recently so I just searched group beta strep on the CDC site...

http://www.cdc.gov/groupbstrep/guidelines/guidelines.html
http://www.cdc.gov/groupbstrep/guidelines/algorithms-tables.html

I didn't look through them since DS is destroying the house and dinner is cooking...
be back later...
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