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Group B Strep test and avoiding a positive result

post #1 of 21
Thread Starter 

The other day, my doula sent me a few articles about how to avoid testing positive for Group B Strep, so one wouldn't need to take antibiotics during birth.  Mostly the suggestion is just eating yogurt and lots of raw garlic a few weeks before the test.  I'm wondering if any of you have heard of this method and I guess I'm wondering if you still have Group B Strep if you do these things and test negative, or if it actually makes it go away.  I don't want to do anything to put baby at risk so If I need an antibiotic to protect baby, that would be more important than my dislike of taking antibiotics.  What do you all think?

 

post #2 of 21

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post #3 of 21

Ooh I can't wait to see responses to this one! IF baby does not turn by the time I am in labor, I am going to have a hospital birth. It would be a total bummer but I'm just not brave enough to UC a breech baby so anyway I have been in contact with an OB willing to be my back up and allow me to deliver vaginal breech at the hospital....but she wants me to get a Group B strep test. I can refuse it of course, but she said when people refuse the test they "strongly encourage" antibiotics in labor "just in case". Rrrr. So I might not even be going to the hospital, but I am faced with this decision and don't really know what I want to do.

 

I would love to hear ways to make sure I test negative (If I choose to take the test) & then I won't have to worry about it either way. 

 

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post #4 of 21

I discussed this with my midwife at my last visit.  I was GBS+ with my last pregnancy, and I am really wanting to avoid antibiotics.  I'm lactose intolerant, so eating yogurt is out for me.  She suggested that I start taking probiotics, both orally and as a vaginal suppository(at night).  She didn't suggest any particular brand but advised that the good ones are in the fridge at the vitamin/supplement shop.  I've been taking them orally 2x per day for the last couple of weeks, and plan to do the suppository thing for a week or so before the test.

 

I'm really curious to hear what others suggest.  I'm really interested in trying anything to avoid testing positive and having to do antibiotics.

post #5 of 21
So re: probiotics as a vaginal suppository -- are we supposed to open up the capsule or does it dissolve on its own?
As some may have gathered from my other post from today - I'm also treating a yeast infection (ugh) but these remedies are the same --
I was GBS + last pregnancy and had to have the two doses of IV penicillin during labor. DS had an awful case of thrush at about 4-5 weeks (that's when I noticed it) and I am so totally convinced it came from the antibiotics. I personally am super sensitive to antibiotics - try to avoid them whenever possible for myself and DS.

Quote:
Originally Posted by BrokenFish View Post

I discussed this with my midwife at my last visit.  I was GBS+ with my last pregnancy, and I am really wanting to avoid antibiotics.  I'm lactose intolerant, so eating yogurt is out for me.  She suggested that I start taking probiotics, both orally and as a vaginal suppository(at night).  She didn't suggest any particular brand but advised that the good ones are in the fridge at the vitamin/supplement shop.  I've been taking them orally 2x per day for the last couple of weeks, and plan to do the suppository thing for a week or so before the test.

 

I'm really curious to hear what others suggest.  I'm really interested in trying anything to avoid testing positive and having to do antibiotics.

post #6 of 21

I had a long discussion about this with my midwife. I was thinking about doing all the stuff to avoid the positive result but then I know I'd stop doing it right after I tested negative so would that increase the chance of it coming back?

 

In the end, after a lot of research and a lot of talking, I decided I'd do a probiotic pill and leave it at that as my pre-testing regimine (although I suck at that, soooo....) but I would still say no to the antibiotics. The antibiotics slightly decrease the risk of early onset GBS in baby, but increase the chance of a different infection (such as ecoli) and also increase the chance of whatever strain of GBS the baby contracts being antibiotic resistant. The death rate (what we're all trying to avoid!) is the same in the antibiotic group and the non-antibiotic group. Yikes! So really, it's a total toss up. Slight decrease in infection vs. higher rate of antibiotic resistant GBS = same loss rate. Sucks either way.

 

I would like to know if i was GBS positive to avoid vaginal exams entirely if possible, do a water birth if possible (some evidence shows that it disperses the bacteria more making infection less likely), and watch even more closely for other symptoms of GBS in baby then I might otherwise. 

 

But yes- I've heard raw garlic (to eat), raw garlic in your vagina, lots of yogurt/yogurt in the vagina, douching with a mild vinegar solution (eugh), avoiding sex, taking echinasea and vitamin C in large quantities to fight off infections, and taking probiotics.

For taking the probiotics vaginally, you can insert them as is. Do it at night though so they don't fall out!

post #7 of 21
Quote:
Originally Posted by hollyann View Post

The other day, my doula sent me a few articles about how to avoid testing positive for Group B Strep, so one wouldn't need to take antibiotics during birth.  Mostly the suggestion is just eating yogurt and lots of raw garlic a few weeks before the test.  I'm wondering if any of you have heard of this method and I guess I'm wondering if you still have Group B Strep if you do these things and test negative, or if it actually makes it go away.  I don't want to do anything to put baby at risk so If I need an antibiotic to protect baby, that would be more important than my dislike of taking antibiotics.  What do you all think?

 


 

Well, the first thing I suggest you do is read up on GBS, so you understand what you're looking at.  Because nothing makes it "go away".  Not antibiotics, not natural measures.  It is completely normal for your body (and all bodies) to have GBS present in/on the body.  It is one of the bacteria that we carry around on a regular basis, along with hundreds of others.  It is naturally occurring in the GI tract, and commonly found around the anus for this reason.  These measures are intended to minimize it, not eliminate it.

 

Then I'd start asking questions.  What is your HCP's testing protocol (how do they do the test - what locations do they swab, do they do it or do you)?  What is their testing threshold (how many bacteria present - some have a threshold of zero, some have a threshold of a few hundred/thousand)?  When do they do the test (36 wks, 38 wks, labor)?  What are your options if you refuse the test?  What are your options if you test positive?  What are the protocols for your delivery location or your backup delivery location? 

 

And then there are things you need to know about GBS on top of that.  Some the pps have already shared...

A test done weeks before labor means nothing.  A positive at that time can easily change to negative in the intervening time, and a negative can become positive.  This is one of the BIG complaints about the entire concept of the GBS testing.  This is the big reason why most people have no issue with doing what they have to in order to pass the test - it's worth is questionable at best. 

A hibiclens douche in labor has been proven to be as or more effective as IV antibiotics during labor at preventing GBS colonization.  It also doesn't have the negative side effects of antibiotics.  It is not widely available (on-site), but if you can get your practitioner to agree to it, you can order it/bring it yourself. 

There is an "instant" GBS test available, that does not need to be done in advance of labor.  It will tell your practitioner whether you are colonized at that moment, rather than weeks before.  It is not widely available, but you can ask your practitioner about it.  Chances are the answer will be no though.

 

And then the things to know about infection in general:

Once your water breaks, or you suspect your water has broken, do not allow unnecessary vaginal exams.  Ask what they hope to learn from this exam, and what they plan to do with it.  If it cannot be avoided, then insist on a sterile exam rather than a "regular" (non-sterile) exam.  Anyone who argues with you on that point needs to be read the riot act, IMO, and definitely doesn't have your (or baby's) best interests in mind. 

Allowing anyone to rupture your membranes or insert anything into your uterus (internal monitoring is a big one) is a road to infection.  Avoid it whenever possible. 

If you have the option, use a peri bottle after peeing during labor.  Pat, don't wipe. 

 

And ultimately, if you do have to have antibiotics during labor, be prepared to counteract their effects.  Probiotics for yourself and baby are crucial - you can open a capsule and sprinkle a bit on your nipple a few times a day before nursing. 

post #8 of 21
Definitely planning on the acidophilus on my nipple thing if I have to have the antibiotics in labor. I didn't even know that there is a powdered form for babies until DS's thrush had been around for weeks. I stopped with the ridiculous nystatin and just used the probiotics and it cleared up within a week. Having that on hand right away post labor if you have antibiotics is a must. It's a HUGE dose of penicillin they give.
Quote:
Originally Posted by cristeen View Post



Quote:
Originally Posted by hollyann View Post

The other day, my doula sent me a few articles about how to avoid testing positive for Group B Strep, so one wouldn't need to take antibiotics during birth.  Mostly the suggestion is just eating yogurt and lots of raw garlic a few weeks before the test.  I'm wondering if any of you have heard of this method and I guess I'm wondering if you still have Group B Strep if you do these things and test negative, or if it actually makes it go away.  I don't want to do anything to put baby at risk so If I need an antibiotic to protect baby, that would be more important than my dislike of taking antibiotics.  What do you all think?

 


 

Well, the first thing I suggest you do is read up on GBS, so you understand what you're looking at.  Because nothing makes it "go away".  Not antibiotics, not natural measures.  It is completely normal for your body (and all bodies) to have GBS present in/on the body.  It is one of the bacteria that we carry around on a regular basis, along with hundreds of others.  It is naturally occurring in the GI tract, and commonly found around the anus for this reason.  These measures are intended to minimize it, not eliminate it.

 

Then I'd start asking questions.  What is your HCP's testing protocol (how do they do the test - what locations do they swab, do they do it or do you)?  What is their testing threshold (how many bacteria present - some have a threshold of zero, some have a threshold of a few hundred/thousand)?  When do they do the test (36 wks, 38 wks, labor)?  What are your options if you refuse the test?  What are your options if you test positive?  What are the protocols for your delivery location or your backup delivery location? 

 

And then there are things you need to know about GBS on top of that.  Some the pps have already shared...

A test done weeks before labor means nothing.  A positive at that time can easily change to negative in the intervening time, and a negative can become positive.  This is one of the BIG complaints about the entire concept of the GBS testing.  This is the big reason why most people have no issue with doing what they have to in order to pass the test - it's worth is questionable at best. 

A hibiclens douche in labor has been proven to be as or more effective as IV antibiotics during labor at preventing GBS colonization.  It also doesn't have the negative side effects of antibiotics.  It is not widely available (on-site), but if you can get your practitioner to agree to it, you can order it/bring it yourself. 

There is an "instant" GBS test available, that does not need to be done in advance of labor.  It will tell your practitioner whether you are colonized at that moment, rather than weeks before.  It is not widely available, but you can ask your practitioner about it.  Chances are the answer will be no though.

 

And then the things to know about infection in general:

Once your water breaks, or you suspect your water has broken, do not allow unnecessary vaginal exams.  Ask what they hope to learn from this exam, and what they plan to do with it.  If it cannot be avoided, then insist on a sterile exam rather than a "regular" (non-sterile) exam.  Anyone who argues with you on that point needs to be read the riot act, IMO, and definitely doesn't have your (or baby's) best interests in mind. 

Allowing anyone to rupture your membranes or insert anything into your uterus (internal monitoring is a big one) is a road to infection.  Avoid it whenever possible. 

If you have the option, use a peri bottle after peeing during labor.  Pat, don't wipe. 

 

And ultimately, if you do have to have antibiotics during labor, be prepared to counteract their effects.  Probiotics for yourself and baby are crucial - you can open a capsule and sprinkle a bit on your nipple a few times a day before nursing. 

post #9 of 21

Great info Cristeen!  You're wealth of knowledge never ceases to amaze me!  loveeyes.gif

post #10 of 21
Quote:
Originally Posted by BubbleMa View Post

Great info Cristeen!  You're wealth of knowledge never ceases to amaze me!  loveeyes.gif



I second that, thanks Cristeen!!!

post #11 of 21

I have a friend that tested positive for Group B and still did a home birth without the antibiotics and no problem came of it. I don't think she did anything homeopathic to cure it either.

Since I UC, I don't typically get tested. And they never seem to tell me the results when I am tested 0_o...so I assume they are all negative.
With my first she was hospital birth so they tested obviously. Never heard the results....
With my second at the birthing center, they wanted to test because I had a family history of fatality due to group b. Never heard the results.....
My two UCs I didn't test.
With this one (even though it is going to be a UC as well) I did get tested.....almost two weeks later and still no news on the results.

If you know you are positive, then I would suggest you do at least something to remedy it (homeopathic or something).....as my nephew died at 9hrs old due to group b.

post #12 of 21
Quote:
Originally Posted by cristeen View Post

A hibiclens douche in labor has been proven to be as or more effective as IV antibiotics during labor at preventing GBS colonization.  It also doesn't have the negative side effects of antibiotics.  

 

...

 

And then the things to know about infection in general:

Once your water breaks, or you suspect your water has broken, do not allow unnecessary vaginal exams.  Ask what they hope to learn from this exam, and what they plan to do with it.  If it cannot be avoided, then insist on a sterile exam rather than a "regular" (non-sterile) exam.  Anyone who argues with you on that point needs to be read the riot act, IMO, and definitely doesn't have your (or baby's) best interests in mind. 

Allowing anyone to rupture your membranes or insert anything into your uterus (internal monitoring is a big one) is a road to infection.  Avoid it whenever possible. 

 

this is exactly what I plan on doing, regardless of whether the GBS test (which I'm doing tomorrow, at around 36w) is positive. the research on hibiclens (chlorhexidine if you're looking for studies) and GBS colonization is very promising. 

post #13 of 21
Thread Starter 

Christine thanks for all the info!  This might be a silly question, but what is the difference between a sterile exam and a regular exam?

post #14 of 21

Cristeen, I spent a long time looking up the hibiclens douche. It is effective as antibiotics at preventing UPWARDS colonization of group B strep- so, it avoids infecting uterus and baby while the baby is still in utero. That's good. But if you can get away with avoiding all vaginal exams, then the rate of upward transmission is the same in the antibiotics, hibiclens, and the "do nothing" group.

 

This is, of course, assuming I'm remembering it all properly! I think this is what I said to my midwife and she nodded along the whole time and said,  "yep, that about sums it up!"

post #15 of 21

Glad to see this discussion, since it's been on my mind for weeks. I tested positive last time, had an incomplete course of antibiotics during labor (I labored at home most of the time, but in the ten minutes it took to get from my house to the hospital, thing accelerated very quickly and I was ready to push when I arrived), ended up staying there 2 days so they could keep an eye on the baby (I think? I don't even really remember now why they wanted us to stay since the baby was in my room the whole time anyway). And, like others have experienced, ended up with a wicked case of thrush that really complicated an already difficult nursing situation. Needless to say, I've been stressing out about it. My midwife keeps telling me to relax, that the test sucks basically because the results can change from day to day, depending on when you get tested. On her advice, I've been taking a daily probiotic for months now, and I eat a ton of yogurt anyway. Thinking of trying the garlic in vagina thing for 5 days before my test (at 38 weeks), just because...why not, right? It's always worked for my yeast infections, so maybe it'll help.

 

I'd never read/thought about sprinkling probiotics on my nipples if I have to have the antibiotics, but I'm so glad Cristeen mentioned it. If I test + again, am definitely going to try that.

 

For those of you who've tested positive before and took the antibiotics, have you ever been told that for a subsequent birth you would not need two full courses, that one course of the atbx would suffice? My midwife said something to that effect to me during my visit last week. Just wondering if that's a common practice. I don't mind getting to the hospital with 45 minutes to spare, but I'd rather not be there for 2 hours or however long it takes to get 2 full doses.

post #16 of 21
Quote:
Originally Posted by Astraia View Post

 


For taking the probiotics vaginally, you can insert them as is. Do it at night though so they don't fall out!



Yes that's what my midwife said.  She also said use a pad because it can get messy.

 

 

Thanks Cristeen for the very informative post, I found it most helpful!

post #17 of 21
Quote:
Originally Posted by hollyann View Post

Christine thanks for all the info!  This might be a silly question, but what is the difference between a sterile exam and a regular exam?


 

You see that box of gloves sitting next to the door in the exam room?  The doc reaches in, grabs a couple and puts them on?  Those are not sterile gloves.  Every time someone reaches their hand into that box, they're contaminating those gloves with whatever is on their hands.  Even just sitting open and exposed leaves them contaminated (coughs, sneezes, HVAC, etc.).  Those gloves are intended to prevent anything you may have from infecting the doctor.  And any open sores on the doctor's hands (think hangnails, mostly) from infecting you.  That's all.  Whatever may have been on those gloves is fair game though.

 

Gloves used for a sterile exam are packaged in sterile wrapping.  Kinda like a big band-aid package, where it has to be pulled apart.  And then putting them on is a bit more complicated because you can't touch any part of the exterior other than the cuff.  I've only done it once, and it's nowhere near as quick and easy as the loose ones.  They'd be very careful to have you situated and all equipment ready to go before putting on the gloves because anything they touch with those gloves contaminates them, so they want to go from the package into your body with minimal stops in between. 

 

Same thing goes for a speculum.  One that is sitting loose in a drawer is not sterile.  A sterile one will be wrapped up in paper that is taped closed (if metal), or will be in similar single-use packaging as the gloves if plastic. 

 

Same for swabs.  Loose in a drawer/jar/whatever is not sterile.  Individually packaged is. 

 

Everything that touches you needs to be sterile.  In most instances (particularly in a large hospital), that means single use and individually packaged.  Including the lube used on the gloves - that shouldn't come from a larger tube that sits open, but usually an individual package (like a ketchup package).  A sterile exam takes a few minutes to set up because of the risk of contamination.  If someone comes in, reaches into that open box of gloves and asks you to hop up on the table and spread your legs, then you know it's not a sterile exam.  And the simplest response is that you stay off the table until they understand you want a sterile exam and they start gathering the equipment they'll need to do one.  And seriously, any practitioner who insists on doing a non-sterile exam when you have requested otherwise and you even suspect ruptured membranes needs to be kicked out of your room and not allowed back in.  You have that right as a patient.  You can ask for a patient advocate, or the head of the department if they're belligerent about it, but ultimately they do not have your best interests at heart if they're insisting on a non-sterile exam.  Obviously I would only be really concerned about this in a hospital setting... I know my MW last time around did only 2 (sterile) exams during my entire (days-long) labor because I had early rupture and we didn't want to risk infection.  Most MWs should feel similarly. 

post #18 of 21
Thread Starter 

Thanks Cristeen! I had no idea that there was a difference, We are planning a birth at a free standing birthing center,  I've only had one vaginal exam, for a yeast infection and they defiantly used the box of gloves.  I'm assuming they will be well equipped to do a sterile exam if necessary, but I'll defiantly ask at my next apt on Monday and if not, I'll bring my own box of sterile gloves!

 

post #19 of 21

Just wanted to say thanks Hollyann for bringing this up.  I had been planning on doing so, but you beat me to it.

 

I'll be taking the test in a couple of weeks and would like to test negative so that I just don't have to deal with the repercussions.  I'm allergic to penicilan and in general try to stay away from antibiotics as much as possible.

 

Thanks for the info everyone!

post #20 of 21
Quote:
Originally Posted by hollyann View Post

Thanks Cristeen! I had no idea that there was a difference, We are planning a birth at a free standing birthing center,  I've only had one vaginal exam, for a yeast infection and they defiantly used the box of gloves.  I'm assuming they will be well equipped to do a sterile exam if necessary, but I'll defiantly ask at my next apt on Monday and if not, I'll bring my own box of sterile gloves!

 



Yeah, you won't get a sterile exam until there's a suspicion of ruptured membranes because it's just not really a risk.  But I'd be willing to bet they have them.  They're just in a drawer or in their kit.  The gloves are individually packaged.  I know my list of supplies for my MW includes both standard gloves and sterile gloves that I have to supply for her. 

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