GBS Positive « Back to Group Discussions

[usagi629]

Well greaaaaaaaaaaaaaat.... Just found out today (because they didn't have the results back last week) that I tested positive for GBS. 

I'm giving birth in a birthing center that's connected with a hospital. The midwife told me I will have to come in a little earlier most likely so they can give me the antibiotics via IV, after which they will heplock it so I don't have to stay connected, but if I don't get at least 2 does (1 every 4 hours) during my labor, before baby is born, then the pediatrician at the hospital (who usually doesn't even get involved with birth center babies) will possibly want us to stay in the hospital versus going home 4-5 hours after birth as we normally would. The reason being for observation of the baby.

I'm freaking out a little bit right now. I know everything will work out and be fine, and the most important thing is to do what is best for baby to be healthy, but I'm just not really coping well with this news. I wasn't planning on having an IV to deal with at all, that's why I chose a birthing center. And the idea of staying in the hospital instead of coming straight home just makes me feel sick. I don't even know how that would work logistically, because we were only planning on having friends watch DS for a limited amount of time since we would be coming home right away. 

Has anyone else tested GBS+ this pregnancy or in a previous pregnancy?

[cjmullin]

I'm so sorry!! I also tested GBS+ this is my first baby so i don't have previous experience. I'm giving birth at home and my midwife was very open to my declining any antibiotics at all. I'm still on the fence and she's bringing them to the house regardless. Her version's not an IV at all but a syringe i'll have in my arm for about 15 min for each dose. Also she said she attempts two doses but feels pretty good if she gets one in about 3 or 4 hours (i think, i can't recall) before the birth.

Doesn't sound like you're given the option of declining the protocol at your center. It really is a mental adjustment to be sure so let yourself feel what you're feeling -- you're right -- it will all work out fine, but that doesn't negate from your need to let yourself feel a little disappointed, annoyed...whatever you're feeling. I was really bummed and then felt stressed to make the call to decline or not for about a week after finding out. I have a feeling, knowing me, i'm going to ask for the antbx.

You might ask what you can and cannot decline. Maybe you can refuse the stay if they end up recommending that?

[usagi629]

Thank you for replying!! I don't know why, but there is just something comforting hearing from someone else going through this same thing.

I don't think I can decline any of it unfortunately, although, I don't think I'd choose to decline the antibiotics. IDK. After reading the statistics of 1 in 200 babies developing GBS without mom getting antibiotics vs. 1 in 4000 if mom does get the antibiotics, and reading all the worst case scenario GBS complications crud, I'm not wanting to risk not getting them. (not that I have the choice, mind you)

I don't know if I can decline the overnight stay. The midwife who saw me today is a student in the practice and had only seen 2 births in the birth center where the mom had GBS and was only able to get one dose of antibiotics, but in both cases she said the pediatrician was OK with the families going straight home. I have to imagine that it depends on the timing of the dosage in respect to delivery as well as the specific pediatrician who was on-call/on-staff at those times. So.... who knows.... :-\

I'm hopeful that if we get in early enough, we won't have to worry. I just am not happy about this outcome at all. I don't know how long the IV takes per dosage or what it means as far as what position I can be in while I receive the drip or if I can still move around or what. I was in a bit of shock and process when I heard the news, so I didn't think of any of these questions until I got home, of course. :-\

I'm sure I'll make my peace with it. But like you said, I'm just letting myself feel what I'm feeling so I can get past it. 

Thanks for sharing your own experience thus far dealing with this. I'm sure we'll both have beautiful healthy babies in the end and it won't matter in the least. That's the thought to hold onto. :)

[lalazap]

I'm sorry, usagi. Testing GBS positive puts you between a rock and a hard place for sure. I was really relieved to have tested negative although there was no doubt in my mind that I would treat with antibiotics if I was positive. (Unless I were having a super fast homebirth with intact membranes and my midwives needed the time to set up birth and resus equipment instead of fiddling with an IV!) I have seen more than one case of GBS sepsis in a baby in my (not-very-long) midwifery career and it is not good at all.

In terms of the logistics you were wondering about, IV antibiotics for GBS are usually run over 15-30 min every four hours. You would need to be a specific position (with your arm very stable) in order to get the IV sited in your hand or arm but you would most likely have your arm back after that. Sometimes the IV line gets kinked if your wrist is bent or something like that, so for the time the abx are running through I suppose it's possible that you'd need to keep your arm in a certain position. There's no need for you to lie down on a bed for abx adminstration. After the first dose is run through, the IV can be capped and taped up so you can go in the bath or shower and you're not attached to long tubing or an IV pole. Four hours later, it gets reconnected for the next dose. I have run IV abx on women in the bathtub, on the birth ball, etc with no problem.

IME, an IV doesn't really restrict a woman's mobility in labour. Continuous monitoring - a thousand times more annoying and invasive - and not indicated with GBS+.

The longer hospital stay is a drag. Fingers crossed you get your two doses! You CAN sign your baby out against medical advice and go home, though it could definitely turn into a nasty fight with the pediatrician. What's the usual follow-up if you went home early? Do you see your midwives again within the first few days? I have been able to get peds to discharge babies to me because they know I am available 24h/d and am planning to see them at home the next day anyway.

I've had clients who've had homebirths with 'inadequate prophylaxis' (no abx or only one dose) and you can be sure I'm not sitting around their house observing the baby for 24h, much less admitting them to hospital for a nurse to take the temperature and count respirations and heart rate every four hours (that's what 'observing' the baby usually means, BTW). I just tell the parents what is normal for a newborn, review signs of sepsis and ask them to page with any concerns at all. I visit again within 24h of the birth and check up on everything.

[hazelbranch]

Usagi, I tested GBS+ for my first pregnancy and just did again for this pregnancy.  I was shooting for a home birth with DD so I took the antibiotics at home, and there were no issues with movement during the process.  I did end up transferring because my water broke and labour wasn't coming on, but it was that situation combined with the GBS that created my troubles.  The pitocin and constant fetal monitoring at the hospital was the bad part, and as long as your labour starts up fine it probably wouldn't be an issue for you. 

Testing positive both times has been very upsetting for me since I have always wanted the least invasive birth possible, and I did not get that last time.  This time I am trying to be positive and remember that a PROM situation is not as likely to happen this time.  I am still focused on a home birth and will be getting the antibiotics again.

[usagi629]

lalazap -- Wow! Thanks for all the great info! That's really helpful. The normal procedure for babies born in the birth center is that the family leaves within 4-5 hours of birth and is to see their own pediatrician within 48 hours of birth. I think we would probably attempt to see our ped within 24 hours this time because of the GBS. With DS, he was born on a Wednesday afternoon, and I believe we took him in Friday morning, I think mostly because we didn't get home until around 9 or 10 at night that Wednesday, so we called in the appt. on Thursday. The ped has already agreed on a written form, submitted to the midwifery, to see baby within 48 hours (unless baby is born like Friday night). We'll just have to see.

I'm really hoping my midwife will be good with administering abx while I'm in the tub or on the ball. That definitely makes it sound a lot less scary/restrictive. :-)

hazelbranch -- I'm sorry to hear you didn't have your ideal birthing experience the first time with this. I hope this time is a lot better for you. FWIW, a friend just told me that she did a lot of research when another friend of ours was diagnosed with GBS in her pregnancy, and she found out that waterbirth decreases the risk of baby contracting GBS. Something about the water preventing the bacteria from being ingested and infecting the baby. I'm going to look into this research myself, but it makes me want to do whatever I can to ensure the waterbirth I want. I didn't get a waterbirth last time, but I'm determined things will be different with this baby!

[sunflwrmoonbeam]

lalazap, just curious, what do you recommend for someone who's GBS+ and severely allergic to all the -cillins? I looked up the CDC stuff on it and they don't list any other antibiotic as being highly effective. I was GBS- last time and as a homebirth transfer had to fight to not get treated anyways. I didn't test this time and everything's been fine.

[lalazap]

If a client has a pencillin allergy we ask the lab to run an additional antibiotic sensitivity test if the swab is found to have GBS. They test 5 or 6 antibiotics on that woman's particular strain of GBS and then we know which of the penicillin alternatives should work for her. MW care is integrated into the system here so we don't have any problems getting the antibiotics for home administration or during transfers from HB. I really feel for women and midwives working in places where a transfer means a battle over irrelevant things like treating for GBS in a GBS neg woman ... as if the indication for transfer isn't stressful enough for everyone. :(

[DeChRi]

I am negative this time but was positive with two of my last three. I had unmedicated hospital births. I got about twenty min of IV abx. Once the hep lock was placed and line connected, they let me move and I sat next to the bed on a birth ball and was able to move freely within the space the line allowed. It was really way less of a big deal than I thought it would be. I am -cillin allergic and trying to remember what I got. But whatever it was had to be given 8 hrs apart so my down side was more time than I wanted at the hospital. My second time, baby came before I got both doses. Our hospital "policy" is baby stays 48 hr for observation. Our family ped signed her out earl (20 hr I think...earliest they would release me) and we agreed to swing by her office a couple days later to have her checked out. Wasn't perfect but her office is three min from us so we went with it.

I hope it goes smoothly, and hope your experience is as easy as mine was. It really is one of the things I remember the least about those birth experiences, despite my extreme angst going in.

[usagi629]

Thanks DeChRi!! It's definitely good to think ahead that this really won't even be something I look back on or care about once that baby is in my arms!! :-)