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GBS+, IV question

post #1 of 21
Thread Starter 

So this morning at my 36 week "make a birth plan" midwife appointment I was informed I tested positive for Group B Strep.  This really throws a wrench in the no IV portion of my birth plan and going to the birthing center as late as possible in labor.

 

After a long discussion with my midwife (who will support me if I decide or don't decide to take antibiotics) the issue basically boils down (for me) to newborn care.  If I get in the two doses of antibiotics (4 hours apart) via IV before baby is born then there is no need for special baby monitoring.  If I only get one dose in then it depends on the in house pediatrician.  If there are no doses given then there is a hospital policy to do an arm blood draw for the baby at 6 hours old and a stay for at least 48 hours with no possibility of rooming in with baby.

 

So my game plan is to go to the birthing center when I'm sure labor has started but sooner then I'd go otherwise and have then give me the first dose while they do the 20 min of baseline monitoring. 

 

Given that I'm needle phobic to the extreme the two possibilities I'm playing with are:

 

1.) Get a hep-lock (midwife prefers this) and keep it in while I labor.  Pro, the only needle jab is to get it set up.  Con, there will be a needle stuck in my arm while I labor ... I feel faint just thinking about it.

 

2.)  Get the antibiotics but have them remove everything after the first dose.  When it is time to do subsequent doses have them re-insert the needle each time.  Pro, no constant needle which I know will throw all my relaxation techniques out the door.  Con, nurses probably won't like the extra work and more needle jabs.

 

So I guess I'm looking for a what would you do?  And if you had a hep lock during labor before, how was it?

 

Thanks in advance,

 

RedTree - mostly still freaking out

post #2 of 21
Sorry to hear about the GBS result. I would definitely get the antibiotics if I tested positive. I would much prefer to deal with the inconvenience during labor and go overboard with probiotics than subject.a newborn to invasive testing. I haven't had a hep lock, but that was my plan if I was GBS positive. I was under the impression that it was in your hand NOT in your arm though, and I could be wrong.
post #3 of 21

I would do the hep lock, personally.  It is a nuisance, however, it could be REALLY obnoxious to have to sit still while they poke around to get your vein while in hard-core labor, 4 hours later.  I'm sorry plans have changed for you.  That has to be disappointing.
 

post #4 of 21

I just posted about Group B in the main thread. I also just found out that I'm Group B positive and I'm incredibly upset about it. So, I just want you to know that you aren't alone RedTree. I'm in the exact same spot.

post #5 of 21
Thread Starter 

Thanks for the replies.  Like you 1stTimeMama4-4-10 I'd much rather have me poke and prodded then the baby.  I knew that the hep lock was somewhere on the arm or hand but I'm not really sure which.  I'm planning on stopping by the store this evening to get some good probiotics to have now and after labor.

 

Thandiwe that's what I'm struggling with.  How obnoxious would it be to have nurses trying to get a needle in during active labor vs. hep lock and its constant reminder.  Sigh.  Maybe a hep lock isn't as bad as my mind is making it out to be.

 

As I analyze my feelings more I guess what I really am worried about is that the nerves of being in the birthing center and now having the hep lock (or multiple needle attempts) will give me high blood pressure readings.  Which will then trigger pushes for interventions or increased monitoring.  I need to be completely zen in a clinical setting to have normal readings.  Anything that messes up my zen sends my readings through the roof.  Sigh, I wish I could have another homebirth like last time.

 

::Hugs:: SallyRae17 sorry to hear you got a positive as well.  We can be upset together.

post #6 of 21

Sounds like you ladies who have tested positive may have already made up your minds already about taking the antibiotics.  My midwife wants to test me for GBS and I am refusing the test based on some evidence I've found.  One of the books that explains it well is Ina May's Guide to Childbirth.  At least it allows you to consider options.  There are also some sites online that provide research that was done in regards to the administration of antibiotics to all women who test positive and if it had any effect on lowering the infant mortality rate.  A friend of mine is forwarding some more info to me from a midwife in Oregon and I can pass that on as well if anyone is interested.  One warning I would like to pass on is in regards to allergies to antibiotics.  The antibiotic of choice for treating GBS, either directly or prophylactically, is penicillin or penicillin-types.  The CDC, which made the recommendation to treat all laboring women with IV antibiotics, did so with the expectation that, on average, 10 women per year will die from complications of allergic reactions to said treatment.  In other words, if you know you're allergic to certain types of antibiotics (especially those in the penicillin family), take care in weighing all of your options before simply deciding to get swept along with the current of medical intervention.  I completely understanding the "heaviness" of making these decisions so it only feels right for me to know all the information and then make a decision with the realization that I am accepting full responsibility for my choices.  Plus I hate not having options and feeling "cornered" into something.
 

post #7 of 21

Is it impossible to not only refuse the antibiotics, but to also refuse the invasive 'care' for your newborn?  It may be a hospital policy, but it's also your baby, and you can tell them you absolutely will room in with your baby, and that the docs can't do the blood draw.  Maybe they have a waiver for this that you can sign?  

 

It's totally up to you - but I might work toward this.  I've also read quite a bit about this issue (I'm not GBS positive this time, but I was with my first.) - and if you have no risk factors for GBS issues - then the antibiotics are not likely to make one bit of difference and your baby is likely to be completely unaffected.  There are also other things you can do to minimize the risk.  During my homebirth with my first - we did a routine of Hibiclens washes and Goldenseal tinctures to avoid issues.  

post #8 of 21

I'm sorry your dealing with this--I was GBS+ with my first, and really upset about it and am absolutely dreading finding out I am again this time.  But I have to say that the labor itself was fine. I had a Hep lock and the IV antibiotics and really it wasn't a bother at all.  I didn't even notice.  I would absolutely do the Hep lock over getting repricked each time.  I'm also not great with needles and I hate the process of having an IV put in with a passion, so I definitely wouldn't want to go through that twice, but once it's in I'm fine.   For what it is worth, the reason I am so upset about the possibility of being GBS+ this time around is that I'm allergic to penicillin so last time they gave me clindmycin which lead to me contracting c diff--not fun at all. and potentiall really dangerous.  I really don't know what I'm going to do this time if I'm +. . But penicillin doesn't lead to c diff anywhere near the way that clinda does, so I'd be much less concerned about being GBS+ if I didn't have the penicillin allergy.   

post #9 of 21
Quote:
Originally Posted by Lizbiz View Post

Is it impossible to not only refuse the antibiotics, but to also refuse the invasive 'care' for your newborn?  It may be a hospital policy, but it's also your baby, and you can tell them you absolutely will room in with your baby, and that the docs can't do the blood draw.  Maybe they have a waiver for this that you can sign?  

 

It's totally up to you - but I might work toward this.  I've also read quite a bit about this issue (I'm not GBS positive this time, but I was with my first.) - and if you have no risk factors for GBS issues - then the antibiotics are not likely to make one bit of difference and your baby is likely to be completely unaffected.  There are also other things you can do to minimize the risk.  During my homebirth with my first - we did a routine of Hibiclens washes and Goldenseal tinctures to avoid issues.  

 

Can you tell me more about the Hibiclens wash and Goldenseal tincture? What exactly did you do? 

post #10 of 21

I am not an alarmist, but babies born to mothers who are GBS positive are at risk for incredibly severe illness.  You should also know that if you refuse treatment and then refuse treatment for your infant, it is VERY likely that the hospital will contact CPS and they will come out to meet with you before discharge. I am not afraid of CPS, but I also wouldn't want them in my life if I could avoid it. 

post #11 of 21
Quote:
Originally Posted by RedTree View Post

Thanks for the replies.  Like you 1stTimeMama4-4-10 I'd much rather have me poke and prodded then the baby.  I knew that the hep lock was somewhere on the arm or hand but I'm not really sure which.  I'm planning on stopping by the store this evening to get some good probiotics to have now and after labor.

 

Thandiwe that's what I'm struggling with.  How obnoxious would it be to have nurses trying to get a needle in during active labor vs. hep lock and its constant reminder.  Sigh.  Maybe a hep lock isn't as bad as my mind is making it out to be.

 

As I analyze my feelings more I guess what I really am worried about is that the nerves of being in the birthing center and now having the hep lock (or multiple needle attempts) will give me high blood pressure readings.  Which will then trigger pushes for interventions or increased monitoring.  I need to be completely zen in a clinical setting to have normal readings.  Anything that messes up my zen sends my readings through the roof.  Sigh, I wish I could have another homebirth like last time.

 

::Hugs:: SallyRae17 sorry to hear you got a positive as well.  We can be upset together.


There are so many factors to weigh while making this decision.  I just know that with my first, I went about 24 hours before becoming really exhausted and agreeing to an epidural just to rest.  Getting the epidural in active labor was so, so awful.  The IV didn't bother me at all, but sitting still during horrendous contractions...I thought it would kill me!!

 

This is a big change to have to come to terms with and have to accept.  I would practice as much meditation, journaling, and healing ahead of time as you can so you're prepared and at peace when you arrive.  Have you ever read Birthing from Within?  It was recommended highly to me after my first traumatic birth while healing for my second. 

post #12 of 21

Just as an FYI, I'm planning to do the antibiotic treatment. I'm not allergic to penicillin and having a heplock or IV during labor isn't that big of a deal to me. I mean, I had a c-section the first time around with HELLP syndrome, so this really is nothing for me. I just don't want to worry about my new baby getting sick or developing thrush and/or a yeast infection from the antibiotics. I've had thrush numerous times and it's not fun at all. I don't want to deal with it while healing with a newborn. I'm just upset with my body again, I guess. Everything else has been absolutely perfect this time around - it's like *something* had to happen or go wrong. 

post #13 of 21

1sttimemama - Actually this isn't true for everyone.

 

I do not do GBS testing and take a wait and see approach. If I have specific risk factors during labour (extended PROM, fever) or if my baby shows any signs whatsoever, then we would take action immediately. I think by having a midwife who does home visits, that also gives me an advantage, even with a hospital birth.

 

My first was born in a hospital, I had an unknown GBS status and he was never poked or prodded, he roomed in and we went home quite quickly with no talk whatsoever of CPS.  I just stuck up for what we wanted.

 

For us, the statistics show it to be a very minimal risk in comparison to the side effects (both short and long term) of the "routine" antibiotics.

post #14 of 21

Just in case anyone is interested.

www.midwiferytoday.com/articles/garlic.asp
 

post #15 of 21
Quote:
Originally Posted by Tizzy View Post

1sttimemama - Actually this isn't true for everyone.

I do not do GBS testing and take a wait and see approach. If I have specific risk factors during labour (extended PROM, fever) or if my baby shows any signs whatsoever, then we would take action immediately. I think by having a midwife who does home visits, that also gives me an advantage, even with a hospital birth.

My first was born in a hospital, I had an unknown GBS status and he was never poked or prodded, he roomed in and we went home quite quickly with no talk whatsoever of CPS.  I just stuck up for what we wanted.

For us, the statistics show it to be a very minimal risk in comparison to the side effects (both short and long term) of the "routine" antibiotics.

I didn't say every baby will get ill or that CPS will definitely investigate. I said that the risk of illness increases, and that the illness newborns exposed to GBS contract is very serious. In my state, whether CPS gets involved is entirely up to the care providers at the hospital - which includes well intentioned but uninformed nurses. Certainly not everyone who refuses testing or treatment will be referred to CPS, but there us a big risk. Putting those two factors together, I would opt for testing and treatment. I know not everyone agrees, but advising that opting out of treatment is somewhat irresponsible without also advising the mama about the real risks.
post #16 of 21

I'm doing my GBS test this week, and if I test positive, my midwives have a treatment course they would like me to follow for a week (including probiotics, a garlic suppository, a periwash with various essential oils that promote good flora, etc.).  I'll get re-tested in a week and if my colonization levels have gone down significantly and I don't have any of the risk factors when I go into labor (like a fever), I don't think I will choose to go in to the hospital.  If my colonization levels remain high and/or I have any of the risk factors, I will likely opt to go in to the hospital for antibiotics.  You might want to check out things you can do to minimize your colonization levels.   
 

post #17 of 21

I don't know if this will help, but try not to think of the heplock as a "needle"; think of it instead as a tiny, flexible tube - which it is.

post #18 of 21

RedTree, to add to what JennaSpring was saying, I know a number of people who tested GBS+ at 36/37 weeks and then were able to turn the results around by 39 weeks or so just by using probiotics.  I don't think it can hurt to try and then retest in a few weeks. So definitely seems worth considering. 

post #19 of 21

I was GBS- with my first, but the results didn't get sent over to the hospital in time so I ended up with the IV through my whole labor and it sucked.  The worst part wasn't the needle, but the cord/tube/.  I kept yelling at DH for stepping on it even though he wasn't.  I wish I would have thought to ask for a hep lock b/c I think that would have been ok.  I'd rather have that then subject a baby to an extra poke though.  

post #20 of 21

Most hospitals once you have the hep lock in won't let you take it out. :( 

 

 

I completely sympathize, i did not sleep after I did my swab and the days waiting to find out. LIterally DID. NOT. SLEEP. Because i'm that phobic of IVs. It doesn't help that I have icky veins and every time I get one, I get huge bruises! 

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