GBS discussion « Back to Group Discussions

[scruffy too]

I'll start the discussion.

The link below discusses GBS and water births.  The theory is that when GBS is diluted in water, the baby has a harder time contracting it.

http://www2.cfpc.ca/local/user/files/%7BE757C7FC-F557-4CED-A956-D73E666774C0%7D/ACOG%20Waterbirth%20%20GBS.pdf

It does however, poke holes into my arguement to see if I can only have a vaginal swab done (or both, but different cultures so I know what's what) due to fecal matter going into the water...  My old theory was that since the baby wasn't coming out of my butt, I don't much care what kind of bacteria exists there.

I have decided to get the test (97% sure I'm not changing my mind).  I have not decided what to do with the results.  I haven't had antibotics for over a decade (before that, I didn't react poorly to them, but still...)  My MW is not pushing for the test at all.  And IF it's positive, she's not pushing for antibotics, but is willing to administer them if I want.

Is anyone else as confused as I am? 

[cocoanib]

With my last birth, midwife had me do a warm water and tea tree oil sitz bath starting 2 weeks before testing.

She had me swab myself for the test. It came back negative.

If I had a pos, I planned to treat with garlic and probiotics and test again. She was open to that, but said she never saw a positive test with the sitz bath routine.

This time around, i am seeing a mainstream ob. I plan to start my sitz baths this week(I think my test is next week). I won't tell them about the sitz baths, don't see a reason too.

If for some reason, it comes back neg, I will ask about retesting. If they refuse, I won't battle abou it, I will treat with garlic and probiotics and possibly do hibiclens when i go into labor.

We are having a UC, so I'm not worried about them trying to push antibiotics on me, if they don't let me retest.

[Melany]

My homebirth kit includes hibiclens, (sorry for the mispelling). I believe that my MW will use that during the birth as well as watching baby, whether you're positive or not. She also adds sea salt to the water during the birth, again going back to the sea salt being mildly antiseptic. So, I'm not worried about the water birth if I am, indeed, negative. 

[jodieanneanton]

Thanks for starting scruffy!  I haven't been able to be on all weekend! 

I am as confused as you and it's my 3rd baby!  Sheesh!   I am planning to probably get the test and (like you) it is what I am going to do with the results (if they are positive) that I am not sure about.  Here are my questions/concerns:

1. I tested positive for GBS in my urine when I was pregnant with DD2... So I was *required* to have antibiotics during labor at the birth center.  I was not able to get the full dosage due to a fast labor and then had to be kept for observation which really sucked big time.

2.  I know there is a good chance that I am still GBS + because I was tested positive in my urine (although that was 3 years ago) and they consider that to be heavily colonized.

3. If I test positive, my hb midwife doesn't have the ability to administer antibiotics... (Ohio law is lame in that way).  So I don't know what to do/what I would want to do in the case that GBS is present.  (My mw suggests hibiclens protocol, but I am slightly weary of that wiping out vaginal flora/good bacteria that baby should come in contact with during birth.)

4.  I don't really want antibiotics anyway, so I am left with "what do I do if I am positive?" questions still...

Ugh... Really I have no input on this topic, just more confusion, concern and craziness to add to the question side.

Thank you cocoanib for the suggestion about the tto sitz bath.  Something to think on.

[Melany]

WA allows MW's to administer antibiotics, so my MW said its up to me.

I've been on a lot of antibiotics throughout my life to the point that some antibiotics are no longer effective on me. I had a surgery when I was 15 months and my mother was told by some dentist during my childhood that I had to have antibiotics prior to every cleaning. He put the fear of possible death into my mother and she took the prescription from the dentist without even questioning it. As an adult, I questioned this because I didn't like taking the horse pills. My doctor at the time looked up the kind of surgery I had and told me I should never have had the antibiotics. Now, when I need antibiotics I have to warn doctors of my past and tell them that standard dosages do not work. One doctor did not believe me and gave me a standard dose in college for my first ever UTI. That turned into a kidney infection because the antibiotic was not strong enough. My point is, I don't want to expose baby to antibiotics "just in case" if it isn't necessary and if there are protocols that you can follow that can keep you and baby safe. I actually remember having an interesting discussion about antibiotics with the pediatrician who started the practice we used to go to. He mentioned how much dosage has changed during his career, to the point that what is now a standard dosage for children is an order of magnitude larger than what it was in the 70s. At some point, will antibiotics no longer be effective? This scares me and I tend to really question when we need one.

Have I given my kids antibiotics? Absolutely, but we really try to be careful how often this occurs. 

[buko]

I am having a HB and my MWs definitely offer the test as a routine.  Not sure how strongly my MWs feel about the test and declining it, but have a feeling they will strongly recommend it, even though they always allow informed refusal and don't usually push things.  I am doing (vaginal) garlic and (oral) probiotics every other day starting soon, in hopes that will help.  I plan on continuing with garlic until labor, as I am not trying to "fool" the test but to genuinely not have GBS or take unnecessary abx.  However, if I am +, I will "happily" take the IV abx doses my MWs (CNMs) can/do administer in labor.  Because I think it's a good idea.  Still, it sucks mainly for two reasons-- the discomfort of a heplock and the possible issues with thrush and other things that can happen when mom and baby's flora are knocked out of whack.  But since I'll be at home and my MWs are relatively hands-off (and I can't imagine they'd preclude water birth), there's definitely less of an issue for me in terms of any cascade of interventions.

Just my 2 cents. 

[LDoulaSteph]

Originally Posted by scruffy too 

I'll start the discussion.

The link below discusses GBS and water births.  The theory is that when GBS is diluted in water, the baby has a harder time contracting it.

http://www2.cfpc.ca/local/user/files/%7BE757C7FC-F557-4CED-A956-D73E666774C0%7D/ACOG%20Waterbirth%20%20GBS.pdf

It does however, poke holes into my arguement to see if I can only have a vaginal swab done (or both, but different cultures so I know what's what) due to fecal matter going into the water...  My old theory was that since the baby wasn't coming out of my butt, I don't much care what kind of bacteria exists there.

I have decided to get the test (97% sure I'm not changing my mind).  I have not decided what to do with the results.  I haven't had antibotics for over a decade (before that, I didn't react poorly to them, but still...)  My MW is not pushing for the test at all.  And IF it's positive, she's not pushing for antibotics, but is willing to administer them if I want.

Is anyone else as confused as I am? 

Without reading through the rest of the posts I'll tell you that the guidelines for our MW's here in Ontario. Canada is to just treat baby on symptoms and not to go automatically to antibiotics in labour unless that is what mom has requested. So for me I was originally going to do the swab but I would choose to treat on symptoms if I tested positive. I've since decided there is no point in swabbing since the results won't change my treatment plan. I feel comfortable with the stats on babies actually getting sick so for me this is the best course of action. Do the midwives in your part of our lovely country follow the same guidelines? They just recently changed so might be worth finding out? Good luck!!

[scruffy too]

Originally Posted by LDoulaSteph 

Do the midwives in your part of our lovely country follow the same guidelines? They just recently changed so might be worth finding out? Good luck!!

The sole midwife in the Yukon is unregulated as the Yukon doesn't officially have midwives.  And she's very low intervention / testing.  And since she has no hospital rights, if I want to get tested, I go to the doctor. 

If I want the antibiotics, I get a prescription, pick them up from the pharmacy, and she'll do the IV at home during labor.  I get the feeling she doesn't want me to be tested, but wants me to be informed. 

She will obviously be looking for signs and monitoring me and baby - especially since you can test negative AND STILL DEVELOP GBS by the time you go into labor (this is the MOST confusing part of all this testing / treatment for me!!!!  Why take the test if it can give "false negatives"...) 

If I was positive, I'd do the garlic thing and the salt bath.  Not sure on the antibiotics yet.

Can someone tell me more about the probiotics?  If I could take another pill / vitamin to up my good flora, I'd be happy with that.

[SamSarah]

Originally Posted by LDoulaSteph 

 Do the midwives in your part of our lovely country follow the same guidelines? They just recently changed so might be worth finding out? Good luck!!

Over here in East Vancouver, my midwife said that the anti-biotic was standard (though optional).  I will the Ontario information up with her and see how she responds.  Thanks!

[SamSarah]

Originally Posted by scruffy too 

Can someone tell me more about the probiotics?  If I could take another pill / vitamin to up my good flora, I'd be happy with that.

Scruffy,  I'm not a big source of info here.  I take them orally, regularly to help with general intestinal/digestive ease.  What I know about purchasing them, is never buy ones that are not being refrigerated, because all the good stuff dies in them.  

My midwife told me take them, and that I couldn't take to many - and to take them both orally and vaginally.  I nodded, but now I'm realizing I have questions: how much, how frequently.  When taking them vaginally, is there anything you need to be aware of in the capsule?  I too have questions.  

[writermama12]

I have a little knowledge about probiotics but I am not an expert. I have only been taking them for a year but there are some key guidelines for choosing good ones and how much to take and things like that I've picked up from reading widely. Others may have different information. 

You want to go with a probiotic that has at least 11 strains of bacteria. And the amount varies by person and reason taking them but I go by theraputic adult dose, between 20-80 billion per dose. Not all capsules are made the same. Some are made to NOT have to be refrigerated but most do need to be refrigerated but can withstand short periods of time not refrigerated before dying. Google highly rated probiotics for a start. 

I go back and forth between brands looking for a great one. I have taken Biokult, it is very good but it is more expensive. I am taking Ultimate Flora Critical Care 50 billion right now and will begin Garden of LIfe Raw probiotic 85 billion for Women this week, which is much better priced and I've read it is a quality product. 

Also supplementing your diet with yogurt, kefir, kombucha, and fermented veggies will help. 

[scruffy too]

SamSarah and WriterMama - thx for the crash course on probiotics.  Where would I go about purchasing these?  I don't think my local health food store has a fridge section, but maybe I'll call and see in case it's in the back...

[Chapsie]

Originally Posted by scruffy too 

SamSarah and WriterMama - thx for the crash course on probiotics.  Where would I go about purchasing these?  I don't think my local health food store has a fridge section, but maybe I'll call and see in case it's in the back...

I take "natural factors" brand multi acidophilus as that was recommended by my midwife. It says to take 1-3 capsules daily, and to wait 2 hours after taking an antibiotic if concurrently on antibiotic therapy. It was at my local organic/natural food co-op. it was refrigerated. I'm sure your local store must have something in stock! (Natural factors is a Canadian brand,btw).

[rnra]

The CDC website on GBS can be found here:  http://www.cdc.gov/groupbstrep/about/prevention.html

Here's a quote from that page...

Quote:

Antibiotics taken by mouth instead of through the vein, and antibiotics taken before labor and delivery are not effective at preventing newborn group B strep disease. Birth canal washes with the disinfectant chlorhexidine do not reduce mother to baby transmission of group B strep bacteria or the risk of having a baby with early-onset disease. To date, receiving antibiotics through the vein during labor is the only proven strategy to protect a baby from early-onset group B strep disease.

[spughy]

Scruffy I'm sure Three Beans carries probiotics, and Superstore probably does too.  My sister takes them - she must get them somewhere.  I just messaged her to ask - I'll let you know.

[scruffy too]

Spughy - thank you SO much.  I was just about to google Three Beans number and call and ask.  But now I'll wait and keep lurking on MDC!

[spughy]

Okay so my intel suggests that Three Beans, Aroma Borealis or Riverside Grocery would all be candidates for decent probiotics - but if you want some really hard-core ones, check with the local naturopaths (my sister suggested Janice Millington?)  I think you'd probably be fine with just what you can get off the shelf in one of the stores.

[maydaymom10]

OK. Just got back from Vitamin Cottage with a full stock of komacha (I thought I'd buy some more seeing the ones my bro gave me are a little over fermented), kefir, Garden of Life Raw probiotics, & some tea tree oil. I think my test will be in about a week, so I figured I'd better get going. 

[scruffy too]

Thanks again Spughy (and thanks to your sister).  I'll wander over to Three Beans on my lunch break - they're just a block over.

[SamSarah]

Almost any health food store will supply them - and many bigger stores with a "natural section". 

Good luck.

SamSarah