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GBS

post #1 of 29
Thread Starter 

Hi ladies - are you doing the GBS test and if positive, what are you doing about antibiotics? I don't take antibiotics (probably took one dose at 2 years old before my mom decided she didn't want to go that route) and then I never needed them due to a very strong immune system.

 

I'm not sure I want to do the GBS ones even if I am positive, particularly since it would require me a) to go to the hospital way earlier than I intend to and b) to get an iv which I don't plan on doing either (I absolutely hate needles).

 

That being said, I kind of don't even want to do the test, because I think not knowing will be less stressful than knowing it's positive and doing nothing.

 

Would love to hear what others have done, either in this pregnancy or previous ones.

 

Thanks!

post #2 of 29
Well in my last pregnancy I gave birth in the hospital and was GBS positive so had IV antibiotics. Annoyingly, they still treated us as if baby was GBS positive and the nurses were constantly bothering us day and night checking baby's temp and vitals. It was super annoying.

This time we are planning a homebirth and I just did the GBS test and am awaiting for the results. My midwife doesn't do IV antibiotics, preferring instead to treat GBS with a hibiclens douche every few hours during labor. Even if I do end up testing positive I am torn about even doing the hibiclens because I now know how important that first colonization of microbes from the vagina is important to establishing a healthy gut in a child. My dd had/has many digestive issues and I often wonder if the antibiotics during labor could have contributed (she has only had antibiotics once in her life).
post #3 of 29

I did the test, too, but I'm feeling really unhappy about the idea of taking antibiotics if I'm positive. I agree with talldarkeyes, I'm really concerned about gut flora. My dh has celiac and there have been some studies lately about certain intestinal bacteria tipping the scales if one has a genetic predisposition. I feel like the risk of gbs infection is really low even without. But the midwife who administered the test seemed to be pro-antibiotic, so I guess we'll have to talk more if I'm positive. 

 

I also came across an interesting tidbit, though I'm totally blanking on where I saw it, about gbs infections in newborns being drastically reduced by waterbirth. Has anyone else heard of this? I'll go see if I can hunt down the study later, and I'll post it here if I find it.

post #4 of 29

My midwife did the test on me last week. I tested negative with my first pregnancy, so she's pretty sure I'll be negative this time. But, she said she does an antibiotic shot instead of IV antibiotics. I told her I would be opting out of that though as I've researched it in the past and feel the risks antibiotics bring outweigh the benefits. She warned that some places will make a big deal upon transfer if you were GBS positive, but then told me my area isn't typically that way. So, sticking with the plan. Hopefully, I'm negative and then I don't have to think about it at all. I think it is good to get the test because they will just automatically treat you as positive if you opt out from what I understand. Better to hopefully get that negative result and be cleared of it. 

post #5 of 29

i am not getting tested and didn't last pregnancy either. my midwife is fine with me opting out-- but i agree with dayiscoming--if we did transfer to hospital then i'd be treated as positive. but if i transfer--that means i have bigger problems than antibiotics.

post #6 of 29
Last pregnancy I was pos. I was to get 4 bags of antibiotic during labor but only got three because labor was short. Therefore i had to stay for 3 days to be monitored. Baby was FINE. Nurses bugged the crap out of me night and day. I feel like my entire internal system was thrown out of wack by all the antibiotics at birth. Thrush, yeast infection, etc etc.
This time I've been taking pro biotics and planing a home birth. If I'm pos my me will do a shot of antibiotic just to be safe. Im guessing I will be pos because I had some Utis In early pregnancy that had gbs strain in it which indicates ill prob test positive. Darn. Hopefully the probiotics will help. Fingers crossed!
post #7 of 29

I just tested negative, but given that group b strep can (easily) cause sepsis in newborns, it's not something I planned to mess with - though I'd strongly prefer to not use antibiotics for normal infections. [One of the few "nearly bad outcome" stories in Ina May's Guide to Childbirth is about a baby with it...]

post #8 of 29

Here's the reference about waterbirth and gbs infection rate: http://www.ncbi.nlm.nih.gov/pubmed/21322437

 

1 case of newborn gbs infection out of 4432 waterbirths, vs. 1 out of 1450 "dry" births. In any case, I would not call either statistic "easily" causing sepsis. Another one of the many birth-and-baby-related risk/benefit decisions we've all got to make.... 

post #9 of 29
Personally, the risks of GBS, if I turn out on be positive for it, seem worse to me than having to replenish my gut flora. I wouldn't want to be ignorant of my status as a carrier or not.
Quote:
Originally Posted by zeeohee View Post

Here's the reference about waterbirth and gbs infection rate: http://www.ncbi.nlm.nih.gov/pubmed/21322437

1 case of newborn gbs infection out of 4432 waterbirths, vs. 1 out of 1450 "dry" births. In any case, I would not call either statistic "easily" causing sepsis. Another one of the many birth-and-baby-related risk/benefit decisions we've all got to make.... 

Hmm... The CDC seems to have very different stats, saying that "if you have tested positive and are not in the high risk category, then your chances of delivering a baby with GBS are:

1 in 200 if antibiotics are not given
1 in 4000 if antibiotics are given" ... Implying that if you are positive and high risk, it's much more likely even than that.

and on the American Pregnancy Association website the description of what GBS causes are:

"The signs and symptoms of early onset GBS include:

Signs and symptoms occurring within hours of delivery
Breathing problems, heart and blood pressure instability
Gastrointestinal and kidney problems
Sepsis, pneumonia and meningitis are the most common complications
Newborns with early-onset are treated the same as the mothers, which is through intravenous antibiotics.

The signs and symptoms of late-onset GBS include:

Signs and symptoms occurring within a week or a few months of delivery
Meningitis is the most common symptom
Late-onset GBS is not as common as early-onset
Late-onset of GBS could be a result of delivery, or the baby may have contracted it by coming into contact with someone who has GBS."

Keep in mind the figures each refer to really different populations.
post #10 of 29

For me, it's not about *my* gut flora or yeast infections, it's about the baby. Birth is a crucial time for the baby to become colonized with her intestinal flora for *life*. If I turn out to be positive, I am going to have to do some serious reading along those lines. I am not sure that I consider a .5% infection rate for positive mothers "easily" causing infection in any case. Something to ponder.

 

As for the statistics from that study, it reads to me like they actually do match up with the CDC's overall infection rate for *everyone*, positive or negative (somewhere around 1/1000). The study was done on all women, not just those testing positive.

 

So the way I read this, birthing into water is not quite as effective as antibiotics, but something that definitely seems to cut the risk. If 30% of the 4432 women in the water birth study were positive, that would cut the infection rate for babies of *positive* mothers down to 1/1329, or .07%. 

post #11 of 29
Something else to remember: We are ALL carriers of GBS; it lives naturally within our digestive tracts. Not all of us have it in our vaginas, which is where it is a problem.
post #12 of 29
Quote:
Originally Posted by zeeohee View Post

For me, it's not about *my* gut flora or yeast infections, it's about the baby. Birth is a crucial time for the baby to become colonized with her intestinal flora for *life*. If I turn out to be positive, I am going to have to do some serious reading along those lines. I am not sure that I consider a .5% infection rate for positive mothers "easily" causing infection in any case. Something to ponder.

 

As for the statistics from that study, it reads to me like they actually do match up with the CDC's overall infection rate for *everyone*, positive or negative (somewhere around 1/1000). The study was done on all women, not just those testing positive.

 

So the way I read this, birthing into water is not quite as effective as antibiotics, but something that definitely seems to cut the risk. If 30% of the 4432 women in the water birth study were positive, that would cut the infection rate for babies of *positive* mothers down to 1/1329, or .07%. 

 

Depending on the issue, 1/200 risk of dangerous bacterial infection is plenty for lots of people's choices to be influenced. What's the risk that taking the medication will have effects comparable to that? I don't know, but that might be something to consider. Also to be considered are your real choices in healthcare. For someone with other risk factors, opting out of a hospital birth just to avoid this intervention might be taking on many other risks that should affect the decision more than IV antibiotics. 
 
You're right though, that I missed the subtlety there regarding whose bacteria you were talking about.
Maybe you've seen something I've missed on the topic of the sources for all those bugs, but I had the overall impression that it's a life-long collection, and easily affected by diet, exposure, and medicine throughout our lifespan. All the studies I've seen done on, for example, cesarean vs. vaginal births and bacteria colonies are limited to short term impact and do not even look into wether that difference is balanced out later in life. 
 
Also, I definitely don't know anything about Celiac disease, so I can only speak for otherwise healthy babies, but I think there are many more opportunities past birth to get that beneficial stuff, especially if you're not a family that bleaches everything in sight! Only speaking for myself, I was a c-section baby and my parents were NEVER shy about using anti-biotics even as "preventative" medicine during viral colds (something that I hope isn't done any more...) and I've always had a very healthy digestive system.
 
I've always suspected that the reason I do OK despite having been on SO MANY anti-biotics early in life (I got a lot of bronchitis too as a child) is that I lived in a country that was not obsessed with sanitizing everything in sight, and that I LOVE probiotic rich foods like yogurt, kombucha, cultured cheeses, and old-school pickled things. 
 
 Counter that with my husband, who was born vaginally, naturally, to crunchy-minded parents and who has scores of digestive upsets that are only calmed by taking over-the-counter probiotics.
 
Birth is not an "all or nothing" moment in our lives. 
post #13 of 29

I think the other thing to consider is that, yes, it is a 0.5% infection chance for infected mothers, but what are the outcomes like for babies that test positive for GBS? And what are the risks associated with the antibiotics? Depending on which ones the hospital uses, the risks are very, very low. 

post #14 of 29
I have the same concerns & thoughts as op and others previously mentioned. I just had the gbs culture and I am waiting for my results. I am hoping they are negative so that I don't even have to make a decision (I know, the wimpy way out) although I do realize I can still be gbs positive at the time of delivery.
I do NOT want the antibiotics - I had a previous c-section and we dealt with horrible thrush for MONTHS. Now, I have not started any serious research but another thingsweighing on my mind is that my husband's family has a crap load of allergies - I want my lo to have as much of the "good gut flora" from me as possible. I have read other posts about the use of antibiotics causing other lifelong issues (haven't verified this yet with sturdy studies yet) among other things. On top of that, I am truly allergic to Penicillin so they will have to give me something else (which has been shown to be less effective than Penicillin) so I will need to research that as well.
Since I am considered to be a crunchy hippy by many (especially by my hmo health care providers) I have already had to do hours of research to prep for "intelligent," productive debates, err, conversations with my providers. I am huge, pregnant and tired, so if I can avoid one more "hot" topic I would be so grateful. I am already in for: vaccines, vitamin k, eye ointment, and my soon to be vbac.
Sorry, I feel like I have just hikacked this post. Lol. Anyway, if anyone has resources to sound studies etc about not using antibiotics while gbs + I would love/welcome them as I am sure op would.
It is a tough decision that anyone will just have to be sure they are comfortable with regardless of which avenue they take.
Ps. The chances of baby acquiring gbs infection is 1/200 - this is the same chance of a vbac ending in uterine rupture - most people/providers are fine with these rates. However, I have not looked into the rate of serious illness/death IF the baby does in fact become infected.
post #15 of 29
Thread Starter 

I spoke with a friend of mine who is a midwife last night. She said that in her opinion (and this may just be for our area), it's better to be GBS unknown, then GBS positive and refusing antibiotics.  She said for a number of reasons, many women don't get tested for GBS and its legitimately unknown whether they are positive or negative. They generally then apply the universal treatment, but if someone requests the risk based treatment, the midwives at her hospital are fine with that. 

However, she said it's important to know the philosophy of either your pediatrician, or the hospitals pediatricians if you won't have your own ped checking out the baby at the hospital and during the first few days.  If the peds are not open to a risk based approach, they really can make your life hell, requiring all sorts of additional blood draws and tests of the baby.  She said it's important to know what your OB or Midwife's opinion is, but in reality, it's the pediatricians who drive this one, as the risk here is to the baby, not really to the mother.

 

I found these two links to be helpful in my reading:  http://evidencebasedbirth.com/groupbstrep/ and http://www.gentlebirth.org/archives/gbsEvaGR.pdf

 

I think I will try to find out what the Pediatric hospitalists are like where I'll be delivering. I'm certainly open to receiving antibiotics if I show risk factors for it, but I don't want to go the universal approach.  So I'm still on the fence about whether to get tested or not.

 

I've been appreciating hearing the input of all of you, it's helpful to get other opinions.  I also think a big part of my reluctance is being in the hospital earlier than I have to be, and getting the IV, because hospitals and needles are really scary for me and it's been enough that I'm going to be there to give birth, I don't want to start piling on all the other things that can potentially go with that. I kind of just want to get in and get out as fast as I possibly can.

post #16 of 29
Quote:
Originally Posted by cynthiamoon View Post

 

 

I would never suggest that someone opt out of a hospital birth simply to avoid this intervention...not sure where you got that idea. I personally am planning a home water birth (for reasons that have nothing to do with gbs), so I was interested when I came across that reference. I thought others here might appreciate me sharing it. As I said before, I have not yet decided my course of action should my test come back positive. But the water birth study is a factor that will play into my personal risk/benefit analysis, and is heartening considering my wariness of antibiotics in general.

 

As for lifelong gut flora, I understand that its affected by many things, but I am under the impression that those first few months are pretty crucial in terms of immune system development. My understanding is that we have a "core" flora that does not fluctuate much, and then a "peripheral" flora affected by diet/antibiotics/etc. Again, as I said before, I do not know what the effects of antibiotics in labor are on the gut flora of a vaginally born baby. If my test comes back positive, I'll have more reading to do. If anyone else knows of any studies/info on this, I would be interested to know!

 

Just as being born to a GBS+ mother does not automatically equal infection in a newborn, being born by Caesarean does not equal allergies/asthma. It's great that you never had problems! Nevertheless, the current science suggests that gut flora at birth *does* have an impact on our lifelong immune system responses. Since my baby will have a genetic predisposition to severe food allergies as well as Celiac, this is another factor that plays into my decision-making process, and might into others' as well.

 

But this is only one of my concerns with antibiotics. I think antibiotic-resistant bacteria is potentially a much more serious problem, and that alone gives me pause enough to want to research the knee-jerk administering of antibiotics in *any* situation.

 

And LisaTee, I'm also allergic to penicillin...I didn't realize that was the most effective antibiotic for GBS. I guess I'll have even more reading to do if I'm positive. But I'm like you and crossing my fingers for a negative result so I don't have to stress about this anymore!

post #17 of 29
Quote:
Originally Posted by zeeohee View Post

 

I would never suggest that someone opt out of a hospital birth simply to avoid this intervention...not sure where you got that idea. I personally am planning a home water birth (for reasons that have nothing to do with gbs), so I was interested when I came across that reference.

 

 

Sorry, I didn't mean to imply that was your suggestion. I was actually thinking of my hairdresser, who told me that she had a bad experience with GBS treatment because it required slowing down her labor, and she said it's the reason she is planning a birth center birth for her next son. I didn't know it at the time, but now I know that the BC we were talking about also requires the same treatment, or they *claim* they will not take you as a patient. I was mostly thinking of her when I wrote that, and wondering if this meant she'd be looking at homebirth to avoid this particular intervention, and thinking that it's just not important enough for me to try to avoid it in light of other things I want hospital support for. 

post #18 of 29

I have my GBS test on Friday. I'm going to do a colloidal silver spray/douche tonight, tomorrow, and possibly Friday morning. I should have started on Monday but I completely forgot about it until I opened up this thread!

post #19 of 29
Just found this collection of studies on a midwifery website (scroll to bottom).

http://mountainviewmidwives.com/group_b_strep.html

I havent read all of the abstracts, but from the ones I saw, hibiclens is no replacement for IV therapy.

It seems like the hibiclense is seen as a low-risk modest-results treatment for places without access to IV antibiotics, but the rates of infection transmission aren't much improved over the control groups.

The studies that concluded that they recommended it, did so only for places with no access to advanced medicine.
post #20 of 29
Tested negative! Happy dance!