or Connect
Mothering › Groups ›  January 2014 Due Date Club › Discussions › Group B Strep Positive?

Group B Strep Positive?

post #1 of 23
Thread Starter 

I got all lab results back this week and all looks great, except that my urine tested positive for group b strep.  I did not have this during my first pregnancy and hadn't heard of it before.  The lady on the phone reviewing my results said I just needed to have an IV during labor... which I do not want at all.  I am planning a waterbirth, like last time, in a birthing center and strongly prefer not to be hooked up to an IV.  She told me I wouldn't need to be hooked up to the actual IV the whole time, just once every 4 hours when I need a new dose...  I asked if I could be tested again around 35 weeks, as that's what I'm reading is the normal testing time, but she said no because I would likely still be positive.

 

Experiences from natural birthing mamas?  Info I'm getting online is mostly from moms who were hooked up to IVs for hydration and pain meds anyway so they didn't care.  I really really hate the idea of needing to be hooked up if I don't need to be.  If I transferred care to an independant birthing center (not attached to a hospital; and not because of this issue, because I had been considering it anyway), how would they manage the Group B Strep?  Should I insist on being tested again just in case I'm negative later?  Will needing the IV interfere with my waterbirth?  I see my midwife again in two weeks, but have all these questions now from that phone call :(

 

http://www.mothering.com/community/a/treating-group-b-strep-are-antibiotics-necessary  Reading this has me torn...


Edited by kt~mommy - 8/8/13 at 11:33am
post #2 of 23

I tested positive with my DD but I had her in the hospital so I was already on an IV. So this was a concern for me with this pregnancy since I am (Lord willing) having a water birth at home. My midwife is a DE midwife and can't even test for in. So I won't know if I have it or not with this one. So I was a little worried but she calmed me saying that for 1. If you give birth in water it would dilute anything, including this bacteria, to the point of it being very hard for the baby to contract it 2. If I was still worried there is an herbal wash that you can use down there before giving birth that does just as well as the antibiotics! smile.gif

 

This is my midwife's page and is a little about Group B Strep. http://www.preciouspassage.com/d/gbs.php  There is more information in there and more options. Hope this helps! And good luck! 

post #3 of 23
Avoid the IV! There's tons of info available about treating strep b naturally and you don't have to start until the last few weeks of your pregnancy. I tested positive early in my last pregnancy also and it was the one thing I was fixated on and worried about so did TONS of research. Like every concern in pregnancy and birth there is tons of heavy terror mongering about a relatively small risk of adverse effects. I'd be happy to share more with you about what I learned over the coming months! I'll also try to dig up some of the research/articles I found helpful last time.
post #4 of 23
Wow I'm really into 'tons' right now!!
post #5 of 23
Thread Starter 
Yes please, anything you've found would be great!
post #6 of 23

So with my first I chose not to test so they treated me as though I was positive. It only became an issue when my water broke 12 hours before I went into labor and therefore needed to have a dose of anti right as I was going into transition (labor was quick once it started!). I had a planned homebirth and was SO blessed to have a midwife who also worked at the hospital as a nurse and kindly brought the antibiotics to me (I should have gone to the hospital for the first dose but then could have had subsequent doses at home assuming I had no reaction) . There is a picture somewhere of the bag hanging from my potted plant and then running down into me in the birthing pool! Both me and babe ended up with thrush though and I made the decision with the next 2 to test! both came back negative BUT my midwifes at that point said that had it come back positive I could do lots to try and change it. Eat probiotic foods -naturally fermented stuff like miso, sauerkraut etc. also yogurt and just take probiotics.  

I would test again if it were me and between now and then I would eat lots of probiotics!

 

hope that helps!

post #7 of 23

The midwives I trained with use a lavage.  Basically a sterile wash to clean the area out.  If the bag remains intact through most of labor (which is common) the rush of the birth waters help clean the area also and there isn't enough time for recolonization before birth.

post #8 of 23

Hi kt-mommy, 

 

You may want to print out the 2010 CDC Guidelines on Group B Strep. They may (and should) take it seriously. The 2010 CDC guidelines specifically say that GBS tests in early pregnancy are not reliable for this purpose. Here's an excerpt: "Because GBS colonization status can change over the course of a pregnancy, the timing of specimen collection for determination of colonization status is important. Because colonization can be transient, colonization early in pregnancy is not predictive of early-onset GBS disease (44). Late third trimester colonization status has been used as a proxy for intrapartum colonization (140). The negative predictive value of GBS cultures performed ≤5 weeks before delivery is 95%--98%; however, the clinical utility decreases when a prenatal culture is performed more than 5 weeks before delivery because the negative predictive value declines (37)." http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm?s_cid=rr5910a1_w

 

Some women who test positive for GBS at 35-37 weeks *still* end up being negative at birth! 

 

Here is a resource I think is helpful in understanding this issue: http://evidencebasedbirth.com/groupbstrep/

 

I plan to do what I can throughout my pregnancy to prevent a Group B Strep issue. Although I labored with an IV in place (in my arm, but not hooked up to a machine/pole) last time and it was totally fine - didn't affect my mobility for different positions - I feel strongly that antibiotics should be avoided when they are not absolutely necessary. They have a permanent effect on the gut (the foundation of the immune system), and all the nice things we can do to rebuild our guts never totally reverse the harm each time we take antibiotics. I presume that if Abx in labor wipe out GBS, they also have some effect on the good bacterial balance that we want to colonize the baby with at birth - which is one of the most important reasons why it matters to avoid a Cesarean. 

 

My plan for now is to regularly take the women's probiotic formula made by Klaire Labs, which impacts vaginal bacteria and I hope will impact what's in the uterus already as well. I know oral probiotics have already positively impacted what's coming *out* of my cervix (I had weird green discharge early on which went away with good quality high dose Pbx), so maybe the good stuff can get in there a little too even though there's a mucus plug. ???

 

Looking forward to hearing more in this thread!

post #9 of 23
Thread Starter 
I am definitely going to ask my midwife what I can do to prevent/treat now and I positively hate when caregivers don't give options... the lady who called me with results made it seem like that's that. I'm super glad to hear the stats about testing early because that's exactly what my intuition told me
post #10 of 23

I am skeptical about chlorhexidine, for the same reasons I don't want antibiotics - all the good bacteria we want to give the baby through a vaginal birth are in the vaginal canal. How does chlorhexidine affect those good bacteria? And even though the study that Odent cites in this article is favorable, it's just one study. The midwife in this area that I've heard speak about it has said that there's not enough evidence to be sure that chlorhexidine has the desired impact (and she's not pushing antibiotics) but she gives the choice to her clients. One of the reasons chlorhexidine may not be so effective is that it's theorized the infection with GBS in babies may actually happen in the womb, not through contact with the birth canal at birth. For all of these reasons (sorry I don't have links for these), I would rather do all I can throughout pregnancy to make my body a healthy environment hostile to GBS, and then at birth monitor my baby for symptoms. Full term normal weight babies are at less risk from GBS then premies or those with low birth weight.

post #11 of 23
Do you have any signs of a uti? Group b strep in urine is a serious risk in labor to baby and it should be addressed now in pregnancy. I am a HBer and UCer, I tested positive in my urine in my second pregnancy and was treated with antibiotics which eliminated the bacteria in my urine. I have sinc assumed I was positive and treated naturally at home prior to birth.
post #12 of 23

Just wanted to paste this comment from another site about a mom's experience with chlorhexidine:

 

"I wouldn’t do the hibiclens. I did that with my second child. I tested positive, and we did the vaginal rinses to protect my baby. She ended up with GBS anyways- at exactly 7 days. Spent 13 days in the hospital with iv antibiotics. I NOW understand that the flora in the vaginal canal is where the baby’s immune system starts. By sterilizing that site- I birthed her without any healthy probiotics to colonize her gut- and left her system defenseless. If I had to do it over- and my plan with future children, is to be proactive rather than reactive. I will use LOTS of probiotics orally, and use yogurt washes. I’ll also eliminate the foods from my diet that would feed GBS. Hope that helps! Best of Luck!"

 

Can you tell I'm obsessed with group B strep??

post #13 of 23
Thread Starter 
Quote:
Originally Posted by Mamatoabunch View Post

Do you have any signs of a uti? Group b strep in urine is a serious risk in labor to baby and it should be addressed now in pregnancy. I am a HBer and UCer, I tested positive in my urine in my second pregnancy and was treated with antibiotics which eliminated the bacteria in my urine. I have sinc assumed I was positive and treated naturally at home prior to birth.

Nope the lady on phone said specifically the count wasnt high enough to be a uti. What did you treat with?
Quote:
Originally Posted by pomegranate79 View Post

Just wanted to paste this comment from another site about a mom's experience with chlorhexidine:

"I wouldn’t do the hibiclens. I did that with my second child. I tested positive, and we did the vaginal rinses to protect my baby. She ended up with GBS anyways- at exactly 7 days. Spent 13 days in the hospital with iv antibiotics. I NOW understand that the flora in the vaginal canal is where the baby’s immune system starts. By sterilizing that site- I birthed her without any healthy probiotics to colonize her gut- and left her system defenselesvs. If I had to do it over- and my plan with future children, is to be proactive rather than reactive. I will use LOTS of probiotics orally, and use yogurt washes. I’ll also eliminate the foods from my diet that would feed GBS. Hope that helps! Best of Luck!"

Can you tell I'm obsessed with group B strep??

Do you have info about what to eat and what to avoid eating?
post #14 of 23

kt~mommy, I believe a positive urine culture trumps the screen.  It has a high correlation with GBS infection in infants even given the fact that many women who have a urine infection early in pregnancy won't have a positive swab later.  So even countries that don't recommend routine screening like the US does, do recommend using antibiotics in women who have had a positive urine screen at any point during pregnancy.  Does that make sense? 

 

I'll attach a link for the Ontario Midwives Association recommendations.  They're super thorough and go through all your options, including garlic and hibiclense and probiotics and the evidence for everything.  They also point out where their recommendations are similar or different from ACOG and SCOG (Is that Canada's OB assoc?).  It's actually pretty similar to the Evidence Based Birth article that pomegranate posted, but might have some additional information and links.  http://www.ontariomidwives.ca/images/uploads/guidelines/No11CPG_GBS_May_2012FINAL.pdf  I don't know if you're familiar with Evidence Based Birth, but it is quite natural birth friendly and doesn't dismiss alternative solutions simply because they are not traditional Western medicine.

 

As far as how it would affect your birth... There's no reason you couldn't have a waterbirth.  You only need to be "hooked up" for your antibiotic dose, which you could get in the pool while your midwife is checking heart tones.  Otherwise you would just need a heplock, which I didn't find irritating at all; but that's definitely a personal thing.  GBS is usually treated with penicillin, which is narrow spectrum - meaning it will have the biggest effect on GBS and leave a significant amount of the rest of your flora intact.  I would still go heavy on the probiotics, but penicillin is less of a concern with leaving you with nothing.
 

post #15 of 23

Here is an article that I appreciated last time around:

 

http://www.mothering.com/community/a/treating-group-b-strep-are-antibiotics-necessary

 

I too tested positive in my urine at 9 weeks in my last pregnancy. I treated naturally with a garlic clove inserted vaginally every night from about 37-38 weeks, mega vitamin c dosing, probiotics, and a teaspoon of colloidal silver daily. I ended up with a c-section so was moot in the end but will use the same protocol as well as make changes to my diet this time around as I go for a VBAC. I am personally not down with prophylactic antibiotics for a number of reasons but understand every mother will do what feels safest and best for herself.

post #16 of 23
I cannot recall the antibiotic I took, but I was retested and I was gbs free. I had a home water birth, my first and no issues with baby.
post #17 of 23

I tested positive for my third child, and the midwife insisted on the iv antibiotic, and I have also been told that once you test positive you are always considered positive.  My first two children didn't have any allergies- with my third child I had horrible reflux and was told to take tums (although I had reflux with the other two I didn't take tums) and then this antibiotic at birth- those are the only two big differences between the pregnancies.  My third child's gut was COMPLETELY-completely missed up.  She had VERY severe allergies to almost EVERYTHING-- I nursed her for YEARS on a very strict diet (I mean oats rice meat some veggies and some fruits and that's about it-it was VERY difficult) I was able to slowly add things to my diet and through my breastmilk over time her gut has mostly healed and she can eat almost everything (too much soy and egg is still hard on her and she's now 5).  While obviously every child is different and the tums (although there is now research showing women who take tums during pregnancy have babies with higher chances of allergies) and antibiotic might not have anything to do with her issues, my feelings are both did and I am NOT happy about taking the antibiotic this time and will probably refuse unless I have a premie baby-the gut is so central to the newborn additional antibiotics at birth are a big deal.  My sister was positive for both her babies and she refused and had no issues, she's having her third now and the midwife she's using is european and she's not even testing her.  I too would love to hear what foods are to avoid eating, I did tons of probiotic's last time and plan to again.

post #18 of 23

I haven't read the thread, but I tested positive for GBS with my first, and didn't take the IV. It wasn't a huge deal AT ALL, and we just kept an eye on my son for fever for the first few days. It always amazes me that it's such a HUGE deal in some places, since my midwives and the nurses were so chill about the whole thing.

post #19 of 23
Thread Starter 
I had a follow up appt with my midwife who told me basically there's nothing I can do. She said they wouldn't retest me because gbs is transient and even if I tested negative later they would still treat with penicillin because in their minds I could be positive again at the time of birth. She also said there was nothing I could take that would change the decision to treat. Feeling frustrated.

Eta she did say she understood my concerns about the antibiotics but said the penicillian is so localized or whatever. She did say I could refuse the antibiotics but then I couldn't have a water birth and the staff would be paranoid about babys health and do lots more monitoring than usual.
post #20 of 23

kt~mommy that is so frustrating. is there any way around this? i know it's extreme but is there any way you could switch practices? i find the prophylactic antibiotics so short sighted, especially considering deaths occur directly (anaphylaxis) and indirectly (antibiotic resistant bacteria/superbugs) from the overuse of antibiotics. for some perspective, did you know they don't use the antibiotic protocol in the uk, nor do they even routinely screen for gbs?? http://www.rcog.org.uk/womens-health/clinical-guidance/prevention-early-onset-neonatal-group-b-streptococcal-disease-green-

  Return Home
  Back to Forum: January 2014 Due Date Club
Mothering › Groups ›  January 2014 Due Date Club › Discussions › Group B Strep Positive?