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GBS + anyone BTDT?

post #1 of 16
Thread Starter 
TItle says it all. I'm planning a hospital birth with midwives and will ask about options at my 37 week appt in a couple days, but I'm wondering if this has come up for anyone else, either this time or in previous births? Previously, if you did have IV antibiotics, what was it like?
post #2 of 16
I am waiting for my results. When they did the test, my MW said it isnt that big of a deal during labor, not that intrusive she said. At this BC, You have to get IV antibiotics every 4 hours. The drip takes (20 minutes? Maybe) and it is on a pole so you could walk with it if you wanted. I dont have any personal experience with it, though. I was negative with my last 2. My sis had to do it with her first and they put the IV line in, ran the first drip but after that was done the needle and tape drove her nuts. She made them remove the port thingy and refused the second round of abx. . . Think she was in labor 2 days with that babe. So maybe you will have some say in it?
post #3 of 16
Thread Starter 

Thanks, VTAmanda, that is reassuring. I was envisioning being hooked up continually, which was bumming me out because I really don't want to be tethered to an IV. Then I read that it is just a couple of doses intermittently, which I would be OK with. My midwives have been very flexible and emphasized that their approach is to keep the mother moving around and they dont' believe in unnecessary interventions, so I suspect they will help me work around the IV. I don't think I want to decline ABX because of what I've read about how much they reduce the risk of baby's illness--though if the midwives offer an alternative (like hibiclens) I will go for that.

post #4 of 16

I tested GBS+ in my last pregnancy, and refused antibiotics with no issue (hospital delivery with midwives). We just checked my son's temperature at regular intervals for several days afterwards. It always stuns me how strict many other places are with the antibiotics.

post #5 of 16
Just a general comment on IVs - I haven't had one in labor, but have had *many* during various hospitalizations and treatments, and it makes such a difference where it is! And it's a personal thing... some have said the inner elbow vein is their favorite, I can't stand it there. For me, the outer forearm makes it truly painless and I can move all my joints without feeling the catheter, which makes me absolutely crazy. Also, the tubing and tape gives me a rash so I always ask for the nurse to put gauze between the plastic and my skin and use special paper tape for sensitive skin. If I didn't know all these tricks I would dread the thought of laboring with one in place... but I know it can be relatively comfortable, and might even be worth pulling the first one and trying another spot if it didn't seem to be working well.
post #6 of 16
Thread Starter 
JelloPanda--yeah, I don't know if the antibiotics thing is more the hospital's policy or the midwives', though it sounds like they are pretty autonomous. I'll ask about it on Thursday.

LilyofJudah--it was a weird situation last time--my OB insisted on an IV rather than saline well, even though there was no indication I would need an IV. Luckily, one of the nurses went ahead and just gave me the saline well. It was a real sticking point between my OB and I--I almost changed practices, but didn't have midwives available under my insurance at the time and the positives outweighed everything else (she had a 10% c-section rate and was very hands-off in other respects). So I was super relieved not to have it. This time I'm a little less concerned because I know from experience that I didn't *want* to move around enough for an IV to inhibit. BUT I really, really want access to the birthing tub, so continuous IV would be bad news to me.
post #7 of 16

Like others have mentioned, the IV antibiotics are not a continuous thing.  It just takes about 20 or 30 minutes every 4 hours.  If you are relaxed enough that you can keep your arm out of the birth tub water, you could receive the antibiotics while you're in the birth tub.

 

Also, hibiclens washes do not reduce the chances of your baby having GBS.  The CDC has a lot of good information about GBS.  Here's a link to their website:  http://www.cdc.gov/groupbstrep/about/prevention.html  

 

And here's a quote from that CDC page:

 

Quote:
"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."
post #8 of 16
Thread Starter 
Quote:
Originally Posted by rnra View Post
 

Like others have mentioned, the IV antibiotics are not a continuous thing.  It just takes about 20 or 30 minutes every 4 hours.  If you are relaxed enough that you can keep your arm out of the birth tub water, you could receive the antibiotics while you're in the birth tub.

 

Also, hibiclens washes do not reduce the chances of your baby having GBS.  The CDC has a lot of good information about GBS.  Here's a link to their website:  http://www.cdc.gov/groupbstrep/about/prevention.html  

 

And here's a quote from that CDC page:

 


Thanks, RNRA, that is both reassuring and helpful. I've seen a lot about how different regimens can rid your body of the bacteria, but it doesn't mean anything because it can just reappear at any time, so this makes sense.

post #9 of 16

Routine antibiotics may reduce the risk of your child contracting early GBS, but they do NOT reduce the number of deaths in infants, and actually have several not-so-great side-effects.

 

Quote:

Very few of the women in labor who are GBS positive give birth to babies who are infected with GBS and antibiotics can have harmful effects such as severe maternal allergic reactions, increase in drug-resistant organisms and exposure of newborn infants to resistant bacteria, and postnatal maternal and neonatal yeast infections.

This review finds that giving antibiotics is not supported by conclusive evidence. The review identified four trials involving 852 GBS positive women. Three trials, which were around 20 years old, compared ampicillin or penicillin to no treatment and found no clear differences in newborn deaths although the occurrence of early GBS infection in the newborn was reduced with antibiotics. The antibiotics ampicillin and penicillin were no different from each other in one trialwith 352 GBS positive women.

http://summaries.cochrane.org/CD007467/intrapartum-antibiotics-for-known-maternal-group-b-streptococcal-colonization

post #10 of 16
Thread Starter 
Thanks, JelloPanda--definitely food for thought. I have never had a yeast infection of any kind so I would not like to start now! I will definitely ask my midwife what she knows about this study.
post #11 of 16
Hear hear, JelloPanda. I have such a problem with prophylactic antibiotics. Myself I'm taking a vaginal flora support probiotic, colloidal silver, and will alternate garlic and boric acid suppositories. And not be overly concerned.
post #12 of 16

Of course, death isn't the only concern with GBS.  Personally - we have no family history of allergies to penicillin or of yeast infections.  I wouldn't hesitate to risk a yeast infection over a newborn with pneumonia, meningitis or sepsis and stay in the NICU.

 

Blanca, I've seen pictures somewhere of a woman laboring in the tub with an IV in place.  I hope your midwives can work with you on that.

post #13 of 16
And of course a yeast infection is not the only risk of using antibiotics prophylactically.
post #14 of 16
No, I was trying to point out that it's our personal biggest risk and that it's not a very big one because no one is prone to them. So the risk of GBS is higher for us. Obviously if you're allergic to penicillin or if you get frequent yeast infections you have other personal risks that you need to consider.

Sorry if that wasn't clear.
post #15 of 16
Thread Starter 
Well, the midwife was totally chill about it. Their standard protocol is one dose of antibiotics four hours before delivery. She said they often do it while you're getting your initial cervical check/monitor, and then they avoid any AROM which her practice avoids anyway. Other than that, shouldn't affect birth plans. She said if we miss the four hour window, it's not a big deal, they just observe the baby more closely after birth. So I'm happy with that. Must say I'm with Cwill--I very rarely take antibiotics of any kind, so the potential benefits of prophylaxis in this case outweigh my concerns about risks.
post #16 of 16
I have been Gbs+ 3x out of 7. Each time has been Iv antibiotics for me and no issues (I don't have allergies and I'm not too prone to yeast infections...though I do up probiotics afterwards just to be safe). This time they did a new dose every 4 hrs since I was on an Iv anyway. In the past I don't remember getting dosed that often. I thought it was once and then if no delivery within a larger window then another dose...anyway that's been my experience. They tried to get me to stay another day as 48 hr protocol to check her but she was so good and I've done this so often they let us leave without grief at 24 hrs.
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