Did you get tested for GBS?

[raynelady]

My midwife wants me to decide by Tuesday if I want to be tested for GBS. She passed on some reading material (an article from Mothering and some CDC material too). What I've gleaned from it, the testing seems harmless enough--but what would I do with the information? If I'm negative, it doesn't matter. If I'm positive, do I want antibiotics during labor? From the reading material, there doesn't seem to be a huge benefit from taking antibiotics during labor. I'd love to hear from other mamas and some of the midwives who I know lurk around here what you think about the GBS test, and whether IV antibiotics are good practice if the test is positive.

Thank you!

[momto l&a]

I will be having our third hb in about 4 weeks or so.

I have never been tested for GBS.

[Beverly_T]

gbs test

hi,
i think the gbs test is a good idea.
my midwife insisted...
if you are positive, it is likely that you will have a fever during labor (unless you have the iv antibiotics), and your baby will be born with a fever. if this happens, your baby will most likely need to be in the neonatal intensive care unit for the first 24 hours at least, just for monitoring...

the likelihood is that you'll be negative, and it's one less thing to worry about...

all the best,
beverly.
mom to sofia (10/12/03)
http://www.ccd.bnl.gov/~tomov/Sofia.html

[Glittergal]

raynelady-

if you are positive, you will not most likely have a fever in labor.
it's just that if you do have gbs, a fever in labor may be more dangeous to your baby, which is why antibiotics are recommended.

Are you planning a hospital or homebirth? I will tell you what I did. Although intellectually, I wanted to not test and follow the risk based protocol for antibiotics (labor before 37 wks, maternal temp, etc), I also knew the hospital protocol for untested babies. We were planning a homebirth and I knew that in the unlikely event of a hospital transfer, the NICU and MD staff would insist on obtaining blood cultures and doing a whole work up on our baby if I had not been tested (because of the unknown status). If I had documentation that I was negative, it would save the baby ridiculous blood draws. I know this hospital policy is silly but I worked there (in OB) and decided if I had to transfer, I wanted to do it as gracefully as possible. As it was, I was negative and had a lovely homebirth.

I hope that helps you. It is a very personal decision. Good luck!

[KariM]

-

[nikirj]

I was tested both times, positive both times, both times the water broke just a few minutes before my babies were born, so it didn't matter. It only really matters if you start to run a fever, if the waters break far before the baby is actually born, or if the baby is born in not-so-great condition (DD was born with a rather extreme fever (aka BROKEN THERMOMETER ) that had everyone freaking, until they found a functional thermometer and we found out that her temperature was totally normal).

[Jemper]

I tested with my 1st PG, I was positive. Read up on the risk factors that Niki mentioned (prolonged rupture of membranes, fever in mom or premature labor). Decided that if I encountered one of those factors, then we'd consider antibiotics.

Didn't test with 2nd PG, my m/w considered my status "unknown." I took Vitamin C & Echinacea in the last month of my PG to boost my immune system. There are lots of other herbal remedies available, too.

With both births, I encountered *none* of the factors. Full-term baby, no fever, and my membranes broke during the pushing stage.

Here's a good website with tons of info ~ http://www.gentlebirth.org/archives/gbs.html

GL making the decision that's right for your family!

[Mom2baldie]

I am having a homebirth any day now and did not test for GBS. I find all the information about it very unclear and confusing.

[rad]

With my first hb I did not get tested at all. Had no problems during that labor. With my second HB, I did get tested (same practice). Not sure why their policy had changed. I ended up being positive. What they did was give me oral antibiotics that I took when my water broke and labor started, then I took 2 more after DD was born. If my labor had been longer than 4 hours, I would have taken a dose every 4 hours. If I had spiked a fever, they would have treated me with antibiotics via IV. With my first, they would have done the same if I had spiked a fever.

[Lucysmama]

I had decided to skip it, but after realizing that in a homebirth transport situation that my baby and I would be treated as if we were +, I just decided to go ahead and test. My MW sends you in to the bathroom to swap your vagina in private, and she takes it to a lab and lets you know the results. I am not doing the antibiotics if I am +, but will consider doing the hybi-cleanse vaginal wash in early labor. So basically I am doing it so that if I am negative and have a transport, my baby and I will not be treated as if we have a "dangerous bacteria."

[raynelady]

Thanks for the advice! I think I'm going to do what Lucysmama did, for the same reason--that is, get tested so that we will have documentation in the unlikely event of a hospital transfer. (Yes, we're having a homebirth.)

And I agree, Mom2baldie, the information is confusing, and everyone seems to have very strong opinions on the matter, so it seems that everything I read is somehow tainted with preconcieved notions.

But then, so many things about pregnancy and parenting are like that, aren't they? Homebirth/hospital birth, cloth diaper/disposable, spanking/no spanking--everyone else seems to have it all worked out sometimes, and I wonder where I was when roll call happened and everyone divided up into camps. Oh well. One day at a time and one choice at a time, I guess, right?

[Nancy J]

Struggling with "care givers"

I posted Weds that my Dr. had me scheduled for inducement that morning!! Ten days early. We have disagreed about every "normal" hospital practice. Vaccinations first hour, glucose water, staying with baby,etc.

I thought this test was another intrusion. I did test positive. I am to go to the hospital the moment water breaks so they can begin the IV with anti biotics every four hours. I got down right weepy about having the needle in my arm, I'm a wimp.
I am not looking foward to a day in the hospital if dialation and labor is slow.

They told me this is a precaution because the baby will most likely have some congestion at birth if I don't get antibiotics.

They said it was strep.... What is the story? What fever? Is this why I have been in and out of labor for the last ten days??

[momsgotmilk4two]

I'm having a hospital birth with a midwife and am not being tested. My midwife is totally fine with this, she doesn't insist that you do anything you are uncomfortable with. My reasoning is that if I do test positive I do not want antibiotics in labor because I don't want an IV at all and the antis are usually not necessary anyway. I would rather just be treated with antibiotics IF I have signs of Group B strep such as a fever and there are a few other warning signs that I'm forgetting. They do this in other countries rather than routinely test every woman.

[azyre]

A positive GBS result, combined with the unlucky chance I had PROM with no real labour, caused the interventions that led to my c-section all because of hospital protocols. I think testing for GBS is a big deal, you need to know if you agree with your care providers stance on GBS treatment, and if you don't, you probably need new carers. It's hard to fight in labour, or before and hope to go into labour in a negatively charged atmosphere.

From memory, about 1 in 1000 trips down a birth canal colonised with GBS will result in an infected baby, when the mother isn't given antibiotics. At any time 30% of the population is colonised, and it comes and goes - so a negative test a month before labour does not mean you will be GBS free at the time of birth. The statistics for those babies infected aren't that crash hot. But obviously, simply reading positive is not a good indication of risk - 999 out of 1000 times it makes no difference. Surely there is something else at play here and it's not blind luck IMO. Maybe it is even beneficial for baby to be colonised with such a bacteria when it is so common and will have Mum's immunity being passed to it via colostrum. This is lowest common denominator medicine at it's worse. It makes far more sense to treat for symptoms rather than a test result when the test result is meaningless INDIVIDUALLY and GENERALLY.

[candipooh]

You have to understand also that the test if faulty. Just because you are - at 36 weeks doesn't mean you will be at delivery. My SIL tested - and her son got GBS.

I did not test with my younger 2 (homebirth) but I did with my oldest (hospital)

[Chiromom]

I am wondering why less mama's are concerned about/talking about the problems associated with the prophalactic use of antibiotics on their child. I understand if there is a verified life-threatening bacteria diagnosed in the child it is a good idea, but as a protective measure it seems like the risk to the child is much more dangerous given the statistical likelyhood of a GBS infection in the child, even if the mom is +. I mean, we have lots and lots of warning signs in the infant and can respond with antibiotics as needed in a timely fashion, right? However, every exposure to antibiotics (especially in a child under the age of two) in a child permanently (negatively) affects the development of that child's immune system.

Antibiotic use, the use of vaccinations, and other environmental polutants have been strongly linked in much of the medical literature to the development of atopic disorders and Th2 mediated immune responses. This means that when your body is exposed to something yucky, rather than forming normal, healthy antigens (IgGs etc) of a Th1 response, it will overreact and create crazy antigens (IgEs) which are the allergic and over-inflammatory response. (Let me know if I need to search for links for this stuff.) This (Th2) is usually a marked response in people with asthma and allergies and autoimmune disease.

My family already has a history/genetic predisposition to autoimmune disorders so I avoid antibiotics like the plague...especially when my kids are young! I am not saying never use antibiotics..I am saying do not use them "just in case" because you can potentially open a big big can o' worms. Every exposure to the drugs (and other chemicals) increased the odds of this reaction exponentially.

I don't mean to lecture or scare anyone..I just was suprised no one was discussing why avoiding the antibiotics was important beyond just the fact that is is likely unnecessary.

[nikirj]

I was just thinking that it goes without saying that the kinds of people who hang out on this site would know to avoid antibiotics if possible.

As I said, I had positive test results and no antibiotics, because I refused them unless I had the risk factors - the positive test result just told us to take the risk factors seriously.

[lorijds]

I just wanted to address a few things.

According to the CDC (your choice whether you buy their info or not), a mom who is colonized has a 1 in 200 chance of having a child who becomes infected with group B strep. Of those babies infected, 1 in 20 will die from the infection. Others can experience menningitis, organ failure, pneumonia and/or sepsis. If you treat with antibiotics, the CDC says that your baby has a 1 in 4000 chance of contracting group b strep.

Another poster points out the problems with prophylactic usage; true, there are several cons to treating prophylactically, even in the presence of a positive group b strep swab. Waiting to treat until baby shows signs of illness isn't such a great plan either, as there is often little sign that the baby is sick until he is really ill. If a baby becomes ill with (or even if he is suspected of being infected with) group b strep, it isn't just a matter of doing antibiotics, which sounds so benign. Your baby will most likely be admitted to a NICU for 7 to 10 days of IV antibiotics, multiple blood tests, spinal taps, x-rays, etc.

A point that I don't think anyone has made is the increased chance of developing yeast gone wild, aka thrush, when antibiotics are used.

Personally, I would probably refuse the antibiotics, but would get the testing. For the reasons many have already listed. Unless of course I developed a fever during labor (that wasn't due to dehydration or a hot birth tub), or other signs of infection; then I would be okay with getting IV antibiotics. The testing can be inaccurate (if you get tested at 36 weeks, and then go 2-3 weeks overdue, your status of being colonized or not can change), and there are always false positives and false negatives.

I don't think anyone is a bad mom, which ever direction they go. I think it is one of those things that you need to know all sides of, and then make a decision you are willing to take responsibility for. I would be willing to take the responsibility of the small chance of my child becoming ill due to my decision to refuse antibiotics; but that is just me. I respect others who make a different decision.

Hope this helps!

[puddinnpeanut]

What is involved in being tested for GBS? I honestly don't remember if I was tested for my first two pregnancies! Is it just a blood test or someone mentioned swiping the inside of their vagina? Anyway, I'm curious since we are planning a homebirth this time, thanks!

[azyre]

It's a vaginal swab.