GBS and homebirth

[bygones75]

I'm pretty much as anti-standard intervention as can be... but I admit that GBS scares me. I recently read an article that said 2% of babies born to GBS positive mothers (w/o antibiotics during labor) develop sepsis . That may not seem high to some, but I'd hate to be the mom to one of those poor babies.

Obviously, you don't get an iv antibiotic during a homebirth. Does this scare anyone? I may be showing my ignorance, but I really do want to learn and be comfortable with this so I can go into homebirth fully prepped. Any info or experience is appreciated.

Thanks,

[ryansma]

I was GBS positive and my midwives had me take Acidophilus for the weeks before the birth. During labor I would periodically sit on the toilet and spray myself with a water and Hibicleans mixture from a peri bottle. No problems here. I am no expert on GBS but from what I understood even if you test positive at 35 weeks you may not even have it at the time of birth. Then the likelyhood that you will pass it to your baby at birth is even smaller than that. Hopefully someone else can give you some solid numbers.

[angington]

Some do IV abx at home. Others do them orally. Others use topical remedies like Hibiclens (sp?). But birthing at home also gives you the added advantage of few or no vag exams to push bacteria inside of you.

[Rico'sAlice]

Mothering Mag. Article Treating Group B Strep: Are Antibiotics Necessary?

PLUS-
Sidebar: Herbal Treatments
Sidebar: Benefits Of A Probiotic Diet


I didn't test. Followed a home treatment protocol very similar to the one they outlined. I also used TTO suppositories at one point. I "Just Say No" to VEs!
After doing all of that, I'm not worried.

[rootzdawta]

:

[MsBlack]

2% of babies getting GBS sepsis is a VERY HIGH OVERESTIMATION!

If a baby is born at 37weeks or more;
if a baby is born at 5lbs or more;
if mom and baby are otherwise in normal health;
if water is broken for less than 18hrs (and no or few vag exams)
THEN GBS sepsis occurrence is approx 1 in 2-3thousand. Death from sepsis is far lower!

more later

[MsElle07]

Some midwives do IVs at home, depends on your state and what type of MW you have.

I was GBS+ with my most recent baby and declined antibx. Most babies with GBS disease were subject to the risk factors in the above post. A full term baby whose mother has intact membranes and doesn't have any vag exams has a VERY low risk of contracting GBS even without antibx.

Another reason I chose not to do them is because women and babies who receive the antibx have much higher rates of thrush (which I went through with a previous baby and would NOT recommend) and of antibiotic resistant e coli infections.

[bygones75]

This is all fascinating... and it's making me feel better. Of course, last time, I had several of the risk factors mentioned (and indeed was GBS pos). But I'm better educated this time around.

Am going to read the article now. Thanks!!

[wwisdomskr]

I was tested for GBS without my consent. I sent a urine sample to the lab because mw and I suspected I might have a UTI that was causing contractions. They found me GBS+.

It was our first hb, and I was worried about how my baby and I would be treated, in the event we had to transfer to the hospital. I didn't want the docs taking my dd away from me for a "full work-up" just because they saw the GBS+ in my chart and we had not done abx.

So, we planned to do the IV...

But...

My active labor was about 2 hours!

I remember mw fiddling with the IV bag and then just tossing it aside because dd was well on her way!

Dd was completely fine. We watched her carefully and that's what we plan to do again this time. I will avoid testing and the abx at all costs...but will probably assume that I am positive and take all necessary natural precautions.

Let me tell you: Dd1 was premature and I received abx during labor with her. We had horrible thrush. Not having it with dd2 was like heaven in comparison.

I also worry about the abx masking more serious infections in the newborn...as well as the issue of resistance to more serious infections...

I understand that 1 out of 3 thousand is someone's baby...and I also firmly believe that the risks can be managed in other ways.

Hope this helps.

[midwyfjan]

I'm a homebirth midwife and I do test my moms at 36 weeks, but if she is positive, I request that they do a protocol that includes intravaginal garlic for 4-5 nites, then another week or so of TTO suppositories or "tampons" (a couple of drops of TTO on a cotton ball, with dental floss attached for removal the next morning), then a week's worth of good probiotics inserted vaginally at nite. I ask them to use the Hibiclens wash during labor (no studies show any benefit from doing it prenatally). So far, so good. About the normal percentage of moms come up GBS+ during pregnancy, but no cases of fetal infection so far. Of course minimizing VEs and laboring in water probably help. 120 gallons of water dilute the bacteria quite a bit!

The risk of the baby getting seriously ill, among babies whose mothers are positive and who don't get ABX, is 1/200. I think at home, it's less. Naturally, the risk factors of prematurity, prolonged ROM, maternal fever change things and require medical help.

good luck!

[ajmckay36]

I homebirthed my last son with GBS. My MW and I decided that if I fell into a "risk" category (labor before 37 weeks, water broken 18+ hours, fever) that I would go to the hospital for IV antibiotics. It turned out not to be an issue, thankfully. I did do a few cholorohexidine washes during labor.

Aviva Jill Romm has a great protocol for GBS in The Natural Pregnancy Book. Best of luck!

[KarenMT]

I discussed this with my hbmw at a recent interview. I was GBS - with my first birth so hope for this with the 2nd birth. Her protocol is to use a chlorhexedine wash (maybe the same as Hibiclens). She cited numerous issues with mom and baby for both thrush and e.coli infection when IV abx are used.

[AugustLia23]

The rate is 1 in 200, 0.5%, not 2 in one hundred, 2%. I am okay with doing things to help encourage healthy intestinal flora and then doing something to help treat possible GBS if I show the risk factors, but I don't want prophalyctic abx just because I might be positive. I have never tested for GBS though.

[scheelimama]

I did extensive research on this subject in my last few weeks of pregnancy last time. I was very against antibiotics since the antibiotics during labor gave me horrid thrush for the entire nursing relationship with dd1. What I concluded was that a) slightly more babies get sepsis if mom is not treated with antibiotics, but b) less babies actually die if mom is not treated. Since mom was not treated, the GBS has not been partially killed off, leaving the super bugs. Therefore, it's much harder to treat the baby who gets sepsis anyway when mom is treated. Make sense?

Garlic cloves used internally for at least 3 days prior to labor help eliminate GBS. Massive amounts of probiotics are great (I take 6 Nature's Way daily when treating something). And the hibicleanse is good. I discussed what I would do to eliminate GBS and my mw agreed to let me birth without antibiotics unless my water was broke for more than 6 hours or she had a reason to believe I needed them. She would not break my water at any point during labor (even if I had had antibiotics, she refuses to break the water bag if the mom is GBS+). My water broke as dd was crowning, so she was never exposed to the birth canal. We had a perfect experience.

ETA: I will be going to a different midwife this time unfortunately, but I will do all I can to hopefully test negative. If I test positive, I hope my new midwives will allow me to go the same route.

[groovynaturemama]

i was GBS +, and did chlorhexadine (4%) washes while in labor...that's it. my active labor was 4 hours, and that is also how long my water had been broken before dd was born. i asked my mw about profilactic abx (to take before labor) and she said that it was likely the GBS would re-colonize once the course of abx was finished, so it was moot to take them. the hibiclens/chlorhexadine works on killing the GBS just as well as abx during labor..there is a study out there with the stats, but i consider me and dd living proof as well

[jessitron]

MsBlack, that makes a lot of sense. Thanks! It's silly to lump all women together into one statistic (1:200) when there are clear indicators of lower or higher risk.

[aylaanne]

Everyone's pretty much nailed this topic, I just wanted to let people know that chlorhexadine and hibiclens are the same thing. Hibiclens is a brand name, like tylenol, that just gets applied to everything made with that product.

[heidi_m]

Lots of good info has been put forth here... I just wanted to say that I was GBS+ at 37 weeks and gave birth at home in the water with no problems. I adopted a probiotic regimen (I actually have taken them ever since as they help to establish healthy gut flora - and thusly healthy immune system - for baby via breastmilk) and did a couple of peroxide washes (found on Ronnie Falcao's gentlebirth.org site) prior to giving birth.

Hydrogen peroxide kills GBS, and it is also a natural byproduct of acidophilus metabolism, hence the probiotics and the wash.

In any case, it is possible to watch for symptoms of GBS infection in a newborn (lethargy, fever) and treat if symptoms warrant.

[MyBoysBlue]

I was GBS + and had a UC. I didn't UP so I got tested at 36 weeks. I did probiotics and immune boosting vitamins for 2 weeks before Birth. DS was born after a quick labour at 39 weeks and was fine.

[HeatherB]

Great info. Also, remember that you can test one day and be + and one day and be -. An OB at a meeting I attended this evening says he doesn't think much of the whole GBS thing, because it's so variable like that.

First pregnancy I was GBS-, 2nd was an HBAC and I opted out of testing after discussion with my MW. This time, I doubt we'll test BUT if we do and it's +, my MW also suggested doing the Hibiclens wash and then REtesting. That gets a lovely GBS- on your charts so you don't get harrassed. If I was concerned about it, I might also do the wash during labor, etc.

For me, at least at this point, I'm just not all that worried about it. Another HBAC'er mentioned tonight that in the UK, they don't even test for GBS! And seems their babes are doing just fine...