Q for doula client - GBS+ and water broken for 51 hours?

[tree_hugger]

This client has been so committed to a natural and drug free pregnancy and birth. She has had no antenatal testing or ultrasounds.

Her water broke and she's been having early labour contraction for two days now. Unfortunately, I think she went to the hospital and she's been found to be GBS+. She is very tired and stressed, and the hospital is pressuring her to come and in be induced with pit and get the IV antibiotics.

They've tried homeopathy, essential oils, acupressure, acupuncture, reflexology, nipple stimulation, relaxation strategies, positioning, birth ball bouncing, walking to get labour happening, without a lot of success.

What would you suggest? Is it time to give up the birth plan do the best they can in the situation?

PS This isn't my client, its a friend's.

[MsBlack]

If there are no signs of infection, then she's probably ok. But--if this is a planned hosp. birth, at what point are her care providers going to say that she's got their hands too tied to help her?

[mwherbs]

what does the mom want to do now?

a while back we had a long discussion on sleeping meds for prodromal labor- this would have been one of the cases in which I could see it being useful-- that being said - I would recommend since it is day time that she get up and walk- walk all day sort of briskly - not race walk but not slow careful walk either- move so that the baby finds it's way in and the upright pressure on the cervix may help to trigger dilation/contractions

[JamieCatheryn]

Has she considered accepting the antibiotics but no Pit? Wiping out all bacteria has it's downsides but if it would ease GBS worries while awaiting labor it might be helpful. (I'm not a midwife, just a CBE in training and a mom who dealt with the GBS+ thing myself)

[BirthIsAwesome]

Is she eating a lot of raw garlic, taking echinacea and vitamin C, and drinking A LOT of water (like at least 2 gallons of water daily)? The supplements will keep the infection risk down and the huge amounts of water will protect baby, and keep flushing the bacteria out of her cervix/vagina. If she ends up taking the abx, make sure she knows to eat TONS of yogurt/kefir and start taking probiotics.

And, she can take Passionflower tincture to help her sleep at night (30 drops in a glass of water right before bed).

[SalmonBayDoula]

Recent client in similar situation

I recently had a client in a similar situation, and she was able to reach a compromise with her provider and the hospital (planned hospital birth) to come in periodically for IV abx and then go home and continue her attempts to get labor started naturally, after ROM and GBS+ status. Unfortanately, the abx cycle was something like every 4 hours, which seemed very crazy, but eventually she negotiated every 6 hours. I wondered if there weren't different varieties of abx, and she could have received one that required dosing at longer intervals. It made me tired just watching how much time she spent going back and forth, but it was important for her to stay at home as long as she could into active labor, so though she was exhausted and tried to find the balance between resting and getting labor going on the home shift, she and her partner seemed please with this solution.

This client also did things to prevent infection that others have listed here..

Good luck to your client and sending her labor vibes!

Sharon
www.newmoonbirth.com

[midwifemom3]

prolonged rupture and GBS

Hi All,
Well GBS can be a lethal bacteria, and when you are looking at which client will have the baby with systemic infection from GBS it is this scenario when it occurrs. The longer the membranes are open and the baby is exposed the higher the chance of GBS infection. Also there is a direct correlation between chorioamniitis, and Cerebal Palsey. When prolonged prodromal labor is going on there is usually an issue with malpresentation, OP ETC! I would rater have her go in for antibiotics and pitocin, you can still walk, shower etc, on pitocin and have no pain meds, than end up with choris and have a section. If the mom gets a fever, the baby will respond with fetal tachycardia, and a section could result. So when looking at the scenario, I would not continue to do nothing. She could try caulaphylum to see if she can get the contractions stronger, use a breast pump to stimulate oxytocin, and down two ounces of castor oil.
Now if she had a high leak that sealed itself off, she doesn't need anything. How did they confirm rupture?
Hope this helps

[homewithtwinsmama]

I did not test for GBS, but my water was ruptured at 37 weeks for 4.5 days. I did the European protocol for Chlorohexidine vaginal wash, took my temp every 4 hours, checked fetal heart tones regularly, took garlic, Vit C, Echinacea and goldenseal 3X daily-all this I did for myself, homebirth midwife took my blood every other day and we did white cell count (to look for signs of infection) and waited for labor. Had nice quick 9 hour labor when it commenced. Baby was fine. GBS can kill however and if she has gone this long and done nothing to proactively protect herself and baby I would be leery of continuing to do so. I had one birth center client who was sent home with enough antibiotics and a hep lock with dad instructed how to give every four hours and we waited to go in. The reason we went in was I got a non reassuring FHT at home followed by some meconium. That was that and we got pit, but she had made nice progress at home until that time in an environment more like what she had hoped for (planned birth center but of course ended at hosp with pit vaginal birth-no pain meds).

[tree_hugger]

Thanks for your insights, everyone.

She ended up going to the hospital last night for IV antibiotics and synto. She had an eleven hour labour, no pain meds and a spontaneous delivery, so everything was as close to her original plan as it could have been!

[SublimeBirthGirl]

That's great! I'm glad it worked out so well for her.