Group B Strep

[starflower1]

My group B strep test came back positive. I am planning a home birth, so iv antibiotics are not an option for me. . . not that I would want them anyway. . but I still worry. Anyone else dealing with this or have any advice.

[mtm]

can your midwives not do the antibiotics at home? Here its fairly common. I'm gbs positive too but am already a hospital birth so while the iv sucks, its not a huge issue.

[crazydiamond]

You have a couple of options. . .

1) Do nothing. The vast majority of babies born to GBS+ mothers do not get colonized. . .and the vast majority of those that do get colonized don't get sick.

Antibiotics have reduced the already low rates of GBS infection in infants, yes, but they have not prevented them. That is to say, there is no guarantee that if you received IV antibiotics, your baby won't still get sick.

Keep an eye on baby for up to a week to make sure things are going OK (that's kinda duh statement, since I'm sure you'd be doing that anyway!). If baby gets sick, take him in. They can do GBS testing on the baby to determine if that's the problem. The most common symptom of GBS infection in a newborn is respiratory distress. . however 99% of cases of newborn respiratory distress are from unknown causes. The infection is largely treatable, so as long as baby gets care right away, there's an excellent chance things will be just fine.

2) Do a Hibiclens wash. This has been shown to be just as effective as IV antibiotics in reducing GBS infection in newborns. My MW has the exact recipe and protocol, but essentially you make a mixture of Hibiclens and rinse the vagina in it (as long as the bag of waters are intact). I've heard of other remedies, too, such as colloidal silver, but I don't know much about them.

Be aware, though, that hospitals do not recognize the effectiveness of these alternatives, so if you do end up transfering, you'll be subjected to IV antibiotics unless you specifically decline. If you decline, they'll want to keep your baby for 48hrs to make sure there are no signs of infection.


For the record, I declined GBS testing because, to me, it wouldn't make any difference. There is a new rapid-GBS test (results in 30min) that I will get if I get transferred.

Overall, though, I feel that the risk of GBS infection is small and the effects of IV antibiotics are too great. Mary Lou Singleton (actually my MWs former partner), wrote an excellent article about it Midwifery Today (May 2007, I think). BTW. . my homebirth MW can legally gives IV antibiotics and I still declined all testing.

The most important thing is that once your water breaks, keep the internal exams to a minimum! GBS+ plus frequent internal exams does raise the rate of infection. . so as long as your MW keeps her hands to herself, your baby should be fine.

[DBZ]

If I end up being positive I will either do nothing or do the hibicleans wash. I'd prefere to do the wash, but I don't know if I'll get my hands on it before I deliver.

[zaner'smama]

I am also positive and am birthing at a birth center. I'm declining antibiotics and using hibiclens. I bought it a couple days ago at Walgreens (I believe). It was in the first aid/alcohol/peroxide section and cost $9.99.
Here is some info and how to use it if you are interested. Good luck!

https://www.birthwithlove.com/pdf/GBS/pdf/GBSCHLOR.pdf
http://www.birthcottage.com/images/GBS%20Protocol.PDF

[gretasmommy]

I am positive as well, and will be doing the abx as I am having a c/s anyway. One dose in the IV before surgery . . .

I haven't looked into the studies and stats on IV abx vs hibiclens . . . .perhaps others here can offer more scientific analysis of the two to help you decide what feels like the right choice.

[XanaduMama]

I did the hibiclens before I tested this time (I was + last time), and think I'm negative (MW said that a + result would come in right away, and I've heard nothing). I might still do a wash once labor starts. It's just as effective as abx without the nasty systemic effects. Another useful link, incl some studies: http://www.gentlebirth.org/archives/gbs.html#Lavage

Still, as PPs have said, your risk of passing it on to baby are very low in the absence of risk factors: preterm birth, prolonged ROM (18 hrs +), fever during labor, etc. And yes--NO INTERNAL EXAMS!! They just increase the risk of spreading the bugs around without telling you anything useful.

[Jes'sBeth]

yeah, I'm conflicted over the whole gbs thing. I know a family where the mom tested neg 2-3 days before birth and her son got gbs and has life long complications from it. It's not to be messed with. But at the same time the midwife caught it on day 2 of his life (ie he was crying and crying and just wasn't 'right') so she got them into the hospital. I don't think they could have done anything that would have helped really...

So, since you have a midwife, you can make some good choices and get advice really easily and have her watch for signs of GBS infection after baby is born.

[1Plus2]

Couple of quick questions about the Hibiclens. You do it every 6 hours even if your water has broken? And you put it in a douce type bottle but do you just clean the outside of your vagina or gently squeeze it inside as well? I declined the GBS test but wouldn't be opposed to doing a quick rinse at the onset of labor.

[crazydiamond]

Originally Posted by 1Plus2

Couple of quick questions about the Hibiclens. You do it every 6 hours even if your water has broken? And you put it in a douce type bottle but do you just clean the outside of your vagina or gently squeeze it inside as well? I declined the GBS test but wouldn't be opposed to doing a quick rinse at the onset of labor.

I'm pretty sure you need to rinse the inside of your vagina, not just the vulva/external area.

My MW stressed upon me that the rinse should only be done when the waters are intact. . after they are broken DO NOT do the rinse anymore.

[1Plus2]

Originally Posted by crazydiamond

I'm pretty sure you need to rinse the inside of your vagina, not just the vulva/external area.

My MW stressed upon me that the rinse should only be done when the waters are intact. . after they are broken DO NOT do the rinse anymore.

Thank you!

[Romana]

Originally Posted by Jes'sBeth

yeah, I'm conflicted over the whole gbs thing. I know a family where the mom tested neg 2-3 days before birth and her son got gbs and has life long complications from it. It's not to be messed with. But at the same time the midwife caught it on day 2 of his life (ie he was crying and crying and just wasn't 'right') so she got them into the hospital. I don't think they could have done anything that would have helped really...

So, since you have a midwife, you can make some good choices and get advice really easily and have her watch for signs of GBS infection after baby is born.

This is a good point about the test (emphasis mine). Even if you're negative when tested, you may well be positive at birth. So the only really prophylactic treatment (still not 100%, since it's not 100% effective) would be to simply not test and treat 100% of women with IV antibiotics. Goodness knows there are ramifications from the current overuse of antibiotics; could 100% really be justified? Maybe, since the current 30% or so has been deemed justifiable. I'm guessing you could get an OB to prescribe prophylactic IV antibiotics regardless of GBS result, or choose to decline the test and just get the IV antibiotics if the small chance of contracting GBS are of concern to you (general you).

[Incubator]

Originally Posted by gretasmommy

I am positive as well, and will be doing the abx as I am having a c/s anyway. One dose in the IV before surgery . . .

I haven't looked into the studies and stats on IV abx vs hibiclens . . . .perhaps others here can offer more scientific analysis of the two to help you decide what feels like the right choice.

Ok... I know I have a bad memory, and I'm not always "all here" but if you're having a c section, why does it matter if you're GBS positive?

[crazydiamond]

Originally Posted by Incubator

Ok... I know I have a bad memory, and I'm not always "all here" but if you're having a c section, why does it matter if you're GBS positive?

It's the other way around. She's getting abx because of the C-section (usually standard protocol). . .and just happens to be GBS+.

At least that's how it worked during my cesarean. . and I was GBS-.

[clutterbug]

Originally Posted by Romana9+2

This is a good point about the test (emphasis mine). Even if you're negative when tested, you may well be positive at birth.

True. And mom's vagina is not the only source of GBS...baby can pick it up from external sources as well. They can also get a late-onset infection so evern though the hospitals want to observe for 48 hours, that's not a guarantee that something won't pop up in two weeks' time.

Basically, there are no guarantees...! I am torn on the GBS issue as well, simply for this reason. I tested +ve last time and had one dose of abx during transition (I don't think anyone realized I would dilate so fast!). For maximum benefit they want to see you dosed about 4 hours before birth. So DS didn't even get the full protection of the drugs, but I did get one wicked case of swelling from all the fluids that ran into me (one bag with abx added before birth, one bag of plain saline after to keep the IV open "just in case").

ETA: Whoops, I sorta jumped in there without intro...I am not in your DDC, I thought this post was in mine (May!). My apologies for being so forward

[crazydiamond]

Originally Posted by bluepetals

ETA: Whoops, I sorta jumped in there without intro...I am not in your DDC, I thought this post was in mine (May!). My apologies for being so forward

No worries! You make some excellent points, so I'm sure your knowledge is more than appreciated here

[gretasmommy]

Originally Posted by crazydiamond

It's the other way around. She's getting abx because of the C-section (usually standard protocol). . .and just happens to be GBS+.

At least that's how it worked during my cesarean. . and I was GBS-.

Yep . . . . thanks for clearing that up!

[oneduemommy]

I too have been informed that I'm GBS positive. I am planning a natural hospital birth and will get the antibiotics through the IV. I researched and found out 1 in 200 babies get sick with no antibiotics. Only 1 in 4000 get sick if on antibiotics. My husband was sick when he was born due to this. According to my mother in law, he was a miracle baby and was not supposed to make it. Because of this illness aat nd my husband's unfortunate experience, I chose to get the IV with antibiotics. Just my 2 cents.

[starflower1]

Well, Little Georgia arrived before I had a chance to do much about GBS. My due date was March 10, and being a first time mom, I expected to go late, but I went into labor Tuesday 9/26 at 11 pm and Georgia was born at 7:32 pm 2/27 at home. My sister guided her out and caught her. I was wonderful!

Tuesday night before bed I had inserted a goldenseal capsul vaginally because I had read in Aviva Jill Romm's natural pregnancy book that that is an option for treating GBS after 37 weeks. It can also be a labor inducer, but it is hard to believe that one dose would have kicked me into gear like that! I guess I will never know! I was planning to do start a wash the next day, but my little one had other plans!

Georgia is absolutely beautiful and I am keeping a very close watch on her. So far everything is good. I love her soooo much. Best of luck to all of you!

Thank you for your suggestions and thoughts. I am sorry I did not have more time to put them into use, but I am so glad Georgia is here.

Please keep us in your thoughts and pray that Georgia stays strong and healthy!

[lilkat]

Oh, congrats, mama!! I hope sweet Georgia stays strong and healthy