Refusing GBS Test

[NDFanatik]

I think I'm going to refuse the GBS test that my OB will want me to do. I've talked it over with my husband and he said that it was up to me.

I just don't know if I really see the need for it since the possible repercussions IF I have it are pretty small. Plus, I'd hate to test pos at 36 weeks and be doomed to being stuck to an IV pole with antibiotics (since I've already denied an IV) when I may not even have it at the time I go into labor.

So I'm going to go into that appt prepared with statistics about why I want to refuse the testing, just in case my OB starts trying to convince me to have it. I have this site so far... Any others that might offer up more statistics that would support me not wanting the test?

[janasmama]

I think that site gives you enough info...

Besides, saying that you don't want to take the test should be enough since it is recommended not mandatory.

If they give you any flack about it ask them if they have a waiver you can sign for not accepting the test.

[jenmidwife2b]

Just be aware that if you refuse this test, they may go ahead and treat you as GBS positive at the hospital, because you were not tested prenatally. I have seen this happen and I just wanted you to be aware of that possibility.

[NDFanatik]

Originally Posted by jenmidwife2b

Just be aware that if you refuse this test, they may go ahead and treat you as GBS positive at the hospital, because you were not tested prenatally. I have seen this happen and I just wanted you to be aware of that possibility.

EEK!! I CAN refuse the antibiotics though, can't I? It's not like they can force the IV into me... I mean, if I start running a fever or whatever, I'll consent to it, but I see no reason to automatically get the IV if I wasn't tested.

[Baby_Cakes]

Originally Posted by jenmidwife2b

Just be aware that if you refuse this test, they may go ahead and treat you as GBS positive at the hospital, because you were not tested prenatally. I have seen this happen and I just wanted you to be aware of that possibility.

I asked my midwife this same question. She said they would only treat with abx IF I started showing signs of infection (fever, waters breaking early, etc).

I'm also debating declining the test. My midwives are really encouraging me to have the test done, but they know that I'm thinking about declining the test. They told me to really think hard about it, b/c while thrush from abx can happen and will be annoying, it isn't fatal. Some of the complications for baby from GBS are fatal.

Ugh, it's so not clear in my mind what I'll do yet.

[ellesmom]

I guess it all depends on your hospital and doctor. The current CDC guidelines are to test all women at 36ish weeks and treat all "unknowns" as positives. My mw and I had a lengthy discussion about this at our appointment yesterday, and I decided to decline the test and any abx unless I get a fever in labor. So, it really depends on where and with who you are having your baby. I used to work L&D in a HUGE hospital and we treated all unknowns with abx. I had a mom refuse and she just signed some papers, but the doctor pulled the "we are going to have to do a lot of testing on your baby card". Luckily this mama had a good relationship with her ped (it was her 5th baby!!!), and her ped discharged her the next day without any testing.

[Kim919]

I plan on having the test, though I think my midwife says we will do it closer to 38 weeks. I feel comfortable with her that whatever the results she won't "freak out." I also liked that she mentioned just because the test comes back clean at 38 weeks doesn't guarantee you will be clean during birth. 2-4 weeks is a long time! (if you tested at 36 weeks & delivered at 42 that would be six weeks even - plenty of time for an infection to start up or go away.)

I know your with an OB but you said he was natural birth oriented, so maybe you could take the test & explain that you want to use the results as a tool in determining your care instead of the be all end all deciding factor.

[Turtlemum]

Ugh, the dreaded GBS question...I fully support you not testing (as if you needed my approval ) just remember to ask your OB what the hospital policy is for baby care. Sometimes if a woman hasn't had the swab they treat you as positive and if you refuse the antibiotics they take the baby to NICU for observation or even for a septic workup or they won't let you go home early. I am not saying this to scare you at all I just think you need to know how to navigate that if that is what is commonly done in your hospital.

[PassionateWriter]

im not getting the testing done. but i do think it causes some issues in hospitals that you should consider.

[ferretfan]

i heard conflicting views regarding this test. my friend who's an L&D nurse in the hospital where i will deliver said that if i refuse the GBS they will put me on abx IV during delivery. if i refuse that, they will do all manner of invasive tests to poor beaker

i mentioned this to my FP doc (did i mention how cool he is ) he said it's not mandatory. they will only administer IV abx if the time between water breaking and delivery is longer than 18 hours, or if i have a fever during labor.

i need to go over this with him more, incase i deliver on the one day around my edd that he's going to be out of town, and make sure the standin will honor my requests. but as of right now i'm refusing it

he also told me that 10% of women test +ive, and of those only 1% will pass it on to the baby, and even then it's not necessarily serious. he thinks it quite unnecessary to routinely test everyone

[casemnor]

Can someone explain to me why having an iv (if you test positive) is something that is annoying/upsetting/damaging enough that it outweighs the risks that GBS would cause complications for a newborn.

I know of some personally devestating stories for newborns that were impacted by GBS (often fatally) and wonder if the precautionary iv antibiotics aren't a small price to pay to offset even the small risk?

[Soogie]

If you do decide to test and it should come back positive, there are things you can do prior to delivery to not warrant an IV uring labor. You can take oral antibiotics up to delivery to change your overall flora. GBS status can change daily. Also, during labor you can use hibicleanse to flush the vaginal area hourly after your water has broken.

Personally, I am going to waive the test. For all 3 of my previous labors, my water doesn't break until I am in transition or just before pushing. And I am taking probiotics right now too.

[myrmom]

Originally Posted by casemnor

Can someone explain to me why having an iv (if you test positive) is something that is annoying/upsetting/damaging enough that it outweighs the risks that GBS would cause complications for a newborn.

I know of some personally devestating stories for newborns that were impacted by GBS (often fatally) and wonder if the precautionary iv antibiotics aren't a small price to pay to offset even the small risk?

well just a few reasons

-It restricts movement in labour which is never beneficial to a natural labour
-antibiotics leads to a higher risk of Thrush, which in turn leads to painful breastfeeding which can in turn lead to no breastfeeding which is very detrimental in my opinion.
-babies can still develop infection from your GBS Status even if given antibiotics and then because of the antibiotics during labour babies often do not respond to antibiotics given after birth.

[Soogie]

Originally Posted by casemnor

Can someone explain to me why having an iv (if you test positive) is something that is annoying/upsetting/damaging enough that it outweighs the risks that GBS would cause complications for a newborn.

I know of some personally devestating stories for newborns that were impacted by GBS (often fatally) and wonder if the precautionary iv antibiotics aren't a small price to pay to offset even the small risk?

Well for one, you can test positive one day and be negative the next. The test isn't a true indicator of the flora in your body. And being tethered to an iv really inhibits how freely you can move during labor. For my first baby, I had agreed to a hep lock (didn't know better to refuse everything then ) and even that was a pain in the butt. My hand and arm ached.

And also, if for some reason if you were showing indicators or risks of GBS at delivery or after, baby can also be treated with antibiotics within 24 hrs after birth as well.

[sonshine_rae]

I'm planning a home birth and refused the gbs test.... I've always been negative in the past anyway. But I hate the unreliability of the tests......

[Celticqueen]

Originally Posted by jenmidwife2b

Just be aware that if you refuse this test, they may go ahead and treat you as GBS positive at the hospital, because you were not tested prenatally. I have seen this happen and I just wanted you to be aware of that possibility.

Yeah I've heard of hospitals doing that, just to be on the safe side.

-Caitrin

[TaraRae82]

I'm taking all this in......this is still something I haven't decided on yet.

Since I'll be in a hospital for the birth, my fears were of being treated as though I were + since it'd be unknown if I decline and thus the infant would be treated the same way. What I'm considering is accepting the test and if I test + then I'll treat naturally to get the number to acceptable and ask my OB to retest before the birth and hope it's neg. I've been taking probiotics to encourage acceptable levels so hopefully I wouldn't have a prob if I did accept. I need to talk to my OB and CNM and see how they feel about it all. They're pretty crunchy so I know I can trust their opinion for most things.

[casemnor]

Well, I've got to have antibiotics onboard because of heart valve issues anyways (my heart)...so I guess having an IV is a non-issue for me...as it's just part and parcel of my usual care (even for dental work). Last time around my use of antibiotics didn't result in thrush. And due to incredibly severe back labor...walking around wasn't an option for me....I was incapacitated from movement from the moment my water broke because I literally could not will myself to move through the lower back pain (I have damage to that joint). All I could do was vomit and scream hysterically (I'm not a screamer, the pain was just that nuts). So...I'd never thought about it.
I do agree, the hep lock is painful...my wrist/arm ached for weeks afterwards...longer than any pain to my girl bits.

Why does having an IV inhibit movement? Just the fact that you have to negotiate pulling an iv around with you?

[TaraRae82]

^It gets in the way of position changes, and can be painful in some positions (like when your elbows or wrists have to bend) and then you have to drag it along with you when you want to walk and when you're in pain, I can't imagine that's much fun.

[LemonPie]

Originally Posted by ellesmom

I guess it all depends on your hospital and doctor. The current CDC guidelines are to test all women at 36ish weeks and treat all "unknowns" as positives.

Not quite true. The CDC actually advises managing unknowns with a risk-based approach. You can read more here:
http://www.cdc.gov/groupbstrep/guidelines/summary.htm

Originally Posted by casemnor

Can someone explain to me why having an iv (if you test positive) is something that is annoying/upsetting/damaging enough that it outweighs the risks that GBS would cause complications for a newborn.

I'm concerned about the abx, not having an IV. Having an IV is a minor annoyance I could live with. I am concerned about the abx for a number of reasons. . . mainly because I think interfering with colonization and establishment of the infant's gut flora is a huge concern. I'm also allergic to penicillin, and the alternatives aren't as good. And having the abx puts the baby at risk for e. coli infections.

Here's a great article from Mothering:'
http://www.mothering.com/articles/pr...n/group-b.html