Group B Strep and antibiotics - Mothering Forums
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#1 of 27 Old 07-18-2011, 02:40 PM - Thread Starter
 
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I found out early on in this pregnancy that I'm positive for Group B strep.  My OB said that this is something that they will retest for again around 36 weeks, but since I tested positive once, this means I'll definitely need antibiotics via IV every hour during labor - something I'm not thrilled about.

 

I'm planning to deliver in a hospital but want as few interventions as possible, and while I don't want my baby to be infected during labor, I also don't want myself or her to be pumped full of antibiotics.  Does anyone have experience with this or thoughts on how necessary antibiotics are?  thanks.

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#2 of 27 Old 07-18-2011, 03:21 PM
 
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Here is an article about it that was right here on mdc - http://mothering.com/pregnancy-birth/treating-group-b-strep

 

I personally waived the test in my first pregnancy (the only hospital birth I've had) because i would have refused antibiotics anyway.  You CAN refuse them, btw.  You just sign a waiver, just like any other informed consent item.  There is medical research to show that even IF (which is a rather large if) baby gets sick from GBS, they will respond better to antibiotics after birth and that having had antibiotics during labor COULD cause antibiotic resistance.  Not only that, but even IF mom is GBS positive, it doesn't mean baby WILL get sick.  Plus, just because you are positive now, doesn't mean you will be at the time of birth.  There are lots of things you can do to boost your immune system to get your bacterial flora back in balance.  Like, lots of garlic in your diet, probiotics, vitamin C, sitz baths, etc.  here's another link from mdc's archives on herbal remedies - http://mothering.com/pregnancy-birth/herbal-treatments-for-group-b-strep 

 

If it were me.....I'd do everything I could to test negative and then have them retest before the birth.  hug2.gif  Good luck!


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#3 of 27 Old 07-18-2011, 05:39 PM - Thread Starter
 
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Thank you for these very helpful links, Earthylady!  I will definitely start trying the herbal remedies/immune boosters in hopes I can get rid of the GBS before they check for it again.

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#4 of 27 Old 07-19-2011, 10:28 AM
 
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I found that article really interesting... I did test last time because if I tested negative and ended up in the hospital I didn't want a fight on my hands (they try to medicate everyone who has not tested because they assume you are positive if they don't know - so I was told by my midwives). Since most people test negative I decided it was worth the risk, since my midwife didn't advocate automatic IV antibiotics if you tested positive. In most of Europe they only medicate if you show signs of active infection (high temperature) or have had your water broken more than 24 hours.

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#5 of 27 Old 07-19-2011, 11:23 AM
 
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Honestly, given the risks associated with GBS, it's one test I wouldn't try to "throw", and not something I'd ignore if I tested positive.  If anything, knowing my status would help me organize my birth to minimize risks of transmission (a good reason to refuse any and all VE, internal monitoring, a possible reason to use a shower instead of a tub, a more specific diagnostic in case of maternal or infant fever, etc)

 

There is a very interesting series of articles on GBS published by Midwifery Today:

 

How to Treat a Vaginal Infection with Garlic (here)- discusses the risks posed by GBS as well as a possible garlic based treatment for GBS positive women in the final section.  It's the article mentioned in the Mothering Article.

 

The full text of the original GBS article (the one the Midwifery Today editor references in the "how to treat" article) can be found at Birth Cottage, here.  It's written by a midwife for other midwives so the tone is fairly "professional".  Not chatty or conversational, but readable by the normal person who may not have a background in medical terminology and it's jam packed with studies that can be found on PubMed (free internet library of peer reviewed health/medicine articles, EVERYONE should know about PubMed!  ok librarian hat off lol).  It's from Midwifery Today issue 63, in case you happen to have it available... the copy on the Birth Cottage site is a bit grainy.  This longer article discusses a wide variety ot prevention measures, treatment options, and possible pros/cons of a variety of testing/treatment protocols.  it also talks about what exactly GBS is, where it is found, and what it can do to moms/babes.  While it's more medical in tone than the other articles, I think it's an important read for anyone considering the pros/cons of testing.

 

I totally support a woman's right to refuse testing and to refuse treatment, but I feel like many care providers don't do a good job in providing informed consent (and not just about GBS but about a lot of complications and interventions).  On one side providers try to make things seem more risky or more dangerous and really push interventions which could cause more harm than good, while on the other side there are providers who minimize risks and downplay possible consequences.  For me, I'd rather see the studies myself, see what options are out there, and make a truly informed decision about the risk/benefit balance I'm comfortable with.

 

Oh, there is a really nice summary of GBS and treatment options (including the use of hibicleans, the "european protocol") on the Better Birth site here.  I like this one personally because it lays things out in a very straightforward manner and includes the risks associated with different treatment options.

 

 

 


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#6 of 27 Old 07-19-2011, 11:38 AM
 
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I like how there are 5 risks of antibiotics but only 2 with Hibiclens.  I'll take burning and not CDC approved over the others any day.

 

 

I chose not to be tested and use the Hibiclens last time and will again.  My labors last time wasn't long and I only used it once.  The hardest part was measuring it out between ctx :) lol

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#7 of 27 Old 07-19-2011, 11:46 AM
 
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LOL

 

It's a nice website, and their info pages tend to be pretty solidly balanced between risks and benefits and between the medical and more holistic approaches to a given situation.

 

As a librarian (well, free range librarian at the moment) I have this horrible habit of throwing information at people.  I'm an info-pusher I suppose!   lol


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#8 of 27 Old 07-19-2011, 11:54 AM
 
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Quote:
Originally Posted by wombatclay View Post

LOL

 

It's a nice website, and their info pages tend to be pretty solidly balanced between risks and benefits and between the medical and more holistic approaches to a given situation.

 

As a librarian (well, free range librarian at the moment) I have this horrible habit of throwing information at people.  I'm an info-pusher I suppose!   lol


Oh no!  I am all for info pushing! It's part of being a good consumer!  It is also so dependent on WHERE you are going to be birthing but knowing that if you are going for a home birth and need to tx, there are things the hospital are going to throw at you that you may want to be prepared for as well!  Knowledge is power as "they" say!

 

 

Also wanted to add, I have no memory of the Hibiclens burning.  None at all.

 

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#9 of 27 Old 07-19-2011, 11:57 AM
 
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Quote:
Originally Posted by wombatclay View Post

Honestly, given the risks associated with GBS, it's one test I wouldn't try to "throw", and not something I'd ignore if I tested positive.

 

 

Hey wombat, I feel the same way about the GBS test and GBS risks. I am currently taking a good probiotic (Jarrow Fem-Dophilis), and I will take this probiotic daily up to the birth and even after I deliver my baby. Do you consider using a probiotic as something that would throw the test? I am feeling ok about it because it's a daily protocol that will continue up to, and beyond, the time of birth. So I don't think it would give me an artificial negative, kwim?
 

I have had folks in the past (during pg #2) advise me to wash with hydrogen peroxide just before the swab. That I consider to be gaming the test. I actually did that with my last pg, but I feel differently about it now for several reasons.
 

I would love to have your opinion on this -- it's rare that I can talk to someone in the birth community who is of like mind. Most of the birthy folks around here are pretty dismissive of GBS risks, and seem to just think that getting a negative test result is the most important thing.


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#10 of 27 Old 07-19-2011, 01:09 PM
 
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I wouldn't call routine health care (vitamins, probiotics, routine herbals or homeopathics, etc) trying to throw a test.  That's just taking the best care possible of the only body you've got!  And by staying as healthy and aware as possible I feel like a person would be reducing their chances of getting something nasty in the first place, or at least reducing the impact of that nasty if they did in fact develop a problem.  For me, "throwing" a test would be doing something unusual and/or doing it for the specific purpose of affecting the results of the test.  So if you don't routinely use garlic suppositories, using garlic suppositories every night for a week so that you'll "test negative" would be out of bounds for me.  Especially if you weren't planning on sticking with the nightly garlic treatment (and supplementing it with other herbal, homeopathic, or topical treatments to prevent and minimize GBS and maximize immune health) until your baby is born.

 

I feel the same way about a lot of the "guidelines" that go along with modern pregnancy... if you've been taking a sauna 3-4 times a week for the past however many years, I doubt continuing to use a sauna while pregnant will have too much of an impact.  Your body is accustomed to it, and you know how you "should" feel while in the sauna and afterwards.  But if you haven't used a sauna in a year or so?  Pregnancy really isn't the time to start.  That sort of thing.

 

I DO understand how the current system works to minimize the ability of a woman to make informed choices and control her own medical care though... heck, I wouldn't have taken the GD test if I didn't "have to" as a vbac mom of historically large babes.  And if I was diagnosed with GD I could have lost my chance at a VBAC.  So I totally understand women who decide they really "have" to throw a test in order to get the birth they want.  I just hope that when a person does that they're making an informed decision after considering the various risk/benefits to each option 

 

(and no, I didn't do anything unusual to pass my GD test, unless following doctor's orders and drinking sugar syrup on an empty stomach counts as "unusual" LOL, but I understand how tests can be used as restrictive hoops and why some women would rather accept the risks of going undiagnosed than risk having a positive test result).


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#11 of 27 Old 07-19-2011, 01:21 PM
 
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The thing is, as stated the test results change SO quickly! So even a teat at 34 weeks doesn't mean much.  Also, many times the test is administered incorrectly and the anus is often swabbed as well.  Well, I would EXPECT that to have GBS in many cases if not all!  So there are issues with the testing as well as the timing.  These are just a few of the reasons I chose to do the hib wash.

 


I totally agree about "throwing" the test though.  If that's what you are trying to do, maybe research more into options and outcomes before you "mess" with it.

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#12 of 27 Old 07-19-2011, 01:41 PM
 
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The full testing requires swabs from both the anus and vagina... though since many practices now ask patients to do their own swabbing, I'd be interested in seeing how many swabs are "done right" so to speak given that by 34-36 weeks most women are probably having a hard time reaching around for "detail work"!

 

And I totally agree that results can change quickly and that it's most likely that any given person will test positive at some point in their life (if, say, they were tested weekly or something like that).  Just like getting a UTI or yeast infection or an upset stomach... it happens and it's not normally a big deal for a healthy person.  If I had a positive result at 36 weeks I'd do everything in my power to reduce the infection and ask for a retest at 36 weeks and again at 38 weeks, and so on.  But if I was still testing positive at 38 weeks I'd be seriously weighing my options.  If I tested negative at 34 and had a history of GBS that made my provider want to do a routine course of abx, I'd again ask for testing at 36 and then 38 weeks and if those tests were also negative I'd be pretty darn adamant in refusing routine abx as well as refusing internal monitoring/exams (though I might "give in" on things like using a shower instead of a tub, or allowing the abx if I started running a fever).

 

But that's just me, and it's just hypothetical.  Not actually being in that situation and not having done the really in depth research I would do if I was... I can't say where my personal risk/benefit balance would fall.  I'd probably start by reading every dang one of the studies and articles cited in the Midwifery Today article and go from there.  Kind of like when this pregnancy was detected while I was taking diflucan for a long standing case of thrush... I think I probably read more studies about the possible impact of diflucan on early fetal development than most ob/gyns even knew existed!  In fact, I'm sure of it, because several times I had to correct the various specialists I saw and provide them with not just the information but the relevant citation.  LOL


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#13 of 27 Old 07-19-2011, 02:35 PM
 
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Thanks for your thoughts, and thanks for the links, too.

 

I am getting tested at 37, and hoping for a reliable negative. I might do the hibiclens protocol during labor even if I get a negative. If I get a positive result, then that'll be a whole 'nother kettle of fish.


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#14 of 27 Old 07-20-2011, 01:01 PM
 
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I'll be tested for GBS sometime soon and if I test positive, my CNM will give me antibiotics that I can take at home during labor.  In the meantime, I'm taking a probiotic to hopefully prevent it.

 

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#15 of 27 Old 07-26-2011, 08:15 PM
 
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Did you test positive early with a UTI? If so, you are more colonized than most people who test positive and are at a much higher risk of complication than someone who tests positive at 34 weeks.

 

Antibiotics will cut the risk of a strep infection to your baby and they are safe. It is one thing that I would pretty much never turn down because I would not want my baby to be in the NICU separated from me due to a strep infection. Not to mention the suffering he would feel not being able to breathe. Or worse, he could be injured permanently.

 

Especially if I were giving birth at home I would be even more eager to have the antibiotics because I wouldn't have medical professionals there to monitor for GBS in my baby. I have been around babies a lot but I would not trust myself to pick up early symptoms of respiratory distress and I wouldn't my baby to suffer until I finally noticed something was wrong...

 

So to me, treatment for GBS is an intervention that prevents a lot of potential suffering as well as other interventions (NICU time especially). 

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#16 of 27 Old 07-26-2011, 09:53 PM
 
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I waived the test altogether. My midwife assured me that they watch baby very carefully for signs of any infection, Group B strep or otherwise... and from what I understand the risk of transmission is extremely low, even if I DO have it at the time of birth. It just seems like yet another unnecessary test to me, after reading everything I could about it.


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#17 of 27 Old 07-27-2011, 08:10 AM - Thread Starter
 
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When I tested positive, it was when I was extremely ill with hyperemesis and had been on IV fluids for a week.  I did not have a UTI, but the GBS was found in my urine, which I know means that I was more heavily colonized at that time.  I do believe this was largely due to the fact that I had been very, very sick, unable to eat or drink anything for nearly a month, and certainly not able to be boosting my immune system. 

 

Since then, I have working to restore healthy flora to my body using some of the natural remedies suggested by articles I've read and by members on here.  The hospital policy at the place where I deliver is to not test me again since the GBS was found in my urine, and to go straight to antibiotics during labor.   Even though I was heavily colonized, my OB said, and I've since read that even infections found in the urine can be transient and based on one's health at the time.  I am going to ask them to test me again at least once, not because I'm trying to "cheat" on the test but because I want to genuinely rid my body of this infection and am hoping my efforts are working. 

 

@ katherineg - If I am to still test positive after my efforts to rid myself of GBS, I will not decline the antibiotics during labor.  I have been reading up on the risks associated with GBS and will not put my baby's health in jeopardy, however, I do NOT feel that antibiotics are totally safe or without risks, either, so that is why I am trying more natural methods first.   Thanks for your concern.

 

 

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#18 of 27 Old 07-27-2011, 11:40 AM
 
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And this, for me, is what makes GBS a difficult issue. The abx are not without risk, so either course of action carries some risk, and it's a research project unto itself to analyze all the risks and make an informed decision.

 

I'm sorry you are having to deal with GBS in this pregnancy.  hug.gif
 

Quote:
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 I have been reading up on the risks associated with GBS and will not put my baby's health in jeopardy, however, I do NOT feel that antibiotics are totally safe or without risks, either, so that is why I am trying more natural methods first. 

 

 


 

 


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#19 of 27 Old 07-28-2011, 10:09 AM - Thread Starter
 
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Thanks, Ms. B. Sprout.  I appreciate the support.  smile.gif

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#20 of 27 Old 07-28-2011, 02:28 PM
 
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I'm so sorry you had such a rough time!  And I agree... everything has it's own risks, and abx are not something you want to have floating around in your system (or your babe's) if you can avoid it.  Finding the balance that works for you, the risks and benefits that you can live with, is key.  And even then things can go all wahoonie shaped and surpirse you!

 

(I was dealing with chronic thrush for over a year... we tried everything.  Eventually I asked my doctor for the "big guns" and did what I could to minimize the impact those were going to have on things other than the thrush... and it was right after I took all the meds, and was finally thrush free, that I got the positive pregnancy test and realized that my unborn babe had been exposed to some potentially devastating meds at more or less the worst possible moment in gestation.  She is ok, and I'm still thrush free, but it was a real "surprise" moment, you know?  Totally outside of what I had researched, predicted, and come to accept as a reasonable risk/benefit balance.)


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#21 of 27 Old 08-11-2011, 09:23 PM
 
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I understand exactly how you feel. I was GBS positive at eight weeks from a urine sample.My family doctor told me it's not big deal, that they would give me antibiotic during labour. At the time I didn't know what GBS was, but taking antibiotics during labour is a big deal to me. I started reading up GBS and I kept reading and reading. 

 

At five months, I was transferred to the care of an OB. The OB has the same attitude as my family doctor. When she read through my file and saw that I was GBS positive, she shrug it off and said that I don't need to worry, that they'd just administer antibiotic during labour. I'm rather baffled at how lightly health practitioners feel about the use of antibiotics. 

 

I'm due September 3rd and have not made my final decision about the use of antibiotics. Just know that you have a choice and you should go with the option you're most comfortable with.

 

Knowing that I was GBS positive at an early stage in my pregnancy is both a blessing and a curse. I couldn't think positively about my labour and it's probably the reason why I didn't prepare much for it either until recently. But it has also made me change my eating habits and do whatever I can to boost the immune system of both my baby and I. 

 

By the way, my OB refused to give me a swap test because she says there's no point since I'm already a carrier. Yet just this past week I was given the package to test for GBS. Have they forgotten? Whatever it is, I'm thankful I can at least know whether or not I'm still positive. I'll find out next week.

 

Best of luck stgertrude!

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#22 of 27 Old 08-11-2011, 10:18 PM
 
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Thanks everyone for the information. I will be speaking with my midwife about GBS testing at our next appointment and will be starting some of the natural remedies that have been suggested shortly as a preventative measure.


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#23 of 27 Old 08-12-2011, 07:59 AM - Thread Starter
 
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Thanks, TeaSquare for your support and for sharing your own experiences!  As other responders and you have mentioned - this is not a fun or easy decision to make!  I plan to ask my OB to retest me at my next appointment, but like your OB, she may very likely tell me it's unnecessary since I've already tested positive.  My clinic is pretty mainstream, and I get very frustrated at the attitudes they have that make it seem like the patient has no control over their own health.  I told one of my OBs that I was taking some probiotics and trying some natural remedies and after looking at me like I had two heads, she impatiently said, "well THAT won't work because you're already colonized!"  - I don't believe this to be true based on what I've read about the nature of GBS infections.

 

Anyway, I hope your test comes back negative this time!  Thanks to everyone who has responded with helpful ideas and support!

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#24 of 27 Old 08-14-2011, 05:30 PM
 
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Just want to throw my 2 cents in here. I'm a CLE, and I routinely see moms develop thrush right after birth who were administered abx during labor due to a positive gbs test. Keep in mind if you are one of those women who often develops a yeast infection after taking a course of abx you run a MUCH higher risk of developing one in this case and its not just you who will be suffering but babes too. Taking abx while pregnant to deal with gbs is not conclusively effective which is why many (most?) practitioners don't chose that option.

Listen to your intuition, if it feels like something you need to do and want to treat with abx, do it. The Violence option is a good alternative though, and you could order it online and irrigate according to the UK standards (btw they get better results treating gbs than we do) during labor.

I will be refusing the test, and I will be watching baby closely (as will the pediatrician) for the first week, but everyone has to make the decision that is best for their family.

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#25 of 27 Old 08-14-2011, 05:32 PM
 
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Sorry...ridiculous typo!

The HIBICLENSE option, not the violence option!
Smart phone making me look like an idiot yet again!!

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Mama2ChicknLil is offline  
#26 of 27 Old 08-14-2011, 07:43 PM
 
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Quote:
Originally Posted by Mama2ChicknLil View Post

Sorry...ridiculous typo!

The HIBICLENSE option, not the violence option!
Smart phone making me look like an idiot yet again!!


snort.  I like it!

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#27 of 27 Old 09-06-2011, 02:36 PM
 
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Im 38 weeks today. I am having a natural birth in the hospital, my second one, but this time I am Group B positive. I totally did not expect this and I am not wanting antibiotics but I cannot shake the fact that I actually have a friend who's baby died of late onset meningitis from infection at birth. I am not prone to yeast infections, my OB is all for intermittant IV, put it in take it out, and I will most likely arrive at the hospital very late in labor. Its only 5 minutes away. I think I will probably accept, but it sucks. 

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