Erythromycin after water birth? - Mothering Forums
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#1 of 12 Old 06-05-2013, 02:21 PM - Thread Starter
 
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My husband and I are expecting our first baby later next month, and since I do not have chlamydia or gonorrhea we've been planning on declining the erythromycin eye ointment. However, one of the midwives at the practice we're using, (we're birthing in a birth center and planning a water birth,) told me that she likes to give the erythromycin anyway after water births because of "stuff" that can be in the water. I have never heard of this before, and I'm wondering if any of you have? My husband and I are not into administering antibiotics unless truly necessary.

 

Thanks!

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#2 of 12 Old 06-05-2013, 02:40 PM
 
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Water generally looks pretty filthy to me after waterbirth, and is likely to have blood, meconium and feces in it. Whether or not that's kept warm, it's a spectacular medium for bacterial growth.
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#3 of 12 Old 06-05-2013, 03:55 PM
 
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Originally Posted by nutmegnovice View Post

My husband and I are expecting our first baby later next month, and since I do not have chlamydia or gonorrhea we've been planning on declining the erythromycin eye ointment. However, one of the midwives at the practice we're using, (we're birthing in a birth center and planning a water birth,) told me that she likes to give the erythromycin anyway after water births because of "stuff" that can be in the water. I have never heard of this before, and I'm wondering if any of you have? My husband and I are not into administering antibiotics unless truly necessary.

 

Thanks!


I have never done any antibiotics after a waterbirth and have had 4 babies @ home in water. In fact, out of all of our children we have had to use antibiotics a total of two times.

 

That being said, I will in the future because of my experience with my last babe.

 

It wasn't her eyes - it was her toes. She got an infection in them that gave her a horrendous rash, and resulted in a lot of crying. I took her to the ER and was sent home. The next day I went back and panic erupted as the rash had went horrible and she looked very sick. It resulted in an ambulance ride 2 1/2 hours away and a two day hospitalization.

 

She had to be pumped full of so many antibiotics (and I had to *fight* to keep anti virals out of her) ...Eventually they believe that some how in the birth her toes being open source for infection to get in - she got an infection and it went through her body. Probably because of the fecal matter or blood or something in the vaginal tract making her sick.

 

We also did a vit k supplement because anti biotic use can deplete the sources.

All of this was very odd as I eat and supplement with copius amounts of garlic, nettles etc.

 

Since we are not first line anti biotic users, I decided that this time I'm going to go ahead and do the antibiotics after birth. I'm not sure if they would have presented the toe thing, but I am definitely checking fingers and toes and noses and eyes more thouroughly this time.

 

It was not a way I ever want to spend a postpartum time again.

 

Ignore my misspellings please!


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#4 of 12 Old 06-06-2013, 09:36 AM
 
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Hold on...The toes were an open source for infection?  Did she have any congenital problems with her toes or any injuries to them during the birth?  Also, if it came from blood or fecal matter inside or near the vagina, then it seems that in that case it would have happened without birthing in water.

 

I'm calling total BS on prophylactic antibiotics for a water birth.  (In the PP's instance, there was a known infection they were treating.  ...PP, were they wanting anti-virals because they thought it was a virus...and a bacterial infection?  That scene sounds confusing and stressful to me.  I'm sorry you had that occurrence with a new baby and thank you for sharing your story.)

 

I've given birth in water and although I never thought of the water as "nasty," I guess some people would.  It just never occurred to me that in the vast majority of cases our skin would not protect us.  And I sat in that water for longer than I am guessing most people would. I stayed in until it was obvious it was time to get out in order to keep us all warm. I also did not bathe myself or my baby for days afterwards.  It was not a worry of mine.  And to answer your question, I have not heard of infection from water birth.

 

My main point is that it is just boggling my mind to use antibiotics without an infection being present.  Maybe I'm cynical, but I think that midwife just likes to use erythromycin for all births and said that about water births since that's what you're having.  Like, maybe she would say "especially since you gave birth standing up" if that were your plan...  Can she show you statistics on babies getting eye infections from water birth? 

 

For me, any possible benefit would not overcome the use of antibiotics and the vision disturbance. 

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#5 of 12 Old 06-06-2013, 01:52 PM
 
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Originally Posted by salr View Post

Hold on...The toes were an open source for infection?  Did she have any congenital problems with her toes or any injuries to them during the birth?  Also, if it came from blood or fecal matter inside or near the vagina, then it seems that in that case it would have happened without birthing in water.

 

I'm calling total BS on prophylactic antibiotics for a water birth.  (In the PP's instance, there was a known infection they were treating.  ...PP, were they wanting anti-virals because they thought it was a virus...and a bacterial infection?  That scene sounds confusing and stressful to me.  I'm sorry you had that occurrence with a new baby and thank you for sharing your story.)

 

I've given birth in water and although I never thought of the water as "nasty," I guess some people would.  It just never occurred to me that in the vast majority of cases our skin would not protect us.  And I sat in that water for longer than I am guessing most people would. I stayed in until it was obvious it was time to get out in order to keep us all warm. I also did not bathe myself or my baby for days afterwards.  It was not a worry of mine.  And to answer your question, I have not heard of infection from water birth.

 

My main point is that it is just boggling my mind to use antibiotics without an infection being present.  Maybe I'm cynical, but I think that midwife just likes to use erythromycin for all births and said that about water births since that's what you're having.  Like, maybe she would say "especially since you gave birth standing up" if that were your plan...  Can she show you statistics on babies getting eye infections from water birth? 

 

For me, any possible benefit would not overcome the use of antibiotics and the vision disturbance. 


You know I really don't know the answers to those questions. Sorry OP, hope you don't think I am taking away from your question, but going to answer this.

About 10 days PP I noticed that it looked like measles on her toes..the next day it was on her hands and around her mouth. I sent pics to my SIL and she said "Could be hand foot mouth"...

I googled, didn't worry so much...but then the rash went BRIGHT red..and by day three it looked like ringworm almost ALL OVER her body.

When I went back to the ER they started all this STD questioning and then when they found out it was a home water birth and I hadn't tested for ______ they said they were sending us up to the children's hospital.

Now there was no fever, but a lot of crying, and she looked uncomfortable (I suppose. How do you really know with a 12 day old baby?)...

I had to fight to keep the anti virals away because they wanted to throw every thing at it because it was some kind of infection. I still think they were suspecting herpes (? believe that's what it was)..

 

LONG story short I pointed out her big toes - they were purple, nail and all. Within 12 hours of the IV antibiotics and topical for the toes - the rash started going away.

 

It really was a very scary thing for all of us. Never really got a 'for sure' answer except perhaps she picked something up in the birth canal.

I've never really sat in the water very long after birth. After the placenta comes out, I get out cause...my water is gross by that time.

 

Sorry OP for the derail!


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#6 of 12 Old 06-06-2013, 06:23 PM
 
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Oh my goodness, Kamiro!   I'm glad everything cleared up quickly. 

 

OP, Here's a link that was mentioned in a current thread about waterbirthing in the Homebirth Forum: http://www.ncbi.nlm.nih.gov/pubmed/20595945

And also the Conclusions from the abstract:

 

"Results suggest clear medical advantages of water birthing: significantly shorter labor duration among the primiparae; a net reduction in episiotomy rates; and a marked drop in requests for pain relievers. During expulsion of the fetus at delivery, fecal matter is released into the birth pool water, contaminating it with micro-organisms. Despite this, water birthing was found to be safe for the neonate and did not carry a higher risk of neonatal infection when compared with conventional vaginal delivery."

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#7 of 12 Old 06-13-2013, 03:03 PM
 
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I haven't heard that, but (at least in TX), it's supposed to be mandatory. Hospital, birth center, or homebirth. I had one midwife tell me that she can't take my baby away to do it, but can record that she attempted to give the ointment and I refused. My current midwife said they have to put it on, but that I can wipe it off, immediately. She just has to be able to write it down that it was applied.

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#8 of 12 Old 06-14-2013, 05:40 AM
 
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That is interesting about Texas and I wonder if the laws have changed?  I have two Texas babies - 2009 hospital and 2012 birth center (water birth) and I declined it with both of them.  They did give me a pretty hard time about it in the hospital but not at all in the birth center. 
 

For the original question, I really don't know if the water birth makes a difference.  My son was born in the water and we didn't do it and my midwives did not say anything about it.  Unless I saw some significant piece of research I would personally make the same choice again.

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#9 of 12 Old 06-14-2013, 06:45 AM - Thread Starter
 
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Thanks, everyone! I'm feeling like we'll opt out of the ointment - I think the best protection for my baby is being alert to possible signs of infection and allowing his or her immune system to develop the way it is intended to, without immediate use of antibiotics unless deemed truly necessary.

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#10 of 12 Old 06-14-2013, 10:11 AM
 
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Regarding the law in Texas, the law requires medical providers to administer the ointment, but does not require parents to accept it. It's sort of an obnoxious law, as there's no exceptions written in (so theoretically a care provider could get in trouble if a parent refused), but there's absolutely nothing requiring parents to allow it, and there's no exception allowing care providers to just do it without consent. I've birthed five babies in Texas, four in the hospital, and none of them had the eye ointment. Neither will this one when he's born in December.

Michelle, wife to DH, and momma to DD16, DS15, DS12, DS10, DD9, DD7, DS5, and baby girl born Christmas Eve 2013!
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#11 of 12 Old 06-19-2013, 10:30 PM
 
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Care providers in Texas are required to OFFER it. There is not even a mandate that they actually administer it. Parents do, absolutely, have full right of refusal, thought have absolutely seen nurses and others try to twist that.

As for the original question, no, I would not (and have not) accepted abx after water birth.

HeatherB ~ mama to 3 wonderful boys:  reading.gif 03/02; modifiedartist.gif09/04; sleepytime.gif 09/07 - and Eliana, babygirl.gif 11/13/10!  
Founder of Houston Birth Alternatives: Be Informed, Encouraged, Supported birth support group and aspiring midwife.

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#12 of 12 Old 06-23-2013, 04:50 PM
 
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Have you thought of putting colostrum in the eyes after delivery?  It has good antibiotic properties but is much less goopy.

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