I don't want an IV of antibiotics - Mothering Forums
Forum Jump: 
Reply
 
Thread Tools
#1 of 61 Old 08-14-2006, 08:34 PM - Thread Starter
 
illinoismommy's Avatar
 
Join Date: Apr 2006
Location: Illinois
Posts: 856
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Yup, its about group b strep. I really need help. They found it in my urine at 8 weeks and I was trying to be nice with the midwife (at the hospital) but I was really frustrated about it, she said because they found it in my urine its a strong concentration, strong enough that they don't care to test again, and they WILL NOT test again (can you tell I asked several times?), and that they absolutely want to put the antibiotics in me. She said unless I am crowning when I come in they are going to try to get that IV in me (so laboring at home won't help), she talked about the CDC's recommendation.... blah.... and I said just because the CDC recommends it doesn't mean I have to do it, but it sounds like if I want to refuse it its going to be a MAJOR hassle. I asked her if there wasn't another route, with pills or even an IV before I go into labor (on another day) and no.... the only thing they offer is the IV during labor. I know its supposed to burn and I don't think I can handle something additional going on during labor or I'm going to want an epidural and just forget the whole thing, if all I have is to concentrate on the contractions then I think i can do it. So anyway after all that conversation I don't think they're going to be in favor of any alternative treatments. She probably wrote "crunchy" on my sheet by the way I was behaving, and at the end she asked if I wanted to find out the sex of the baby at the ultrasound and I said yes and she said "Oh.... I didn't think you would be that kind of person..... " :

What is the risk to the baby if the mom has group b strep? If they do get it from mom, what are their chances of coming out a-ok? The way I see it, urine or not, the chances of me testing negative in 30 additional weeks are just as good as anyones... maybe I'm wrong about that... but I'm still annoyed. I just wanted an intervention free birth. I can't have a home birth in my opinion because I live 45 minutes from the hospital and had a serious tear last time, and because its cheaper for me to go to the hospital.... and we're poor. I just thought I'd mention that before everyone cited that as the answer... and anyway its not the answer because I still want to know about the risks to my baby and how to keep him/her safe.

Please help!!!

Homeschooling SAHM to 3 children under 5 + one on the way.
illinoismommy is offline  
#2 of 61 Old 08-14-2006, 08:52 PM
 
dynamicdoula's Avatar
 
Join Date: Jun 2004
Location: Kitsap County, WA
Posts: 2,339
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Let me address your items...

* the antibiotics burning - as a doula, i have NEVER seen a mom notice the abx having any sensation other than the same as the saline- cold. If someone experienced burning I would be concerned about possible allergy - I've just simply never seen it. not saying it can't happen, just saying it's probably very unlikely.

* You have a right to be tested again if you wish it. Go to your family doc if you have to, call the insurance company and let them know what is going on - heck, maybe you can find a home midwife who is willing to do it for you (if you're able to pay out of pocket)? Your GBS status will change throughout your pregnancy - there's no real benefit to testing until 35 or so weeks because your status is unlikely to change from that point until birth. It doesn't mean it can't, it's just less likely than if you're tested at 8 weeks. Ask your midwife about the *routine* test done at 35 weeks and if she is denying you that, and on what medical grounds? You have a right to have everything explained to you until you at least understand the reasons- itd oesnt' mean you'll agree with it all but you should at least be clear on what is happening and why, from the medical perspective.

Why are you sticking with this midwife, who by appearances, doesn't seem interested in you as an individual? What is the difference between her and most OBs? Something to think about.

Kristina in Kitsap County, WA
Doula, Student Midwife, Mama, Wife & More
http://redspiral.blogspot.com
dynamicdoula is offline  
#3 of 61 Old 08-14-2006, 09:00 PM - Thread Starter
 
illinoismommy's Avatar
 
Join Date: Apr 2006
Location: Illinois
Posts: 856
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by dynamicdoula
Let me address your items...

* the antibiotics burning - as a doula, i have NEVER seen a mom notice the abx having any sensation other than the same as the saline- cold. If someone experienced burning I would be concerned about possible allergy - I've just simply never seen it. not saying it can't happen, just saying it's probably very unlikely.
Yeah my friend who had the antibiotic in her first delivery said it burned, and the midwife actually mentioned it today too. :

Quote:
* You have a right to be tested again if you wish it. Go to your family doc if you have to, call the insurance company and let them know what is going on - heck, maybe you can find a home midwife who is willing to do it for you (if you're able to pay out of pocket)? Your GBS status will change throughout your pregnancy - there's no real benefit to testing until 35 or so weeks because your status is unlikely to change from that point until birth. It doesn't mean it can't, it's just less likely than if you're tested at 8 weeks. Ask your midwife about the *routine* test done at 35 weeks and if she is denying you that, and on what medical grounds? You have a right to have everything explained to you until you at least understand the reasons- itd oesnt' mean you'll agree with it all but you should at least be clear on what is happening and why, from the medical perspective.
She said because it was in my urine, they won't test again.... because its a strong enough colonization... so that gives me the impression that even if I did force a test and was negative at 35 weeks, they're not going to care, they're going to want to give me the antibiotics... on the other hand, it WOULD make a difference to me and then I would refuse the antibiotics because I would feel safer.

I was pretty forward about it though and she absolutely refused me. I don't have a family doctor. What else could I do?

Quote:
Why are you sticking with this midwife, who by appearances, doesn't seem interested in you as an individual? What is the difference between her and most OBs? Something to think about.
The way the midwives work at the insurance-covered hospital is that you see all of them and whoever is on call at delivery delivers you. So I didn't pick her, she's just one of them. Although I have to say she's a lot nicer than the first one I talked to. :

Homeschooling SAHM to 3 children under 5 + one on the way.
illinoismommy is offline  
#4 of 61 Old 08-14-2006, 09:01 PM
 
phoebemommy's Avatar
 
Join Date: Mar 2006
Location: Anchorage, AK
Posts: 1,081
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I'm pretty shocked by your midwife's attitude. The pp put things quite well, but I'd also like to add -- has your mw explained to you the risks of GBS versus the risk of the antibiotics themselves? I know that hospitals are really gung ho on the IV antibiotics, but it's pretty uncool to railroad you into that route without the information, without another test, and without giving you the chance (or help) to work on cleaning out the GBS naturally. I agree, go somewhere else for another GBS test. It's your right.

I'm having a dopey pregnant day and don't have the strength to dig up sources about homeopathic treatment and the antibiotic risks, but maybe someone else can.
phoebemommy is offline  
#5 of 61 Old 08-14-2006, 09:04 PM - Thread Starter
 
illinoismommy's Avatar
 
Join Date: Apr 2006
Location: Illinois
Posts: 856
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by phoebemommy
I'm pretty shocked by your midwife's attitude. The pp put things quite well, but I'd also like to add -- has your mw explained to you the risks of GBS versus the risk of the antibiotics themselves? I know that hospitals are really gung ho on the IV antibiotics, but it's pretty uncool to railroad you into that route without the information,
I think so too. Does anyone have any information? I don't want to refuse antibiotics and put my baby at risk obviously.... :

Another thing.... you said there is a way for homebirth midwives to test at home? And if you are positive, and you have a homebirth, is there any way to test your baby at home to see if they didn't get it?

Homeschooling SAHM to 3 children under 5 + one on the way.
illinoismommy is offline  
#6 of 61 Old 08-14-2006, 09:18 PM
 
shellbell's Avatar
 
Join Date: Jun 2006
Posts: 93
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I will look for more exact information, but I have read that you can use garlic as a vaginal suppository (makiing sure it is not knicked or it will burn) and that can help (not sure how long you use that for either). Also, I read that you can soak a tampon in sugar free yogurt and put that in your vagina over night for three days to cure a foul odor. I don't know if it would work, but I might try that for GBS also, as eating yogurt is as good thing for GBS. Although, I would probably use kefir instead of yogurt. I will look around and post again if I find any exact info.
shellbell is offline  
#7 of 61 Old 08-14-2006, 09:19 PM - Thread Starter
 
illinoismommy's Avatar
 
Join Date: Apr 2006
Location: Illinois
Posts: 856
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I have a list of things to help it... but what good is getting it helped if I don't get tested again.... sigh....

Homeschooling SAHM to 3 children under 5 + one on the way.
illinoismommy is offline  
#8 of 61 Old 08-14-2006, 09:40 PM
 
phoebemommy's Avatar
 
Join Date: Mar 2006
Location: Anchorage, AK
Posts: 1,081
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Do you have a Planned Parenthood or anything like that around? I'd think those places could help you out for cheap or free... or they could point you in the direction of somewhere else that could. But the poster who suggested you call your insurance had a good point. Once my DH went to a crackpot dentist who refused to do xrays or a cleaning and just insisted he needed a very expensive gum treatment that wasn't covered by insurance. He called insurance and they told him how to go about getting a second opinion covered (and it turned out the gum treatment was bs).
phoebemommy is offline  
#9 of 61 Old 08-14-2006, 09:42 PM
 
shellbell's Avatar
 
Join Date: Jun 2006
Posts: 93
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
What is the risk to the baby if the mom has group b strep? If they do get it from mom, what are their chances of coming out a-ok?


okay... here's an answer to your question, quoted from Ina May's Guide to Chidlbirth: "... In the fifteen to twenty percent of women who have group B strep in their vaginas during labor, about half of of the babies wil be colonized at birth. But this does not mean that all of these babies become ill. In fact, ninety-eight percent or more doe not become infected. When the infection does occur, however, it is serious, as it is fatal in ten percent of cases. Still, it is important to remember that only two babies out of a thousand in the population at large get infected. The problem is that there is no really accurate way to know which two babies out of a thoseand those will be. Risks associated with higher than usual risk of infection of the baby:

low birth weight or premature babies
membranes ruptured for more than eighteen hours before birth
long babors, with multiple vag exams
interventions such as induction, IFM's, vacuum extractors, and forceps
babies whose heart reates are unusually fast during labor
mothers who develop a fever during labor
mothers whose vag cultures show expecially heavy beta strep colonization
babies who need resusitation at birth

Also... You can slightly decrease the risk of your baby becoming infected by declining as many intervetions as possible (including vaginal exams) and by having everyone wash their hands frequently before toching the baby during the newborn period. (Some group B infections develpf during the first 3 noths of the life of the newborn)."
shellbell is offline  
#10 of 61 Old 08-14-2006, 09:53 PM
 
MamaTaraX's Avatar
 
Join Date: Oct 2004
Posts: 9,152
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
You know, they can't put an IV in your arm if you don't hold it out for them Just a thought (because everything else I wsanted to say has pretty much been said)

Namaste, Tara
MamaTaraX is offline  
#11 of 61 Old 08-14-2006, 10:21 PM - Thread Starter
 
illinoismommy's Avatar
 
Join Date: Apr 2006
Location: Illinois
Posts: 856
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
"However, a pregnant woman who is a group B strep carrier (tested positive) at full-term delivery who gets antibiotics can feel confident knowing that she has only a 1 in 4000 chance of delivering a baby with group B strep disease. If a pregnant woman who is a group B strep carrier does not get antibiotics at the time of delivery, her baby has a 1 in 200 chance of developing group B strep disease. "

I guess I'll just get the darn thing..... sigh.... has anyone had the group b strep and can tell me it does *not* burn?

Homeschooling SAHM to 3 children under 5 + one on the way.
illinoismommy is offline  
#12 of 61 Old 08-14-2006, 10:38 PM
 
rootzdawta's Avatar
 
Join Date: May 2005
Location: Squarely Outside of the Box
Posts: 3,551
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by illinoismommy
"However, a pregnant woman who is a group B strep carrier (tested positive) at full-term delivery who gets antibiotics can feel confident knowing that she has only a 1 in 4000 chance of delivering a baby with group B strep disease. If a pregnant woman who is a group B strep carrier does not get antibiotics at the time of delivery, her baby has a 1 in 200 chance of developing group B strep disease. "

I guess I'll just get the darn thing..... sigh.... has anyone had the group b strep and can tell me it does *not* burn?
I got it and it didn't burn. It was just uncomfortable and when I was laboring in the pool, fell out which was a god thing because I didn't know it was routine to give mother's pitocin after they give birth (to make sure everything comes out). More than anything, the IV was a PITA and I am really afraid of needles so it was a bit nerve wracking. I would suggest eating lots of probiotic foods if you will have the ABX because ther's a chance that thrush could become an issue in baby and you and also you want to promote the recolonization of the good bacteria thr ABX destroyed.

Stay-at-home mom to 2 beautiful.busy.boisterous boys b. 08.17.05 & 12.29.08
Nirvana is . . . the living happiness of a soul which is conscious of itself and conscious of having found its own abode in the heart of the Eternal. --Gandhi
rootzdawta is offline  
#13 of 61 Old 08-14-2006, 10:58 PM - Thread Starter
 
illinoismommy's Avatar
 
Join Date: Apr 2006
Location: Illinois
Posts: 856
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
would acidophilus work?

Homeschooling SAHM to 3 children under 5 + one on the way.
illinoismommy is offline  
#14 of 61 Old 08-14-2006, 11:13 PM
 
mezzaluna's Avatar
 
Join Date: Jun 2004
Location: Massachusetts, USA
Posts: 1,098
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
i would... try natural remedies until such time as you retest at 35+ weeks - i really don't see why they won't retest that much later! if you test negative, consider declining the IV antibiotics. if you test positive... if i were you i would go ahead and do it. it wasn't a big deal in my labor - i was so distracted by the pain of contractions i hardly noticed the needle going in. once i got the dose, they locked off the IV, covered it in plastic, taped it down and i went in the tub. it was a very minor inconvenience compared to many other things i had to endure in my "natural" hospital birth, like the EFM, the 14 page questionnaire (!?!&#$*&) and the quite incompetent management of my delivery by the OB. anyway, i didn't get the dose in time, even though i'd only labored at home for 2 hours. DS was born 3 hours after i got the dose. we were supposed to stay in the hospital for 48 hours because of this, but at 36 when everything looked good we were ok'ed to go home. as soon as i got home i started taking probiotics every day for 2 weeks to counter at least some of the damage of the antibiotics. and we didn't have any problems with thrush and breastfeeding, btw.

Quote:

low birth weight or premature babies
membranes ruptured for more than eighteen hours before birth
long babors, with multiple vag exams
interventions such as induction, IFM's, vacuum extractors, and forceps
babies whose heart reates are unusually fast during labor
mothers who develop a fever during labor
mothers whose vag cultures show expecially heavy beta strep colonization
babies who need resusitation at birth
oh, and i would also consider consenting to IV abx for these conditions if you know about them in advance (obviously last one cannot be known in time) even if you test negative on the retest.

we talked a fair amount about GBS in my Bradley class, and of all the interventions that we discussed, this was the one that we were most favorable towards.... the risk of your baby getting it is small, but if they do, the risk to them is large. and the risk to having the IV during labor isn't huge.... especially, IMO if you take measures to counter the bad effects of antibiotics.

Rosemary & Gary :
James 12/04 & Cecelia 4/07
mezzaluna is offline  
#15 of 61 Old 08-14-2006, 11:18 PM
 
rootzdawta's Avatar
 
Join Date: May 2005
Location: Squarely Outside of the Box
Posts: 3,551
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by illinoismommy
would acidophilus work?
I think it would be best to eat freshly made yogurt, kefir, and cultured vegetables as you can be sure the cultures are alive and kicking. The acidophilus you buy in the store may or may not be alive--you just don't know.

I agree with pp . . . it is so early. I would try some more natural remedies first and then like at week 38, re-test . . . it is entirely possible that the GBS will not be present then.

Stay-at-home mom to 2 beautiful.busy.boisterous boys b. 08.17.05 & 12.29.08
Nirvana is . . . the living happiness of a soul which is conscious of itself and conscious of having found its own abode in the heart of the Eternal. --Gandhi
rootzdawta is offline  
#16 of 61 Old 08-15-2006, 12:20 AM
 
Emilie's Avatar
 
Join Date: Dec 2003
Location: going thru divorce land
Posts: 7,384
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I would work very hard at finding a different ob/mw/caregiver.

What are your options?

Is there another practice in town? where do you live? Im in illinios to.

I would be more than happy to get you in touch with my mw- she can help you to naturally deal with this now.( you can still birth at a hospital- just a phone consult with her!)

This is ludacris that they are regusing to retest you!
It is your body- your baby- your birth.

please list your other birthing options( other providers, doulas to help inforce etc)

good luck.

oh and pleae go get another practice- ask on here for who is good in your area-.

If you decide to stay with these medwives- please speak to someone about the way you were treated. you do not want to be treated this way during the birth of your child.
Emilie is offline  
#17 of 61 Old 08-15-2006, 12:32 AM
 
Robin926's Avatar
 
Join Date: Jun 2005
Posts: 1,464
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Everyone has given some great advice here. I just wanted to respond to the "has anyone had the group b strep and can tell me it does *not* burn?"

I gave birth at a FSBC and had a hep lock put in when I was admitted in "active labor." Every 4 hours, they hooked up an IV bag just long enough for the little bag of abx to be adminstered and then unhooked it. I even got it while I was laboring in the tub, I just laid my right hand (which had the catheter in it) on the side of the tub while they had the bag hooked up. I never felt any sort of sensation at all while they were administering the abx. Obviously I had the sensation of having the IV in my hand, but it was never uncomfortable, never burned, wasn't cold or anything like that. It really wasn't a bother for me personally.

I definitely think your MW isn't really listening and working with you though. She sounds very condescending. Whether you decide to go with the IV and abx or not, you definitely need a care provider with whom you have a respectful relationship
Robin926 is offline  
#18 of 61 Old 08-15-2006, 01:00 AM
 
savithny's Avatar
 
Join Date: Oct 2005
Posts: 1,820
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Robin926
Everyone has given some great advice here. I just wanted to respond to the "has anyone had the group b strep and can tell me it does *not* burn?"

I gave birth at a FSBC and had a hep lock put in when I was admitted in "active labor." Every 4 hours, they hooked up an IV bag just long enough for the little bag of abx to be adminstered and then unhooked it. I even got it while I was laboring in the tub, I just laid my right hand (which had the catheter in it) on the side of the tub while they had the bag hooked up. I never felt any sort of sensation at all while they were administering the abx. Obviously I had the sensation of having the IV in my hand, but it was never uncomfortable, never burned, wasn't cold or anything like that. It really wasn't a bother for me personally.

I definitely think your MW isn't really listening and working with you though. She sounds very condescending. Whether you decide to go with the IV and abx or not, you definitely need a care provider with whom you have a respectful relationship
Same thing here. Heplock, two bags 4 hours apart, nothing hooked up to me inbetween, didn't feel much of anything. Able to use the tub, they didn't use the IV to push Pit... the IV would have been out before baby if baby hadn't decided to come VERY fast (5cms to birth in an hour).

savithny, 42 year old moderate mom to DS Primo (age 12) and DD Secunda (age 9).

savithny is offline  
#19 of 61 Old 08-15-2006, 01:23 AM
 
doctorjen's Avatar
 
Join Date: May 2003
Posts: 3,112
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
For what it's worth, I don't think your midwife is crazy. :

The reason for not retesting is that group B strep in the urine is different from colonization in the vagina or rectum. Group B strep is normally a pretty innocuous organism that hangs out as a colonizer in the GI tract. Like e. coli, it normally stays there and doesn't cause any trouble. We know that such colonization tends to be transient, too, so that if you test people repeatedly you get a now-you-see-it-now-you-don't kind of effect.

Group B strep in the urine is a different situation. Bacteria that can manage to infect the normally sterile urinary tract are believed to be more potentially pathogenic. This bacteria has already managed to cause one infection, so it's likleyhood of causing another is higher. Even strategies for group B strep that only consider treating women with risk factors (instead of treating all women who are colonized) consider urinary group B strep to be a risk factor (along with preterm labor, preterm rupture of membranes, or a previous infant born to the same mother who had invasive strep disease.) It is not considered standard to retest when mom has group B strep in the urine, because you are no longer looking for a fairly harmless, intermittent colonizer in the GI tract.

You of course should still be able to refuse or decline anything you want, but if you are going to decline you need to check what the pediatric provider's policy will be for the baby. Some will consider just watching the baby closely, some will want baby to have blood cultures and a blood count, and some would start antibiotics automatically until cultures returned negative.

If you choose to have IV antibiotics (the only strategy that has been large-scale tested to reduce group B strep transmission - which doesn't mean that other methods may not work, just that they aren't likely to be accepted by allopathic medical providers) be advised that penicillin is the drug of choice, and it does tend to burn. Ask to have just a heplock, not a continuous IV, and try to have it put in the largest vein they can find. If the penicillin burns, have the rate turned down, and/or have some saline run with it. It takes about 30 minutes to run a dose in, but this should not in any other way interfere with your ability to move around. We often run antibiotics while moms walk, soak in the tub, or move anyway they want. You might just have to drag an IV pole for a little while, though.
doctorjen is offline  
#20 of 61 Old 08-15-2006, 01:48 AM
 
MamaTaraX's Avatar
 
Join Date: Oct 2004
Posts: 9,152
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
doctorjen, I always love your posts I knew that stuff about group b strep in urine, but you said it so...well. (sorry, don't mean to sound like some nerdy groupie or anything)

Namaste, Tara
MamaTaraX is offline  
#21 of 61 Old 08-15-2006, 02:12 AM
 
TwiceBlessed's Avatar
 
Join Date: Mar 2006
Location: Colorado
Posts: 17
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I tested positive for gbs , and I did get the antibiotics during delivery, And yes it did burn so I agree it is best to have them deliver it as slow as possible. I arrived with plenty of time for this because I knew it would be an issue after I got all my antibiotics I was at a 5 we decided to break my water and the bay arrived about 30 mins later. Although I would have prefered to not get antibiotics I certainly felt much better knowing I did. we did have a problem with thrush ( which I didnt treat with nystatin , and it went away on its own in a few months) because of it though so I would talk to your babies dr about acidophilus right away Im not sure how soon you can give it but with antibiotics it always helps since they tend to cause some yeast problems. go with your insticts and youll do great, good luck I wish you a healthy pregnancy and a healthy baby
TwiceBlessed is offline  
#22 of 61 Old 08-15-2006, 02:52 AM
 
maxmama's Avatar
 
Join Date: May 2006
Location: Ann Arbor/Ypsilanti
Posts: 2,454
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by doctorjen
For what it's worth, I don't think your midwife is crazy. :

You of course should still be able to refuse or decline anything you want, but if you are going to decline you need to check what the pediatric provide
Ask to have just a heplock, not a continuous IV, and try to have it put in the largest vein they can find. If the penicillin burns, have the rate turned down, and/or have some saline run with it. It takes about 30 minutes to run a dose in, but this should not in any other way interfere with your ability to move around. We often run antibiotics while moms walk, soak in the tub, or move anyway they want. You might just have to drag an IV pole for a little while, though.
Antibiotics should ALWAYS be piggybacked onto a main line, never run in by themselves. They tend to be quite caustic and often do burn. If penicillin is used, it should be mixed with lidocaine and run in over 30-40 minutes instead of the standard 20. Also, if it's brought to room temp before running it in it tends to hurt less. If you cannot tolerate penicillin, then clindamycin is the CDC's choice for pen-allergic women, and it seems to be better-tolerated. Also, it's only every 8 hours instead of every 4.

I'm a big believer in GBS prophylaxis because I have seen an infant with GBS sepsis, and I've also seen a lot of healthy infants treated as septic because their moms were untreated. GBS is usually not a problem, but when the babies are septic they go bad very, very quickly, and personally I'd take the antibiotics over having blood cultures and a 48-hour stay for a newborn.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
maxmama is offline  
#23 of 61 Old 08-15-2006, 03:25 AM
 
hopefulfaith's Avatar
 
Join Date: Mar 2005
Posts: 2,154
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by maxmama
Antibiotics should ALWAYS be piggybacked onto a main line, never run in by themselves. They tend to be quite caustic and often do burn. If penicillin is used, it should be mixed with lidocaine and run in over 30-40 minutes instead of the standard 20. Also, if it's brought to room temp before running it in it tends to hurt less. If you cannot tolerate penicillin, then clindamycin is the CDC's choice for pen-allergic women, and it seems to be better-tolerated. Also, it's only every 8 hours instead of every 4.

I'm a big believer in GBS prophylaxis because I have seen an infant with GBS sepsis, and I've also seen a lot of healthy infants treated as septic because their moms were untreated. GBS is usually not a problem, but when the babies are septic they go bad very, very quickly, and personally I'd take the antibiotics over having blood cultures and a 48-hour stay for a newborn.
As usual, rock on, maxmama.

Mama to A 8/05 and S 11/06
hopefulfaith is offline  
#24 of 61 Old 08-15-2006, 04:12 AM
 
dove's Avatar
 
Join Date: Jun 2005
Location: PA
Posts: 1,948
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
just skimmed and I saw the mention of "they can't hit a moving target" type post, referring to actually getting the IV in. It is your right to refuse anything you want to, but it would be best to work it out ahead of time. If your mw is really unbending on this, you may end up with a baby that gets railroaded into having a full septic workup (not pretty) because you were not treated. I think this sucks, and it should be your choice, but some practitioners are really into sticking it to people who decide on their own. I've seen court orders come down to have babies kept in the hospital and worked up in this manner (but this was a hostile toward out-of-hospital birth environment in the 90's in a particular geographic locale).
dove is offline  
#25 of 61 Old 08-15-2006, 09:39 AM
 
doctorjen's Avatar
 
Join Date: May 2003
Posts: 3,112
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Clindamycin is no longer the automatic choice for pen allergic women due to increasing resistance. The recommendation now is that the Group B strep strain be tested for clindamycin sensitivity if possible, and if not possible or if it is resistant, the following strategy is used.
If the penicillin allergy was mild and the risk of cephalosporin allergy unlikely, Ancef (cefazolin) is the next choice. If the penicillin allergy was severe, vancomycin is used.
Cefazolin would be an option for someone who just couldn't tolerate the penicillin in their IV.
Also, there is debate over whether it is safe to give lidocaine IV to pregnant women, even though it does work well to decrease the pain of IV penicillin.
doctorjen is offline  
#26 of 61 Old 08-15-2006, 09:59 AM
 
lorijds's Avatar
 
Join Date: Jun 2002
Posts: 2,950
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I don't see how if the abx is piggybacked or not makes any difference; the main line stops while the abx solution is running.

I work part time at a birth center and full time on the medical floor of the local hospital, and at both places we give antibiotics without additional IV fluids running. The antibiotic is, of course, not IV push; it's just mixed in small amount of carrier fluid (usually 50-100 mL normal saline, depends on the antibiotic, though) and given as per schedule. Note that when you set the pump, unless you have a multi-chamber pump, which is not standard in any place that I have ever worked with the exception of ICU, when you piggyback in a medication, the IV fluids that are running will stop until the programmed amount of antibiotic is in; then the IVF resume. So they have nothing to do with the actual infusion or dilution of the antibiotic. Do you see what I mean? Does that make sense?

I have also never heard of mixing PCN with lidocaine. You mean in the bag? Wouldn't that make it a lidocaine drip then? Wouldn't that have a potentially very detrimental effect on the maternal and fetal heart et respiratory rates? I agree with your other suggestions -- larger vein, room temp, slow the infusion rate -- but I am in the dark regarding mixing it with penicillin. Maybe it's something that is routinely done in some places, I don't know. But in our hospital we only use lidocaine for for certain heart arrhythmias, and then only in the ICU.


Yeah that, in regards to Jen's explanation of the difference in treatment modalities for vaginal vs urinary colonization for group B strep. Honestly, unless someone has alot of risk factors, at the birth center we don't worry much about group B strep, and don't have a problem at all with a mama refusing antibiotics. If a mama who had a bladder colonization refused antibiotics, I would be very uncomfortable with that, and would want her to understand the difference between a vaginal and a urinary tract colonization. Absolutely, it woul still be up to her to consent to or decline antibiotics; but to me there is a huge difference between a positive vaginal swab and a positive urine culture.

That doesn't condone your mw's attitude, though. Maybe it was just a bad day for her (we all have them), but she could have done a better job listening to you, and also explaining her reasoning to you. I'm sorry she wasn't more respectful and open to your questions and concerns. That's not okay.
lorijds is offline  
#27 of 61 Old 08-15-2006, 11:09 AM
 
mysticmomma's Avatar
 
Join Date: Feb 2005
Location: Baltimore
Posts: 6,183
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I've never had my urine tested for this... The only thing I've ever had done with my urine is the little glucose/protein stick each visit. When is this done? Is it just not a universal "standard of care"?

hh2.gif

mysticmomma is offline  
#28 of 61 Old 08-15-2006, 11:19 AM
 
lorijds's Avatar
 
Join Date: Jun 2002
Posts: 2,950
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
We always do an initial urinalysis with the initial blood work, to screen for general kidney function, occult urinary tract infections, etc.
lorijds is offline  
#29 of 61 Old 08-15-2006, 11:32 AM
 
Nettie's Avatar
 
Join Date: May 2005
Location: 'Round Here
Posts: 134
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
An article on GBS & antibiotics, from Mothering:

http://www.mothering.com/articles/pr...n/group-b.html
Nettie is offline  
#30 of 61 Old 08-15-2006, 11:40 AM
 
rozzie'sma's Avatar
 
Join Date: Jul 2005
Location: Amdist the urban decay
Posts: 2,325
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
It should not burn if

1. It is given at a slow rate
2. They use a smaller IV needle, The smaller the needle the more blood surrounding it and diluting the abx. keeping it from pooling in the vein
3. It is properly diluted in the saline solution.
rozzie'sma is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off