Group B Strep, did anyone refuse antibiotics during delivery? - Mothering Forums

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#1 of 50 Old 03-18-2008, 11:32 PM - Thread Starter
 
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I am 35 weeks prego & tested positive for GBS. I am planning a VBAC and my Dr wants me to have the antibiotics via IV in my hand. I didn't have this issue with my daughter born almost 4 yrs ago and who is completely healthy.
My doula doesn't agree that the antibiotics are necessary. anyone out there have any advise?
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#2 of 50 Old 03-18-2008, 11:46 PM
 
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I dropped my back up doc at 38 weeks because he insisted I find another doc if I refused the antibiotics. So I found another doc. I didn't see her until after DS was born at home. Planned UC.

Here are some resources I found helpful.

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#3 of 50 Old 03-18-2008, 11:47 PM
 
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I refuse GBS testing specifically because I would not get the antibiotics if positive.

-Angela
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#4 of 50 Old 03-19-2008, 12:06 AM
 
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I was disappointed to find that I was GBS positive and resigned myself to getting the antibiotics. BUT my labor with dd went much faster than anyone expected, and I was ready to push at home. By the time we got to the hospital, it was too late to drug me. And dd was just fine.
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#5 of 50 Old 03-19-2008, 12:08 AM
 
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i wouldn't use antibiotics in labor if testing positive for GBS either. getting those antibiotics in labor, you're not going to be giving your baby the good bacteria present in your birth canal because antibiotics kill everything indiscriminately. the good bacteria are really important for the baby to get. i would try a holistic approach instead, like garlic and tons of probiotics. homemade kefir, sauerkraut, and kimchi would be excellent sources of cheap and plentiful probiotics.

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#6 of 50 Old 03-19-2008, 12:45 AM
 
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I was going to refuse, if I tested positive... but then, surprise of surprises, I tested negative this time. So I don't have to refuse.

I've made many very long posts about my analysis of the stats (taken straight from the CDC data that the antibiotic protocol is based on) and why I was going to refuse them, so you may want to just try searching under my username for all that. ;-)
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#7 of 50 Old 03-19-2008, 04:06 AM
 
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I wouldn't take them, but I didn't take the test either.

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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#8 of 50 Old 03-19-2008, 03:14 PM
 
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I didn't know you could refuse them. It was really annoying to have to put my arm out of the tub for my injection as I was beginning pushing. On top of that, I'm possibly allergic to pennicillin so they gave me ampycillyn which they told me was basically useless in fighting the infection if it were to occur anyway. So why do they even bother?:

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#9 of 50 Old 03-19-2008, 05:24 PM
 
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Well I SHOULD have...it was so dumb because they wanted me on an IV for 4 hours before delivery (now how THAT was going to be determined on when I would exactly deliver was never explained). I came in at 9 cm already and I consented to them trying to give me an IV....it was worthless..at that point I should have just said no. Ds was perfectly healthy.

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It was really annoying to have to put my arm out of the tub for my injection as I was beginning pushing.
This was me exactly!

Now I have to go back to the same place......I'm not sure I want to consent to GBS testing and if I do, if I want treatments. They are backed by docs and have to have certain protocols because of it....I'm not sure what will happen if I refuse. Because of what happened last time, they may let it slide if I do the testing and turn up positive. I'm not close to there yet so I guess I'll do more research for the answer when the time comes.

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#10 of 50 Old 03-19-2008, 05:27 PM
 
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I refused but they stayed in the room threatening to take the baby away for 2 days for monitoring (which I knew we could refuse AMA) and kept asking until I said fine just leave me alone. I would have stayed firm but this nurse who massaged my back so nicely convinced me to give in.
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#11 of 50 Old 03-19-2008, 05:41 PM
 
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I should have refused testing in the first place, or just refused the antibiotics... the m/w bruised both of my arms trying to get the heplock in while I was in pretty active labor (5-7cm). She didn't get a vein and we didn't try again. She broke the water about 50 min before my dd was born, so there was no real danger for my dd.

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#12 of 50 Old 03-19-2008, 05:42 PM
 
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I might be a rare case here, but I refused and unfortunately my dd did contract meningitis. She had a two week stay in the NICU but is totally fine today. I think it really depends on what your numbers are when you are tested and whether or not you are willing to do the homeopathic remedies to help your body get rid of the GBS.

With me, I was tested the day I went into labor and had previously (within the four weeks prior to that) tested negative. I assumed that I was still negative and I didn't see the need for the abx. When the results came in the next day (after I had already birthed dd and she was already sick) my midwife said the numbers were the highest she had seen in a long time. FWIW, my bags of water didn't rupture until I was dilated to 10 and ready to push, so it wasn't an issue of time.

So, I didn't have the chance to educate myself on alternative GBS treatments before going into labor.

Hope this all makes sense. Feel free to pm me if you have any other questions...not meaning to freak anyone out!!

With this baby I am going to do a lot of self-care but I am also consenting to the abx. I just don't ever want to go down the NICU route again! In the end my dd got waaaayyy more abx than she would have been exposed to during labor.

Jacqueline
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#13 of 50 Old 03-20-2008, 04:57 AM
 
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I just found out yesterday that I am GBS positive. As much as I don't want to have that damn IV or heplock in my arm, I am going to consent to the antibiotics. However, I do want to make sure that I regain the flora in my gut and the baby's gut as quickly as possible, because I don't want to risk us getting thrush.
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#14 of 50 Old 03-20-2008, 11:31 AM
 
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If you are GBS positive then there is a 1 in 100 chance that your baby will end up with a serious infection (meningitis or similar) - and this can be very bad and put your babe in the NICU. A good friend of mine is an OB/Gyn and she's seen some really sick babies because of it.

If you receive antibiotics (they say an IV dose every 4 hours) then that risk drops to about 1 in 10,000. From a medical care standpoint, it is much better to give every GBS positive woman antibiotics because of this, despite the fact that most of them wouldn't have complications anyway. If you're on the fence, you can always ask exactly what the protocol is, whether you need an IV in place, could just get a shot, could have a heplock, etc etc. Figure out whether the hassle of getting the antibiotics outweighs the possible benefits of it. It's easy to be reactionary about this sort of thing, but you want to make the best informed decision you can.

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#15 of 50 Old 03-20-2008, 12:01 PM
 
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Originally Posted by kltroy View Post
If you are GBS positive then there is a 1 in 100 chance that your baby will end up with a serious infection (meningitis or similar) - and this can be very bad and put your babe in the NICU. A good friend of mine is an OB/Gyn and she's seen some really sick babies because of it.
Do you have a link? Those are nowhere near the numbers I've seen, especially for full term babies.

-Angela
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#16 of 50 Old 03-20-2008, 12:05 PM
 
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Do you have a link? Those are nowhere near the numbers I've seen, especially for full term babies.

-Angela
it's actually 1 in 200. Go to the resource guide in this forum. There is a great article on it. It also goes over the negatives of using the antibiotics.
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#17 of 50 Old 03-20-2008, 12:35 PM
 
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it's actually 1 in 200. Go to the resource guide in this forum. There is a great article on it. It also goes over the negatives of using the antibiotics.
Yeah, 1 in 200 is more what I've heard. BUT that stat includes preemies. Which totally skews the numbers for term babies.

-Angela
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#18 of 50 Old 03-20-2008, 12:35 PM
 
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I would take mass doses of probiotic, echinechea, garlic, and citamin C for 2-3 weeks and retake the test. I would also use hebicleanse right before the test. You will probably end up testing negative, if you don't then I would take the antibiotics b/c that would REALLY be some aggressive bacteria to withstand all of that

If you test negative and are still worried you can use the hebicleanse during labor every 7 hours (it's a vaginal wash that can kill the Group B strep bacteria). Which is what would do if I was worried I may actually have it, since it can be some really dangerous stuff IF by the off change your baby swallows it during labor.

This is not medical advise, just some silly hb mommas opinion

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#19 of 50 Old 03-20-2008, 12:51 PM
 
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I was GBS+ with DS1 and had the ABX during labor, but the IV was not left in my heplock after I recieved the dose. So I was free to move around during labor.

With DS2 I decided to not even get tested and just take some prophylactic measures. I did the garlic thing, and had planned on the hibiclens, but baby decided to come too quickly for that! We had no problems with his birth. I believe in the garlic tx.
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#20 of 50 Old 03-20-2008, 01:20 PM
 
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Do you have a link? Those are nowhere near the numbers I've seen, especially for full term babies.

-Angela
Those are the numbers I just read in "The Birth Partner" by Penny Simkin (great book, btw). She didn't specify whether they included all babies or just term babies, so yes, it's entirely possible it's skewed. She probably cites a reference but I don't have it off the top of my head.

The American Pregnancy Association cites a number of 1 in every 100-200 babies born to GBS positive moms without antibiotics, and 1 in every 4000 with antibiotics, that will have complications.

All of the CDC literature indicates that if you test GBS negative within 5 weeks of your delivery you don't need antibiotics, so if the original poster can re-test after doing the pro-biotics etc. trick and get a negative result, she's home free.

Either way, my main point was that it is up to each of us as individuals to inform ourselves and decide what odds we're comfortable with.

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#21 of 50 Old 03-20-2008, 01:50 PM
 
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Either way, my main point was that it is up to each of us as individuals to inform ourselves and decide what odds we're comfortable with.
Right, but you have to have good stats to work from.

-Angela
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#22 of 50 Old 03-20-2008, 02:40 PM - Thread Starter
 
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Thank you all so much for the great advice. (It's my first time posting a thread and since I didn't see it right away I assumed I did it wrong)
I was so happy to see all your responses this morning.

I will try the home remedies as well as asking to be re-tested and go from there.

thank you, thank you, thank you.
I feel so lucky to be a part of this wonderful cyber-group of caring mothers.

peace & love,
Michelle (G's Mama)
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#23 of 50 Old 03-20-2008, 03:23 PM
 
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Those are the numbers I just read in "The Birth Partner" by Penny Simkin (great book, btw). She didn't specify whether they included all babies or just term babies, so yes, it's entirely possible it's skewed. She probably cites a reference but I don't have it off the top of my head.

The American Pregnancy Association cites a number of 1 in every 100-200 babies born to GBS positive moms without antibiotics, and 1 in every 4000 with antibiotics, that will have complications.
I've seen numbers similar to those cited by Simkin reported by the March of Dimes, but I don't know where they got them. The CDC's 1993 surveillance data, upon which they based the original risk-based protocol (which was then revised to the screening-based protocol) gives 1 in 200 chance of infection without treatment, and 1 in 4000 chance of infection with treatment.

The overall death rate of babies that develop early-onset GBS infection is 6.5%. However, as Angela pointed out, preemies skew these numbers quite a bit. While the CDC's surveillance data does not break out the infection rates for preemies vs. term babies, they do break out the death rates, and it turns out that while preemies have a 22.9% death rate from early-onset GBS, term babies have a 1.48% death rate.

So, if your baby is born after 37 weeks, and you ARE GBS positive, there is a 1 in 13,615 chance of death from the infection. Any given time a person receives penicillin, even if they've received it before without adverse reaction, there's approximately a 1 in 10,000 chance of anaphylaxis. This is a risk to BOTH mom and baby, and once you've had an allergic reaction to penicillin, you should never ever get it again... which limits your treatment options for future infections. There is little to no data on the other adverse affects of the antibiotic protocol, such as how it interferes with normal labor, increased incidence of thrush in the newborn and mother, or autoimmune issues due to abnormal gut flora colonization for the baby.

The antibiotic protocol has absolutely no effect on late-onset GBS infection (onset after the first week of life).

Ultimately, the antibiotic protocol calls for one MILLION women to receive IV antibiotics to save the lives of 309 babies each year. Meanwhile, the CDC is engaged in aggressive surveillance efforts to watch for a penicillin-resistant strain of GBS (currently, there is no such thing, which is why penicillin is the drug of choice for treating GBS-positive moms). If one wanted to design a protocol for breeding a drug-resistant strain of this bug, I can't think of a better way to do it than to identify a million carriers of the bacteria and pump them all full of the drug. :-/ When it finally does happen, I imagine it will be a public health disaster, and I don't even want to think about how many babies will die from it.

All of the data I'm citing here is available on www.cdc.gov (except that the approximate number of women per year who would be treated for being GBS positive is based on US live birth statistics from census.gov).
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#24 of 50 Old 03-20-2008, 03:35 PM
 
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Great info.

Also to add to that, antibiotics for mom in labor for GBS INCREASE the chance of e. coli infection in the newborn which can ALSO be very serious and cause death. So those stats should be weighed as well.

-Angela
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#25 of 50 Old 03-20-2008, 03:42 PM
 
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An hour after birth my first baby was septic because I was StrepB positive and the doctor took too long approving antibiotics (she was in the building but "busy", and wouldn't even give the okay over the phone until she made it to my room, hours after my water broke). She was very, very sick her first week and could have died. That's all the stats I've needed. With every other birth I have been very diligent about getting to the hospital ASAP to get the antibiotics going.

No baby or mother should have to go through what we went through. It wasn't just the strep, either. Because she was so sick, she was too weak and felt so awful that our nursing relationship had a very bad start. I believe it affected other things, too, but I'll end my post with saying I feel very strongly that antibiotics are not only advisable, but the responsible choice.
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#26 of 50 Old 03-20-2008, 08:30 PM
 
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An hour after birth my first baby was septic because I was StrepB positive and the doctor took too long approving antibiotics (she was in the building but "busy", and wouldn't even give the okay over the phone until she made it to my room, hours after my water broke). She was very, very sick her first week and could have died. That's all the stats I've needed.
A single case is not a statistic. I understand your emotional reasons for wanting prophylactic antibiotics... but the CDC's policy is based on statistical data that, IMO, is being used poorly, and their actions will result in many more sick and dead babies in the future. I wouldn't want to be the mom of the first baby with penicillin-resistant GBS sepsis... would you like to tell her your story? Do you think it will make her feel better? That baby will probably die.

My son has several food allergies, probably at least partly as a result of our repeated treatment with antibiotics. So far none of them are life-threatening, but that could change with any given exposure. I know several people whose children can be KILLED by someone else eating an ice cream cone, and there is a definite relationship between gut dysbiosis (inadequate colonies of "good bacteria" in the intestines) and food allergies, as well as other potentially lethal autoimmune disorders such as asthma. I do not see prophylactic antibiotic use as benign, and in this case, I do not see it as particularly responsible on the part of the medical community.

Especially when it comes to birth, it's very common for people to make decisions from a place of fear. How many women get an epidural the second they are allowed to, because they fear the pain of labor? How many women have surgical births because they're afraid that baby is too big, or taking too long? How many women could not possibly consider having an out-of-hospital birth, because they're too scared of the possibility that "something" would go wrong? Is it appropriate, here or anywhere else, for these women to tell us that pain relief, c-sections, and hospital births are THE "responsible choice" when they've made that choice from a place of fear, rather than information?
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Especially when it comes to birth, it's very common for people to make decisions from a place of fear. How many women get an epidural the second they are allowed to, because they fear the pain of labor? How many women have surgical births because they're afraid that baby is too big, or taking too long? How many women could not possibly consider having an out-of-hospital birth, because they're too scared of the possibility that "something" would go wrong? Is it appropriate, here or anywhere else, for these women to tell us that pain relief, c-sections, and hospital births are THE "responsible choice" when they've made that choice from a place of fear, rather than information?


I've said it before, I'll say it again.

Fear is never a good decision-making tool.

-Angela
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#28 of 50 Old 03-20-2008, 09:07 PM
 
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If you'd been through it, I'm not sure you'd feel the same. But I thought the OP deserved to hear another side of it. Intervention does not automatically equal evil. Infant mortality is higher than it used to be for a reason.
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#29 of 50 Old 03-20-2008, 09:09 PM
 
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Intervention does not automatically equal evil. Infant mortality is higher than it used to be for a reason.
You're right- intervention does NOT = evil.

Not sure what you mean about infant mortality being higher for a reason... the biggest reason I see is intervention...

AND, last I really researched it, antibiotics for GBS did NOT reduce overall newborn mortality because as much as they reduced it for GBS, they increased it for other infections.

-Angela
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#30 of 50 Old 03-20-2008, 10:47 PM
 
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If you'd been through it, I'm not sure you'd feel the same.
I might not FEEL the same about prophylactic antibiotic use. But I would still THINK the same about the actual risks involved. That's an important distinction.

Fear is a feeling. A legitimate, important feeling. It's a feeling that can save our very lives if we listen to it appropriately. But, just because *I've* had a scary experience in a particular situation, it does not translate into a general rule that *you* should follow... and vice versa.

Were my gut instinct to tell me that I and my baby should have antibiotics, I'd definitely get them. And, knowing what I know about the numbers, if I'd gone into labor before my culture came back and before term, I would have gotten antibiotics (since GBS is far more virulent for preemies in general). But no one's feeling, fear or otherwise, changes the actual statistics, and the statistics show that as a society we're taking an *enormous* risk for very little reward.
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