So sad about GBS - Mothering Forums

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#1 of 38 Old 11-24-2008, 06:52 PM - Thread Starter
 
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A couple weeks ago I tested positive for GBS, but at a low colonization rate (2). I've been using the natural suppositories from my MW and ingesting a lot of raw garlic and vitamin C. But they took a new culture last week and my colonization rate is now higher, a 4!

I am so blue. I am 38.5 weeks now, so I don't have a lot of time left to fight this bug. And I really didn't want to have to make the hard decision of refusing the antibiotics if I'm at a high colonization.

It's especially complicated for us because our DS had severe reflux so I wanted to avoid the antibiotics to help improve her chances of having healthy digestion. But now I don't know if that's a good enough reason to say no to the antibiotics because I can't even remember where I read that antibiotics at birth have a negative impact on digestive health!! I called a local naturopath for a consult, but she charges $150. I'm torn.

Yesterday I was feeling like I was ready to have this baby, and now I hope she waits because I don't know what to do.

I'd love any advice or support. Does anyone know where I'd post a question about antibiotics and reflux on the MDC boards? Argh, I'm stressed.

NICOLE | Natural livin', co-sleepin', mostly vegan, work at home mama to N (7) and L (2)
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#2 of 38 Old 11-24-2008, 07:06 PM
 
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i'm in the same boat, nicole. same as you, i tested positive a few weeks ago, then re-tested positive after trying everything possible. i've resigned myself to the IV antibiotic (my homebirth midwives will administer it, but only if they get here in time, as i have very fast labors).

of course, i worry about the effects of the abx on baby, as well as on me. but i'm trying to keep it in perspective: our babies won't necessarily suffer side effects, and if they do, they're a lot better than GBS disease. i'm just not willing to take a chance.

i'm continuing to take a daily probiotic, and i'll do so after the birth. i'm personally less worried about reflux than about thrush. in my experience (i work with nursing moms), dairy is often a huge factor in reflux in breastfed babies. so you could just try to maximize your probiotic intake, and minimize/cut out dairy, at least during the newborn phase.

our babies, and we, will be fine. :
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#3 of 38 Old 11-24-2008, 08:00 PM
 
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Have you tried garlic?

Jessica, mama to Emma, 7, Mattie, 5.5 and Lilly, 3 and someone new this Halloween-ish.

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#4 of 38 Old 11-24-2008, 08:13 PM
 
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Did you do the hibiclense?

YOU taking the antibiotics in labor will be easier on the babies digestion than giving the baby antibiotics after birth, so if that is possible than take them in labor.
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#5 of 38 Old 11-24-2008, 08:29 PM
 
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i tried vaginal garlic for 7 nights before my test, plus hibiclens (plus extra vitamin C & everything else)! what's more, i've been taking probiotics throughout the pregnancy, and have a great diet overall. (i also never tested + before)

you're right, erica, thanks for reminding me of that -- better to treat ourselves than the baby w/abx.
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#6 of 38 Old 11-24-2008, 08:33 PM
 
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I was just going to PM you again. I saw a thread about this, I think maybe in pregnancy? The mama was using garlic vaginally as well. Have you tried that? I asked my MW last week jic b/c we were testing and she said the same thing but didn't give too much info b/c she said we'd just find out next week (tomorrow) if we need to talk about it...she didn't want to add extra stress on me.

So she did mention that a friend (and maybe midwife?) of hers lost her son to GBS many years ago (sounded like she didn't test for GBS at all and that was why) and made this site and had lots of info on it for getting levels down. I can ask her tomorrow night for that info if you'd like. Seems like it's close to her heart b/c of her friend and that she might know what can help.

Oh I would just put a large search in MDC for group b strep and see what comes up. good luck
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#7 of 38 Old 11-24-2008, 08:39 PM
 
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I totally understand your sadness. I was very stressed out by the prospect of being GBS+. What helped me was knowing that the midwives were actually quite supportive of women refusing the abx - where are you birthing? Do they offer alternatives to abx, like closely monitoring babes temps after birth?

It's such a tough decision. The odds are soooooooo low but the stakes are really really high. Good luck.

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#8 of 38 Old 11-24-2008, 10:04 PM - Thread Starter
 
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I've been using garlic vaginally for 3 days or so. We're going to re-test at my appointment tomorrow to see where we're at. I've also started heavier probiotics, even though it's probably too late.

At this point I'm thinking we'll say no unless I have another risk factor - particularly PROM. But we'll see.

My midwife is very supportive of either decision, and very knowledgeable about natural options. I know if we decline she'll give us all the info she can get her hands on about monitoring LO's temp after birth and being as safe as possible. But what a crappy decision to have to make!

NICOLE | Natural livin', co-sleepin', mostly vegan, work at home mama to N (7) and L (2)
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#9 of 38 Old 11-24-2008, 10:56 PM
 
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From what I'm reading, a baby who is born to a gbs positive mom in a situation with no risk factors (no prom, fever, preterm labor), has something like a 1 in 200 chance of developing gbs disease. Something also to consider is that if you are treated with abx in labor, there is a greater likelihood of the germies becoming resistant to that particular type of antibiotic, creating an even bigger problem if your babe develops gbs anyway, which he/she could.

One of the articles I'm getting my info from was a mothering article in the nov/dec 2003 mag.

I just tested today, will get the results next week? If I am positive, then I plan on doing the hibiclens route, garlic, c, echinacea etc... however the backup midwife I'm currently with is strongly pro-abx if I'm + simply because of CYA issues. Which sucks for me : She is willing to do garlic, etc and re-test, but if I'm still + before I go into labor she wants to push the abx.

tough decisions. good luck.
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#10 of 38 Old 11-25-2008, 02:25 AM
 
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I don't know for sure if this would help, but it certainly wouldn't hurt...before I took the GBS test I took a probiotic designed for vaginal health (Jarrow's FemDophilus but there are others out there) for a couple of weeks and also inserted probiotic capsules internally every couple of days during that time. I did test negative although I might just as well have without that.

Anyhow, if I had tested positive I planned to refused antibiotics if I didn't have any other risk factors, but accept them if I did, because I read (can't remember where, sorry) that the changes of having a baby with GBS if mom was positive AND had another risk factor were 1:20...those weren't odds I felt comfortable with. I really agonized over this because my DD has multiple food intolerances in spite of never having been exposed to antibiotics and I didn't want to do anything that could contribute to having another LO with food intolerances. Luckily it didn't end up being an issue for me, but FWIW that was my plan.
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#11 of 38 Old 11-25-2008, 03:02 AM
 
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I tested positive but Im not toooo worried. Midwife said it could just go away on it's own anyways. It comes and goes in womens life week to week, thats why they test you so close to labor so they know if you will have it at labor.

My midwife's naturopathic treatment is acidophilus suppositories in the AM an tea tree suppositories in the PM. Im supposed to take grapefruit seed extract 3x a day. I will do a hibiclens wash at the start of labor an every 6 hours into it as well.
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#12 of 38 Old 11-25-2008, 02:11 PM
 
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I just found out I tested positive as well *sigh*. I'm going to push for retesting at my next appt and try natural treatments (at 38 weeks), I avoided any antibiotics this entire pregnancy and so don't want to be dealing with a yeast infection or thrush or baby issues right after birth, uck! Plus I'm allergic to so many antibiotics anyways, I'd really hate to be trying something new in labor and find out I'm allergic. However if we end up going with Kaiser I'm sure they'll be pushing for the abx even if I retest and come up clean, blah! I left a msg for the midwife to call me back so I'm waiting on that now...

Lisa, mama to Orion (7) , Fiona Star (born sleeping @ 38wks 12/6/08) , our bitty (m/c 7/27/09) , and Charlotte Athena (11/5/10)
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#13 of 38 Old 11-25-2008, 07:14 PM
 
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i've never had any of the risk factors, and i'm unlikely to this time as well (my water never broke, no fever, no preterm, & very fast labors).

however, i'm accepting the abx even though the MW would allow me to decline. the reason is that i have a child who developed a serious, rare illness as a toddler -- an illness whose odds were less than 1 in 10,000 -- with no family history, just a "quirk of fate" if you could call it that.

so i sort of know what it's like to be the parent of that 1 in 200 (or however many) child who gets very sick, and it's not a risk i'm willing to take.

ETA: much as i'm against abx in principle. i never take medication of any kind, OTC or otherwise, even when not pregnant -- and i haven't even had so much as a tylenol this entire pregnancy. but i feel very strongly about protecting my baby even though the risk may be tiny...
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#14 of 38 Old 11-25-2008, 07:19 PM
 
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good luck with what you decide, Nicole. I just know that you will make the right decision for you and your baby.

I'm also in awe of you women using garlic vaginally!

Walking in the light with DH, DD (11/08), DS (4/10) , four dogs, and one insouciant cat.
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#15 of 38 Old 11-25-2008, 07:25 PM
 
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I just found out today I tested positive. I figured as much. The only thing I don't like about having the antibiotics is that they try to sneak in a bag of IV fluids, which I don't want. (And they don't give to women who don't have IV's, only those of us that do get them. Which to me says that it's not necessary.)

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#16 of 38 Old 11-25-2008, 09:11 PM - Thread Starter
 
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i've never had any of the risk factors, and i'm unlikely to this time as well (my water never broke, no fever, no preterm, & very fast labors).

however, i'm accepting the abx even though the MW would allow me to decline. the reason is that i have a child who developed a serious, rare illness as a toddler -- an illness whose odds were less than 1 in 10,000 -- with no family history, just a "quirk of fate" if you could call it that.

so i sort of know what it's like to be the parent of that 1 in 200 (or however many) child who gets very sick, and it's not a risk i'm willing to take.

ETA: much as i'm against abx in principle. i never take medication of any kind, OTC or otherwise, even when not pregnant -- and i haven't even had so much as a tylenol this entire pregnancy. but i feel very strongly about protecting my baby even though the risk may be tiny...
I totally understand. It's really a damned if you do, damned if you don't situation. There aren't enough people studying GBS and abx, so there aren't any really good alternatives.

The thing that's pushing us toward refusing the abx (if my water doesn't break) is our DS's history with serious digestive problems. We went through 3 years of absolute hell with that, so I feel like I have to do absolutely everything I can to minimize what may be genetic digestion issues, even though it's extremely scary to me to refuse the abx. That's why I'm so sad. But I'm going to believe in the best!

NICOLE | Natural livin', co-sleepin', mostly vegan, work at home mama to N (7) and L (2)
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#17 of 38 Old 11-25-2008, 09:15 PM
 
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Oh yay, today I just heard I tested + too. Moderate colonization. All I did pre-test was massive probiotics, guess that wasn't enough? So I'm going to do hibiclense, garlic suppository, extra garlic raw in diet, and more more more probiotics. Might use one vaginally I suppose. This sucks. I actually was + w/DD but the test didn't come back in time and we didn't know and I think ignorance was certainly bliss in that case! My m/w is really pretty laidback about it and will do oral antibiotics if I want. They WILL do IV antibiotics even for a homebirth but what a nightmarish pain. An IV is seriously one of the reasons I don't want to birth in the HOSPITAL! Also she indicated water births reduce risk somewhat, anybody know anything about that? They would like a test with scant or - colonization and I'm going to work on achieving that. Luckily am only 35.5 weeks so we have some time (although DD came 3 wks early). The odds quoted above seem so high--this has existed FOREVER and newborns just don't die that often. Basically one in 200 newborns died or became seriously ill from this back ten years ago when they didn't even test? Is that possible? I really doubt it.
What is the European take on this? They're so much more supportive of non-invasive birth experiences...
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#18 of 38 Old 11-25-2008, 09:48 PM
 
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What is the European take on this? They're so much more supportive of non-invasive birth experiences...
actually, european rates of GBS colonization are overall much lower than here. (i had my first baby in europe, and no one even tested for it then.) in most other parts of the world, the rates are lower as well. so elsewhere, it's much less of a risk. the US has the highest colonization rate in the world.

it's also likely that years/decades ago, before antibiotic overuse became so rampant, the bacteria were less resistant/virulent so fewer babies overall had GBS disease.
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#19 of 38 Old 11-26-2008, 12:56 PM - Thread Starter
 
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Doing some research this morning and thought I'd share:

1) I stumbled across this article, but can't get access to it. Maybe some of our student mamas will have access via their university?

Neonatal group B streptococcus colonization in water births
International Journal of Gynecology & Obstetrics, Volume 98, Issue 1, July 2007, Pages 54-55
R.A. Zanetti-Dällenbach, W. Holzgreve, I. Hösli

2) This provided some good information about GBS screening and rates in the UK.

And this.

And... since I'm allergic to milk I've been looking for probiotic foods, and found this drink I really like @ Whole Foods: GoodBelly (mango drink)

NICOLE | Natural livin', co-sleepin', mostly vegan, work at home mama to N (7) and L (2)
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#20 of 38 Old 11-26-2008, 03:42 PM
 
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A couple of questions about the treatments you all are trying--how are you doing the Hibiclense? My m/w said just put some on a soapy rag and suds up a couple times a day. I'm thinking my vaginal area is not going to survive that kind of attention, as I've done it twice and it's already a bit sore? And can you just use any probiotic as a suppository so long as the capsule melts in warm water, ie not a enteric coated one?
After reading some of namastenicole's reference stuff I am really feeling so not worried about this. I even HAD risk factors w/DD--water broke about 18 hrs before I delivered, she came right at 37 wks...but no problem. I suppose I might take the oral antibiotics but only if I can't get a scant/negative test. But it looks like that just doesn't really mean anything, since it could change again the next day!
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#21 of 38 Old 11-26-2008, 04:27 PM - Thread Starter
 
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Wow, I found a copy of that study here.

The results:
Although the rate of water contamination was significantly higher in the study than in the control group (P b 0.001), the neonates born in water were less frequently colonized with GBS than those born in a traditional
environment, even when preterm rupture of membranes occurred (nasal swabs, P = 0.005; pharyngeal swabs, P = 0.024). All neonates colonized with GBS were born to GBS carriers.

The 2 groups were similar with regard to referral to the neonatal intensive care unit, neonatal infection rate, and neonatal fever rate. Conjunctivitis was noted in 5 neonates in the study group and none in the control group, but the difference was not significant. Swabs taken from the eyes revealed no evidence of GBS. The lower rate of colonization with GBS among neonates born in water may be due to a wash-out effect during the gentle but swift movement through the water to the mother’s chest.

NICOLE | Natural livin', co-sleepin', mostly vegan, work at home mama to N (7) and L (2)
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#22 of 38 Old 11-26-2008, 04:40 PM
 
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Hey Nicole and everyone going through this - I understand your frustration and disappointment. After a near perfect pregnancy, I just tested + too and it really got me down for a while. Luckily, though I may not have time, my midwives will gladly retest me next week so I have launched into this regimen (decided after talking with two midwives, one doctor, and tons of googling): 500 mg vitamin c every 4 waking hours, 1000 mg echinacea daily, 1 container of Bio-K daily (massive dose probiotic drinkable product), lots of raw garlic in my diet and a lightly crushed garlic clove up my bum every night. Everything I read online said to use it vaginally but my midwives explained that the bacteria gets to your vagina from your digestive/rectal tract so it is more effective to get the garlic closer to the source. Makes sense. No fun though especially since you can taste it in your mouth within moments of sticking it in there. Freaky gross!

The thing that pisses me off most about this is that there doesn't seem to be much talk about preventing GBS in advance of the testing (except for here of course!). My midwives never said a thing before handing me the swab. Maybe I just read the wrong books? Oh well, I'll know for next time!

One last thing about antibiotics - I always have a nasty reaction to them so haven't taken any for years, nor do I want to now though I probably will if I stay + or don't have time to be retested. From what I gather, receiving a few "bursts" of penicillin by IV is very different from taking a course of pills over ten days or so. There is supposedly far less chance for the antibiotic to wreak havoc on our systems and leave us weaker and more susceptible to other illnesses. I'm such a skeptic but am hoping this is true.

Happy mumma to my boys Henny Tom (Nov 30, 2008), Arlo Odie (Oct 5, 2010), and baby SISTER! due mid-Dec 2014.
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#23 of 38 Old 11-26-2008, 06:23 PM - Thread Starter
 
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A couple of questions about the treatments you all are trying--how are you doing the Hibiclense? My m/w said just put some on a soapy rag and suds up a couple times a day. I'm thinking my vaginal area is not going to survive that kind of attention, as I've done it twice and it's already a bit sore?
From my reading it looks like it is unecessary to use Hibiclens prior to labor since it's a temporary solution. It will kill the strep, but only for a short period. Since strep b lives in your intestines, you're going to get it again. It may give you a negative on the test, but that's not going to help you in labor (if you are in fact positive).

So my plan is to do an external wash and very light douche at the start of labor, and then again in 4 hours as necessary (20:1 solution). Double check with your MW on the timing, strength, etc., but this is what I keep seeing in my lay-person research.

NICOLE | Natural livin', co-sleepin', mostly vegan, work at home mama to N (7) and L (2)
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#24 of 38 Old 11-28-2008, 12:37 AM
 
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Yes using the hibiclens every 4 hours is supposed to be helpful from what I've read too, just the 1:20 parts in a peri bottle squirted over your labia (you don't need to douche with it or anything).

I'm going to do that along with the other ideas to help reduce colonization for my next appt (and then have to push to retest), and while I know its really fooling the test into getting a negative reading (doing hibiclens before going in) I just don't want to be pushed into the antibiotics or have to have baby stay 48 hours otherwise (is that the standard? I need to ask for my facility but from what I'm reading that's what it seems like) as I'd really like to get to leave as soon as possible after birthing as I can convince them to let me go (I'd worry about signing baby out AMA) and I'd like to go in as late in labor as possible (and not have to worry about showing up in enough time to get the antibiotics).

Then in labor I would also do the wash sneaky like and would be comfortable with that.

Lisa, mama to Orion (7) , Fiona Star (born sleeping @ 38wks 12/6/08) , our bitty (m/c 7/27/09) , and Charlotte Athena (11/5/10)
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#25 of 38 Old 11-28-2008, 06:50 AM
 
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What is the European take on this? They're so much more supportive of non-invasive birth experiences...
Well Europe is a big place, with lots of countries that all have their own protocol regarding GBS. Here in Switzerland we do not routinely test for GBS. We look for risk factors around labour and generally monitor and inform parents on what to look for. (I am a student midwife) I can give you the guidelines we give parents if you like.

IIRC, in the UK they also do not offer routine screening for GBS as per NICE guidelines. I don't believe it is routinely offered in Sweden either. These are the countries I am familiar with.

I wasn't tested and didn't want to be. If you are having a home birth or hospital birth and are GBS+ you can also have an intramuscular injection of ABX instead of running an IV.

In any case, try not to worry to much about being GBS+ it will likely not be a problem. If you don't want the IV, you can have the IM injection, if you don't want either there is a lot of support for refusing abx altogether. This is another reason why I don't like routine screening, it just makes people worry unnecessarily. I'd rather be an attentive HCP watching carefully and weighing the risk factors and not rely on abx to "solve" the problem.
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#26 of 38 Old 11-28-2008, 06:57 AM
 
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or have to have baby stay 48 hours otherwise (is that the standard? I need to ask for my facility but from what I'm reading that's what it seems like) as I'd really like to get to leave as soon as possible after birthing as I can convince them to let me go (I'd worry about signing baby out AMA) and I'd like to go in as late in labor as possible (and not have to worry about showing up in enough time to get the antibiotics).
There is no good reason to keep your baby longer than 12 hours for GBS monitoring barring other risk factors. Early onset happens within 12 hours of delivery, in the vast majority of cases (90%, I believe).
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#27 of 38 Old 11-30-2008, 02:39 PM
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I am GBS + and once finding out from my Dr. was concerned even though she had stated that its a very small chance of women who carry pass it on to their children but that they would want to treat me with an IV when I arrive at the hospital. Whats bothering me so much is, even though I haven't had any reactions to abx before I read that the chances of anaphylaxis is 1:10,000 chance even without allergies to abx. I've been fine with prior abx treatments in my life except for when taken I got severe yeast infections everytime for me no matter how much yogurt or probiotics I took during the treatments.

Does anyone know whether or not IV abx's cause yeast infections as well?

Also when treated with an IV for + can they just administer the abx and you request leaving the needle in but not being hooked up to a bag during the whole labor? I was very busy during my last pregnancy/labor and needed to move around a lot with my first labor in different positions, and its honestly giving me anxiety worrying about being tied down to a pole, so if anyone has info on this and whether I can demand the line be taken off after the first dose and re hooked up for the other doses in between contractions/showering, position changes etc, would be mighty helpful. Daddy already has said he prefers me to get the abx even though I really don't like the idea of getting it, because he'll be upset if the baby gets sick (who wouldn't be :P)
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#28 of 38 Old 11-30-2008, 02:41 PM
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Originally Posted by etoilech View Post

I wasn't tested and didn't want to be. If you are having a home birth or hospital birth and are GBS+ you can also have an intramuscular injection of ABX instead of running an IV.
Sorry didn't even see this prior to my post, thats interesting, so I can demand an IM dose instead?
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#29 of 38 Old 11-30-2008, 03:51 PM
 
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They do it here. I suppose it would be a good idea to discuss it with your HCP before "demanding" it. I can't see a good reason for not offering it as an alternative.
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#30 of 38 Old 11-30-2008, 03:57 PM
 
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Originally Posted by ebbybaby View Post
Does anyone know whether or not IV abx's cause yeast infections as well?

Also when treated with an IV for + can they just administer the abx and you request leaving the needle in but not being hooked up to a bag during the whole labor?
my homebirth midwife will administer the IV abx during labor in one dose (repeated every 4 hours if necessary, but i've never had a labor that long) -- it's a baggie that takes about 15 minutes to drain. during that time, if i want, i'll be able to move/walk/do anything i want (she'll follow me around with the bag). i figure it won't be a huge hassle. if you're giving birth in a hospital, there may be a different protocol... you should ask your dr.

as for the yeast infection, well, i think some women can get them after the IV abx. i'm taking extra probiotics already, and will continue them & keep my fingers crossed after the birth.
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