Can we talk GBS testing? - Mothering Forums

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#1 of 41 Old 08-06-2010, 11:38 AM - Thread Starter
 
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Okay, so there are many of us who are at the stage of GBS testing and many others who have a few weeks yet, but I figured I'd start the ball rolling.

Who's doing it? Who's refusing it?
And then there's the details - my MW has given me the option to forgo it all together, do the swab only vaginally, or to also test anally. What are everyone's thoughts on the swab locations?

For me personally, I've decided to go ahead with the testing, so that in case of transfer we know my status (I've heard if you are untested at time of labor, they often assume + status and reluctant to release the baby timely if they are not able to get the IV antibiotics in). However, I have decided to do the vaginal swab only, as I figure if my anus was GBS+, it would have colonized in my vagina by this point and I would test positive there as well. This is merely my own rationale.

To aid my body in testing negative, I have been doing peri bottle rinses with Grapefruit seed extract (4-6drops GSE in 8oz of water) several times a day, I am taking a daily probiotic (femdophilus), and consuming cloves of raw garlic daily.

So please share your plans.

SAHM to one precious 2 year old and wife to my loving DH. And here we go again!
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#2 of 41 Old 08-06-2010, 11:49 AM
 
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My MW says I have two options:
- Test. If I'm - I'm clear, if I'm + I have to get 4 hrs of IV antibiotics at labor, though I can still birth in the tub, move around, etc. No re-testing, that's it.
- Don't test. If my water is broken more than 18 hrs or if I run a fever at all, I get the 4 hrs of antibiotics, period.

I've done a lot of reading and it seems like a mix of probiotic tablets taken orally and garlic inserted vaginally works, but I'm sort of, erm, active, and I don't think the husband would love the garlic thing.

I've also read that in Europe they use Hibiclens washing instead of antibiotics during labor if you are GBS+. Hibiclens removes all GBS present there for up to 6 hrs. Thinking that's the case, I'm going to wash with Hibiclens before taking the GBS test, since it seems to be a guarantee for a - test. I talked with my husband about this and we agree that while GBS is serious, testing 2 weeks before labor could even possibly happen is BS since status changes more often. We're both comfortable with "throwing" the test.
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#3 of 41 Old 08-06-2010, 12:12 PM
 
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I had the test run last week. I'll find out next week what I tested and go from there.

Teacher Mama to (8/03) (6/06) and (9/10)
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#4 of 41 Old 08-06-2010, 12:14 PM
 
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Originally Posted by louis View Post
Okay, so there are many of us who are at the stage of GBS testing and many others who have a few weeks yet, but I figured I'd start the ball rolling.

Who's doing it? Who's refusing it?
And then there's the details - my MW has given me the option to forgo it all together, do the swab only vaginally, or to also test anally. What are everyone's thoughts on the swab locations?

For me personally, I've decided to go ahead with the testing, so that in case of transfer we know my status (I've heard if you are untested at time of labor, they often assume + status and reluctant to release the baby timely if they are not able to get the IV antibiotics in). However, I have decided to do the vaginal swab only, as I figure if my anus was GBS+, it would have colonized in my vagina by this point and I would test positive there as well. This is merely my own rationale.

To aid my body in testing negative, I have been doing peri bottle rinses with Grapefruit seed extract (4-6drops GSE in 8oz of water) several times a day, I am taking a daily probiotic (femdophilus), and consuming cloves of raw garlic daily.

So please share your plans.
I am testing -- but only swabbing vaginally. My midwife thinks swabbing anally is pointless anyway. I will be doing my own swab. My reason for testing is simply to know in case of transfer from my HB since I've heard horror stories of GBS unknown moms and babies having a hard time with invasive procedures in the hospital.

If I turn out to be positive, I intend to start some hollistic type treatments (I have to research some more, but I believe hibiclens and garlic are two possibilities) immediately to possibly combat it before labor. Once labor starts, I will only be consenting to IV antibiotics if I should happen to show any of the high risk signs such as fever, ROM for 18+ hours, etc. My midwife is on board with all of this -- which is totally awesome

Mom to DD Maia (6/8/04), DS Eli (9/16/10)  and DSS Austin (4/8/96)
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#5 of 41 Old 08-06-2010, 12:46 PM
 
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I need to do more reading on this ASAP to decide what I'll do if it's positive, but I'm planning to have the test done at my appointment this coming Thursday. Then if it comes back negative I can just forget about it. I don't want to fight (if I choose to fight) antibiotics or anything else if I don't have to, so I'll hope for a clean test and go from there.

Isn't it something like 80% chance it will be negative? Or am I thinking of something else?

Jenifer & Tim
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#6 of 41 Old 08-06-2010, 01:11 PM
 
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I am forgoing the test.

Everyone carries the bacteria. You can test positive for it one day and negative the next. That's just the way it is.

SAH Mama to Cooper (3-9-08) and Sawyer (9-3-10).   
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#7 of 41 Old 08-06-2010, 01:22 PM
 
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My midwife could care less...

But, I do know *some* people, when doing the test themselves, to take the swab out of the package, and put it in the test tube container...and then hand it back to the nurse...

My midwife before told me she didn't care *where* I stuck it.

Eh, throw the test and watch yourself for risk factors.

The really frustrating thing to me about this test is that if you are negative weeks before birth, then what if your baby has symptoms? Do they ignore it or assume it could be something else since your were negative?

"If you keep doing the same things you've always done, you'll keep getting the same results you've always gotten."

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#8 of 41 Old 08-06-2010, 02:06 PM
 
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My midwife is having me test at my next appointment. If I don't test, I get treated as positive.

If I do not test or I am positive, I get a vaginal wash. No ABX unless I start to get a fever or whatnot.

Artist, photographer, stay-at-home-mom and Marine wife. Mom to 4; a boy and three little girls.
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#9 of 41 Old 08-06-2010, 02:15 PM
 
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I tested, Vag only, and only to have that info handy in case of transfer.

Mom to two intact boys, born at home. DS1 11/07, DS2 9/10
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#10 of 41 Old 08-06-2010, 02:15 PM
 
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I will allow it. It is a standard procedure, and as far as I can tell, there are no logical reasons not to. It shouldn't be uncomfortable, and if I am + I get IV antibiotics. I like to pick my battles. When it is time to give birth there are so many interventions that I feel strongly against and will have no qualms about signing medical waivers for.

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#11 of 41 Old 08-06-2010, 02:32 PM
 
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I'm going to ask my midwife next week, but does anyone know what quantity of fluids they give you with the IV antibiotics if you test positive? I'm more concerned about over-hydration due to that IV than about the antibiotics themselves, but wasn't sure if I'm concerned over nothing if it's just a small amount of fluids they give with the medication.

And is injected antibiotics ever considered a reasonable alternative to IV? Definitely have more reading to do.

Jenifer & Tim
Caitlin Renee, September 2, 2010
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#12 of 41 Old 08-06-2010, 03:06 PM
 
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I decline the testing and choose to treat based on risk factors (prolonged rupture, prematurity, etc.) I do not worry about in the case of transfer, b/c since this is my 4th birth, I would only transfer for an emergency, in which case, I wouldn't worry about the antibiotics b/c there would really be problems. The transfer rate for first-time moms is much higher, and not always b/c of an emergency, so were I you, I would make the same choice you did, louis.

My MW said a big part of the problem with GBS is all the vaginal exams the doctors do, introducing all that bacteria so high and into the cervix. She says that if we were worried, and really needed an exam, she would use hibiclens during the exam to minimize anything.

Having a bunch of IV antiobiotics unnecessarily is a big problem, IMO, b/c of how it totally destroys my floral balance. I know people who had terrible thrush for weeks and it destroyed their nursing relationship... not something I would want to experience.

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#13 of 41 Old 08-06-2010, 03:52 PM
 
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I also declined testing but have been positive in past and will do hebiclense wash during labor every 6 hours.

Likes a little crunch with occasional sogginess~Misty,Mama to L1, L2, L3, L4,L5 and Loving J!
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#14 of 41 Old 08-06-2010, 04:40 PM
 
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Just got tested at my 35 week appt, but only vaginally. I'm not sure if they'll let me retest if it comes back +, but I'm hoping that since I was taking antibiotics for a UTI, that might work in my favor for a -.

I before E, except after C.  Weird.
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#15 of 41 Old 08-06-2010, 05:00 PM
 
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I like to pick my battles.
I hear ya - but Galatea's post explains why so many women are concerned about the standard protocol for GBS. I 100% agree, IV ABX are NO JOKE and can really wreak havoc on both mom's and baby's systems. See below....

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Having a bunch of IV antiobiotics unnecessarily is a big problem, IMO, b/c of how it totally destroys my floral balance. I know people who had terrible thrush for weeks and it destroyed their nursing relationship... not something I would want to experience.

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Originally Posted by jenifera2 View Post
I'm going to ask my midwife next week, but does anyone know what quantity of fluids they give you with the IV antibiotics if you test positive? I'm more concerned about over-hydration due to that IV than about the antibiotics themselves, but wasn't sure if I'm concerned over nothing if it's just a small amount of fluids they give with the medication.
I just had a client a couple months ago who was GBS positive, so I can tell you what the did for HER, not sure if it's always the same. Might vary by hospital or provider. The did a saline lock, and just hooked up the antibiotics with a minimal amount of IV fluid the first time through. Even though she was drinking during labor, by the second dose, they decided to leave the IV fluids hooked up. Seems like once they get a port available, they tend to like to use it.

Andrea...wife, SAHM to 3.5 yo DS and 1 yo DD.

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#16 of 41 Old 08-06-2010, 05:11 PM
 
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I tested, only vaginally. I don't really see the point in doing the rectal since the baby isn't coming out of there and you are a lot more likely to be colonized there. My midwife wanted it done because she said that she would not strip my membranes if I was positive. Also, she recommended a chlorhexi-something wash if I was positive. I have read that garlic works well, though. GBS can be serious in a newborn, and I definitely agree with the ladies who are doing it in case they transfer to a hospital . A lot of hospitals will treat you as GBS positive if you have not been tested.

Mama to DS (7) , DD (5) and DD (2) and expecting a LO in 2/14

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#17 of 41 Old 08-06-2010, 05:37 PM
 
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I've been GBS positive for the past two births, and I'm assuming I am for this one as well.

Both of my swabs were vaginal/perineal only.

I got IV antibiotics for both births, and to be honest it just wan't a big deal. I had a heplock and they only hooked it up for the antibiotics. After that it didn't get in my way at all, and I didn't feel confined.

Also, nursing got off great. I always use probiotics after antibiotics, but I forgot with my first birth. Still things were great. No complications, no thrush.

I'm glad for the IV treatment actually, considering my labor pattern with both pregnancies...water breaks, then nothing happens for 12 hours, then babies are born about 24 hours later. I never have told the doctors/staff how long my water has been broken (I stay at home for most of labor), so in the back of my head I'm glad I don't have to worry about GBS once I'm at the hospital and having the IV treatment. It's quick. It's not a fussy procedure. I don't mind it.

RedOak ~ Momma to DS (8) , DS (4) , DD (3) , & DD 9/10 ~
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#18 of 41 Old 08-06-2010, 05:39 PM
 
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FYI: regarding the IV/port/heplock...I have it in my birth plan that I will not receive any IV fluids other than what I have approved/requested, and my doctor signed off on that.

So...once those antibiotics are in, I can point to my birth plan (if there's any questiong of stopping fluids) and say "take this out please!"

Birth plans rock.

RedOak ~ Momma to DS (8) , DS (4) , DD (3) , & DD 9/10 ~
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#19 of 41 Old 08-06-2010, 05:41 PM
 
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Originally Posted by jenifera2 View Post
I'm going to ask my midwife next week, but does anyone know what quantity of fluids they give you with the IV antibiotics if you test positive? I'm more concerned about over-hydration due to that IV than about the antibiotics themselves, but wasn't sure if I'm concerned over nothing if it's just a small amount of fluids they give with the medication.

And is injected antibiotics ever considered a reasonable alternative to IV? Definitely have more reading to do.
I wouldn't worry about this. From what I remember, they hook up the IV/heplock with saline fluids, then inject the antibiotic (by syringe) through the IV tube that goes into your arm. It's pretty quick, though they do like to let it go in slowly. Still...it's quick enough, because a nurse has to sit there slowly pressing down on the antibiotic syringe.

And no, you can't do an injection into your body, from what I know. They need it to go into your bloodstream and get to the baby...a muscle-based injection would take too long.

RedOak ~ Momma to DS (8) , DS (4) , DD (3) , & DD 9/10 ~
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#20 of 41 Old 08-06-2010, 05:47 PM
 
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I tested, only vaginally. I don't really see the point in doing the rectal since the baby isn't coming out of there and you are a lot more likely to be colonized there. My midwife wanted it done because she said that she would not strip my membranes if I was positive. Also, she recommended a chlorhexi-something wash if I was positive. I have read that garlic works well, though. GBS can be serious in a newborn, and I definitely agree with the ladies who are doing it in case they transfer to a hospital . A lot of hospitals will treat you as GBS positive if you have not been tested.
chlorhexidine is hebiclense that a couple of us spoke of.
In the case of transfer I'm sure I will get abx, but I am assuming that will be least of my worries. I have had abx by IV with last hospital birth, and single injection at last homebirth and no ill side effects from either.

Likes a little crunch with occasional sogginess~Misty,Mama to L1, L2, L3, L4,L5 and Loving J!
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#21 of 41 Old 08-06-2010, 05:54 PM
 
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http://www.motherlandmidwifery.com/d...BS_ml_0708.pdf

contains some helpful info on informed choices, IV abx, chlorhexidine (Hibiclens), as well and a bit about muscle injection

Likes a little crunch with occasional sogginess~Misty,Mama to L1, L2, L3, L4,L5 and Loving J!
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#22 of 41 Old 08-06-2010, 06:08 PM
 
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Awesome link! Thank you for sharing it here mommamisty!

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#23 of 41 Old 08-06-2010, 06:08 PM
 
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A lot of hospitals will treat you as GBS positive if you have not been tested.
Whatever decision you make, I would just suggest checking with the hospital/midwives/OB whomever about this.

I did test and I *was* negative. In fact I was negative less than a week before I had my baby. Still I had prolonged ROM and despite having no fever (in either of us), perfectly healthy seeming baby with no signs of an infection of any kind they still refused to let him leave until after 48 hours of observation and wanted to do a full septic work up including spinal tap and blood work. I refused both and we left after 24 hours because my family doctor felt that it was a ridiculous policy and signed us out, but it was hospital policy and had he not I would've had to sign out AMA.

So testing doesn't necessarily mean a thing. When I questioned it I was told that your status can change so quickly that even it being done less than a week before doesn't mean you aren't positive at the time of delivery so they still follow risk factors.

As far as I can see that makes testing at all pretty pointless. After all if you are negative at testing but then positive at delivery your baby is at risk... and if you are positive at testing you could be negative at delivery and that would mean you and your baby just both got unnecessary antibiotics with the risk factors that go along with that including thrush and also leading to antibiotic resistance.

FWIW I only had the testing done with DS2 in case I had to transfer. I wanted to be able to avoid the hassle if I was negative and it did me no good.

Alison
Mama to Toad (08/06), Frog (01/09)... and new baby Newt born on his due date, Sep. 8, 2010
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#24 of 41 Old 08-06-2010, 06:36 PM
 
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I wouldn't worry about this. From what I remember, they hook up the IV/heplock with saline fluids, then inject the antibiotic (by syringe) through the IV tube that goes into your arm. It's pretty quick, though they do like to let it go in slowly. Still...it's quick enough, because a nurse has to sit there slowly pressing down on the antibiotic syringe.
.
At the birth I spoke of, they hung a bag and it took about 15-20 minutes total for the ABX to get in. Again, this must be something that varies by hospital/provider because now that you mention it, I think I remember births in the past where a nurse sat there and pushed it through. Something to ask so you know what to expect.

Andrea...wife, SAHM to 3.5 yo DS and 1 yo DD.

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#25 of 41 Old 08-06-2010, 07:30 PM
 
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I'm going to ask my midwife next week, but does anyone know what quantity of fluids they give you with the IV antibiotics if you test positive? I'm more concerned about over-hydration due to that IV than about the antibiotics themselves, but wasn't sure if I'm concerned over nothing if it's just a small amount of fluids they give with the medication.

And is injected antibiotics ever considered a reasonable alternative to IV? Definitely have more reading to do.
It is a very small amount of fluid that they dilute the antibx in -- like 50-100 mL.

Mama to DS (7) , DD (5) and DD (2) and expecting a LO in 2/14

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#26 of 41 Old 08-06-2010, 07:31 PM
 
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Whatever decision you make, I would just suggest checking with the hospital/midwives/OB whomever about this.

I did test and I *was* negative. In fact I was negative less than a week before I had my baby. Still I had prolonged ROM and despite having no fever (in either of us), perfectly healthy seeming baby with no signs of an infection of any kind they still refused to let him leave until after 48 hours of observation and wanted to do a full septic work up including spinal tap and blood work. I refused both and we left after 24 hours because my family doctor felt that it was a ridiculous policy and signed us out, but it was hospital policy and had he not I would've had to sign out AMA.

So testing doesn't necessarily mean a thing. When I questioned it I was told that your status can change so quickly that even it being done less than a week before doesn't mean you aren't positive at the time of delivery so they still follow risk factors.

As far as I can see that makes testing at all pretty pointless. After all if you are negative at testing but then positive at delivery your baby is at risk... and if you are positive at testing you could be negative at delivery and that would mean you and your baby just both got unnecessary antibiotics with the risk factors that go along with that including thrush and also leading to antibiotic resistance.

FWIW I only had the testing done with DS2 in case I had to transfer. I wanted to be able to avoid the hassle if I was negative and it did me no good.
That is ridiculous, Alison. That really stinks that you had to go through that. That really doesn't make any sense to me at all to do all that stuff just for prolonged rupture.

Mama to DS (7) , DD (5) and DD (2) and expecting a LO in 2/14

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#27 of 41 Old 08-06-2010, 07:35 PM
 
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I did test and I *was* negative. In fact I was negative less than a week before I had my baby. Still I had prolonged ROM and despite having no fever (in either of us), perfectly healthy seeming baby with no signs of an infection of any kind they still refused to let him leave until after 48 hours of observation and wanted to do a full septic work up including spinal tap and blood work. I refused both and we left after 24 hours because my family doctor felt that it was a ridiculous policy and signed us out, but it was hospital policy and had he not I would've had to sign out AMA.

So testing doesn't necessarily mean a thing. When I questioned it I was told that your status can change so quickly that even it being done less than a week before doesn't mean you aren't positive at the time of delivery so they still follow risk factors.

As far as I can see that makes testing at all pretty pointless. After all if you are negative at testing but then positive at delivery your baby is at risk... and if you are positive at testing you could be negative at delivery and that would mean you and your baby just both got unnecessary antibiotics with the risk factors that go along with that including thrush and also leading to antibiotic resistance.

FWIW I only had the testing done with DS2 in case I had to transfer. I wanted to be able to avoid the hassle if I was negative and it did me no good.
We did the test, only vaginally (I didn't know they did a rectal swap, how stupid!) and my MW gave me the stick and I went to the bathroom myself, so it was not as weird me doing it as someone else.

We did it in case of a transfer. If it is negative, we can tell the hospital it's negative and they will leave us alone. I don't think labor or directly postpartum is a fun time to fight policies and deal with rude pushy people and have them scowl at you when you do sign the AMA, I just don't want to deal with that.

I am going to talk to my MW about testing every week till the baby comes that way I'll know if I am positive or not closer to the birth time. If we are positive, we are going to do the Hibiclens and such in labor. Also, if we are positive, I may just decide to leave that info out if we transfer and just do the Hibiclens at the hospital.

I don't know, it depends on how soon she can get back to me with results.

She said if I'm negative, I can go longer after ROM with no antibiotics. If I'm positive, and my water never breaks, (as we're not planning on vag. exams either) or breaks late in labor, we won't have to do anything.


---I'm still on the swabbing of the butt, how stupid is that, seriously!
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Just read this:

"(if positive, there
is an 87% chance you will carry GBS at birth; if negative,
there is a 96% chance you will not carry GBS at birth)."

It was on the link provided above. Good to know. If we are negative, we won't test again, but if we're positive, we'll do the echinacea, probiotic, garlic, etc and retest every week to see if it got rid of it.

If we are still positive when labor comes, we'll use the hibiclens. Our son has an allergy to penicillin, and that was NOT NOT NOT fun to go through, he had a reaction called erothema multifory (sp?) and it was torture! So I in no way want to facilitate this baby building up an allergy to penicillin.
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#29 of 41 Old 08-06-2010, 08:24 PM
 
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I went ahead and let them test me. My midwife just swabbed vaginally, and like I was with my daughter, I'm negative.

hippie.gif Hi, I'm Amber

Ava {12.20.08}  Levi {8.19.10}  Aspen  {EDD 7.21.13}

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#30 of 41 Old 08-06-2010, 08:55 PM
 
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I tested positive vaginally last time...didn't do the rectal swab.

My plan was to only do the abx if I developed other risk factors. My waters broke 18 hours before my DS was born and I had a stalled labour so I went ahead with the abx. It was done through a heplock with the abx diluted into the small bag of fluids. It took about 5 minutes to get into me and then they unhooked the heplock from the bag.

The heplock was a PITA though. It interfered with how my wrist could bend and that really bothered me while I was trying to find a position that felt right to labour in.

This time we will test again, to make it easier in case of transfer, but will only use the abx if I develop other risk factors. My 2nd baby was born in a 2 hour labour, so if my water doesn't break in advance again then I could get the abx for no reason if I have another precipitous labour.

Also, the abx ruined my flora. My baby and I struggled with thrush for months afterwards. And, related or not, my baby also had issues with ear infections and was non-reactive to the abx he was given for those. I wonder if it's because of the abx we got while I was in labour.

Emily: Homebirthin' mama to 3 boys and a girl.
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