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Discussion Starter · #1 ·
Ugh, due in 3 weeks and just got back a positive test for GBS.


Having a homebirth with a very experienced midwife we really trust, but also know she tends to be a little more conservative that many.

She recommends using a clindamycin cream for treatment, paired with the usual natural remedies and hibiclens to get the GBS levels down to a neg. test and and get myself recolonized with the good stuff. Her hope is that at least the last test I do prior to birth will be negative, and that we'll do the hibiclens during labor and all will be fine. I think if I still test positive right up to the last test, she'll recommend IV abx, which she could do at home here but I'd probably decline.

I'm on the fence about the clindamycin for all the obvious reasons. I'm wondering if anyone else here has used it and what your experience was. And I'm wondering if it's somehow any more effective that the "usual" natural treatments plus hibiclens anyway...

Also wondering: what are the implications for GBS and water birth or laboring in water? I just ordered a birth pool and I LOVE water so was really hoping to use it!!!

I didn't even notice when my membranes ruptured with DS 1; the OB (hospital! yuck) was all freaked out when she felt hair, b/c I hadn't even noticed the rupture. Got IV abx b/c of that, not knowing how long it had been... I was neg for GBS that time. I'm worried I might not notice if my membranes rupture this time either, and being potentially GBS +, does that rule out water labor or birth??

And finally, my mw recommends the hibiclens in a peribottle at EVERY PEE until birth!! I never heard that b/f...

Any advice much appreciated!!!
 

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Clindamycin is recommended only if you are allergic to penicillin, and then only if the strain has been tested to see if it is sensitive to clindamycin. The protocol you describe is contributing to antibiotic resistance. Not cool.

There are studies with protocols for the hibiclense. "With every urination" is arbitrary and I would ask her rationale for that.

Your results should have no effect on your plans for a water birth.
 

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I don't know about the cream, but the hibiclens is very effective by itself, so personally I would be (and was) satisfied with that. Doing it at every pee seems excessive, but it's a minor thing and I'd go ahead if that's what your MW asks.

The pool is fine--even during my hospital labor with #1, when I was GBS+, they had no problems with me laboring in the pool, even after my waters broke.

The risk of baby becoming infected are very, very small: the risks increase with prolonged ROM, and if you have a fever during labor. But even if untreated, your baby is not at a very high risk at all. In many countries they don't even test for it.

Just keep everything out of your vagina, esp after your waters break (but at any time until baby is born, basically).
 

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Discussion Starter · #6 ·
Wow, great links, thanks!

Met with MW and she said the following, which made sense to me, actually:

-when she has the gbs test done, she has them check the particular strain against a handful of antibiotics and penicillin so neither she (nor hospital, if it comes to that) offers something that it's resistant to. my particular strain is NOT resistant to clindamycin, so that's how she knows a clindamycin cream will be likely effective for knocking it out in my vagina. that doesn't really speak to the gbs that's in the rectum (excuse the graphics!), so hence the hibiclens squirt after using the bathroom (particularly after bm)--as a prophylactic against recontaminating the vag.
 
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