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I just found out today that I tested positive for strep B. Before learing this, we had planned to labor at home as much as possible and to go to the hospital once I am near transition. But now it sounds like I will need an iv with antibiotics. When is the safest time for me to go to the hospital?

Also, I'm really nervous about the effects of the antibiotics on me and the baby--yeast infections or thrush. Did anyone else have this worry? If so, what did you do? I thought about taking acidopholous as soon as labor is over, but will that help the baby?

any information would be sooooo appreciated.
 

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First off, you might want to search these boards for info on home treatments for group beta strep. It's possible to treat it and get rid of it so that you test negative before labor and don't have to use antibiotics. If you're comfortable doing that, that's one way to go.

Also, the CDC is, I think, changing its recommended GBS protocol from "antibiotics for everyone" to "antibiotics only if risk factors are present during labor itself (fever, etc., I don't remember all of them)." You may want to look into this and decide for yourself whether you want to do antibiotics no matter what or whether you want to use them only if the risk factors happen.

I was GBS positive and ended up with only one dose of antibiotics at my birthing center. I didn't feel comfortable refusing them. In hindsight, I would have treated the GBS and asked for a retest, because we did end up with major yeast problems. Or, I would have refused antibiotics unless one of the risk factors had occurred during labor.

No matter what I think it's a great idea to take probiotics, both before and after labor. It's also safe to take some of the powder and put it in your baby's mouth on a regular basis after birth to help the baby ward off thrush. You may also want to cut way back on sugars in your diet before your due date and after your delivery, to give the yeast less to feed on if you do decide to go the antibiotics route.

Here's the best resource I've found online for dealing with thrush if it becomes an issue:

http://www.breastfeedingonline.com/yeast.shtml
 

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I believe I was told that the risk is as the baby travesl through the canal. But I'm not 100%. I agree to ask them to retest close to due date and see if has cleare dup. I'm going to do so if I test + again.

I wish I could tell you when the best time to go, but I'm still trying to figure out how to have spontaneous labor
: I haven't gotten right in 4 attempts yet.

I nor my babies had any problems with thrush or yeast after delivery, and we(I) were treated with antibiotics.
 

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I've done a lot of research on GBS. Here was my conclusion.

There's a 1-2% chance that your baby will contract an infection. That's pretty small.

There's a 33% chance you or the baby will get a yeast infection if you take the antibiotics.

The CDC guidelines suggest antibiotics if the following three risk factors are present, and I agree with them becuase the risk of infection goes to 50% or more in these cases and can be really life threatening for baby.

1. Fever present during labor
2. Membranes ruptured more than 18 hours.
3. Premature delivery before 37 weeks.

I declined antibiotics for my first child. she was perfectly fine.

I am declining antibiotics for this pregnancy/labor and my doc congratulated me on doing some good research and said he is in total agreement. We will only do antibiotics if those three risk factors are present.

But you have to do what you're most comfy with. There is a risk, but it's small.
 

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hi Rebekah~ I also just tested + for GBS & that after doing 2 wks of home treatments (garlic supplements, Vit C & an herbal peri-wash). I have now added 2 wks of echinacea, still the garlic & Vit C, & a stronger douche/wash of hibiclens & we will retest Friday just to see.

Luckily if I do decide to go with the IV antibiotics, it changes my birth plans very little bcz my midwife can administer it all @ home. If it meant a hospital transfer to get the IV for me it would be an entirely differnt decision to make. FWIW, as my MW & I have explored this, she related that her women who do the IV seem to have a speed up of labor while the IV is being administerd, not to the point of difficult to handle. It's only one MW experience, but I thought that was interesting as I am very concerned about "medical" stuff interfering in my labor process.

Anyway, I hear your concern about having to go to the hospital earlier than you thought & I assume you are thinking of the risks of more interventions, etc. the longer you are there, esp pitocin & PROM to "get you going" & then that leading on & on. Can I ask what kind of labor support you are planning on using @ home & in hospital? I think this is your 1st baby, but I can't remember if you have a doula, have taken a CB class or what. I know it might feel late in the game @ this point with your due date coming up this month, but if you don't have a doula that is familiar with helping mamas have a natural birth in your hospital, I would strongly recomend one! Esp the longer you are going to be there, KWIM?

Frankly it could work to your advantage to go in earlier in this way: If you go in strong with a positive birth plan to labor naturally & have plenty of labor support, you can create a safe environment for yourself & have that continuous, safe environment thru out active labor & 2nd stage, into pushing, etc. Having your own doula that stays the entire time buffers you against the negative effects of shift changes during your hospital stay, etc. I hear alot of women who are laboring great @ home, only to have the whole thing slow or stall bcz of the disruption of heading into the hospital environment. Then they need extra time to get settled & restart things & get pegged "failure to progress." Bummer.

As far as doing the anti's, I'm thinking a 2% chance of my baby having GBS desease is more serious than a 33% chance of having thrush. Maybe I am minimizing the thrush bcz I've never had it, but it's not deadly to my knowlege! Also, after reading the CDC page, I believe they are switching to IV anti's for all + testers & away from the 3 red flags mentioned earlier. But I may have read it wrong?
: I also feel that I can mitigate the anti's effect with the probiotics: I have found several by searching under "probiotics" here on MDC that I want to check out. Overall, I am leaning toward taking the anti's but if my retest(finger's crossed!) is - I'll skip them.

sorry I have rambled on so long. I would love to hear more about how you are processing your decision bcz it has been a hard one for me!
blessings, Maria
 

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Yes, do a search of these boards, there is loads of info, I know because I was gbs+ with my last pregnancy. You probably will find my original query! In the end I decided to opt for the antibiotics, but we were never given the time to administer them because I went from 2 centemeters to having a baby in about 10 minutes (literally). Also my water never broke, Dylan was born in her amniotic sac! It was so cool, but that is another thread! I know how challenging it can be to try and make this desision. I did find out that they like you to get a dose about 2 hours before you deliver. SO, unless your labor is anything like mine (29 intense hours of no dilation followed by a VERY quick active labor, transition, and pushing stage) you could just wait until you are pretty sure youre close to transition then go to the hospital. I tried to treat my gbs, but I was 36 weeks when we found out, so when it didnt work the first time, I didnt think I would have time to try again (little did I know she would be 15 days late). If you have time, you could try to treat it. You can search these boards for the remedies, there are qutie a few!
 

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Discussion Starter · #7 ·
Thanks for all your suggestions. I spoke with my doula today and I've decided to go with the antibiotics. The risk feels to great of something happening to the baby. What sucks is that there is decent chance of thrush and I really DON'T want to start off nursing that way--it seems hard enough as it is. But I just have to recognize that I can deal with it and get support and that I will get through it.

Maria: In terms of labor plans, my doula said that what matters is that the baby gets antibiotics at least 4 hours before delivery. So what this means is that instead of trying to stay at home until transition, that I'll have to go to the hospital once active first stage begins (because I just don't know how long my labor will be and my Mom and grandmother had REALLY fast labors). I suppose I'm getting adjusted to all this. It isn't ideal and it is disappointing, though.

Ideally, we'll get the antibiotics and NO thrush!!
 

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I hear that once you test positive they will not retest you, and that even in a future pregnancy you will be considered positive because the test is too expensive to repeat.

If that's not true, that would be great.

I had 4 doses of antibiotics. They said it would be a 20-minute drip but it was really an hour, because the stuff burned my veins so much that they had to drip it in as slow as possible. Then there was supposed to be 2 hours between doses, but they count from the beginning and not the end of the dose, so it was more like only an hour without being hooked up. Also, during my last dose they sneaked in some Pitocin.


I will do ANYTHING to avoid it in the future! I'm saving every piece of info, every article, every post on GBS I can find.

Also, I hear that even women who are having a planned c/s can still pass it to their babies and still need the shots (though probably anyone having surgery gets antibiotics).

I also heard that the CDC wants to do away with all GBS testing and just give everyone antibiotics, because of the cost of the test. I like their recommendation of giving anti's only when risk factors are present so much better!

Oh, and I never had thrush or yeast infections.
 

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I have tested negative with my first two pregnancies - will test next week with this pregnancy. I have never heard of it being an expensive test (it is just a vaginal swab that goes to the lab - how could it be more expensive than any blood test or a test done for strep throat at the pediatrician office, etc.) or of everyone being treated with antibiotics in the future to avoid the "expensive" testing. That just sounds off to me - did a doctor give this info? Or a book? I am just very curious as it doesn't seem right to me. Not questioning that someone told you that - it just sounds funny to me. If the medical community wants to save big $, quit doing routine ultrasounds on perfectly healthy women just for the heck of it....

My understanding is that one school of thought gives antibiotics through an IV to all who test postive for GBS. Other school of thought gives IV antibiotics only to those who have a fever or the other factors mentioned in a previous post.

I had a raging case of thrush with dd2 (went undiagnosed for weeks until it was just so awful....) and wouldn't wish that on anyone but I also know a woman who wasn't tested for GBS, did have it, her baby died a couple of days after birth. I don't think you can compare the agony of thrush with the horror of losing a child (even though that is a very small percentage chance - if it was your baby, it wouldn't matter).

Good luck deciding - I hadn't heard (before reading this thread) of trying to clear it up between testing and birth. I will keep that in mind if I ever find myself in that situation.
Kirsten
 

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Quote:
I also heard that the CDC wants to do away with all GBS testing and just give everyone antibiotics, because of the cost of the test.
I work for a birth center and we charge $32 for the GBS test. The lab we send it to charges us $22. Not too expensive if you ask me. An IV in labor cost $75 for the first hour and $60 for each additional hour plus $20 per dose for the Ampicillin (antibiotic).
 

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I was GBS+ with DS#2 and thought I was barely into labor but when I got to the hospital I was already 9 cm! So I didn't end up getting even a full dose of antibiotics before he was born so they just kept me an extra day to observe baby. To combat yeast they told me to take 2 acidiophilus tablets 2xs a day for a week and it worked no thrush. Good luck!
 

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I was gbs+ with my first pregnancy, and did all the "routine" requirements, never knowing there were any alternatives. This time I will test negative. How? Well, I'm following my doulas plan of eating at least a 1/2 cup plain yogurt twice a day for the week preceding the test, along with taking a little extra acidophilus orally, and vaginally(just put a capsule up there)at night, along with my own idea of tea tree oil suppositories for the week preceding the test(available at your local health food store). I also take garlic capsules daily, and I try to keep my sugar intake to a minimum(bacteria looove sugar). If this doesn't produce a screaming negative, I don't know what on this planet would.

I'm deathly against doing the I.V. antibiotics for many reasons. First, it puts you in the role of a sick patient. Your mind may say "preventative care", but your body screams, "I'm sick, I have medications being pumped into me, and I'm tied to an I.V. pole." Second, the amount of fluid which is being pumped into you along with the antibiotic can cause your contractions to be less effective, and it can give you and the baby fluid overload. This can give baby a falsely elevated birth weight, and cause breastfeeding problems when the baby loses all that water weight. It makes it look like the baby isn't doing well, when all they did is dump the water weight, but the docs will get all concerned over the loss. (Can you spell "supplement?)Read Henci Goers"The Thinking Woman's Guide to a Better Birth". The I.V. section was fascinating. Any post I leave right now is very preachy, because I'm going for a vbac, and I'm mentally gearing up, So please forgive me(Or learn from my mistakes).

 

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Wow Luckymom that is very interesting about the fluid overload with the IV. Now I'm totally wondering about the birth of DS#1. (I didn't have antibiotics for his birth but I did receive IV fluids) At his two week checkup he wasn't back up to his birthweight and yes the doctor was extremely concerned he was dehydrated. Maybe the elevated birth weight came to play in his case. Learn something everyday huh?
 

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I am so glad I happened upon this thread, thank you.

I just had my 8 week appt. and was told my urine tested positive
This did not happen in my last pregnancy. I am planning on having a midwife assisted hospital birth but so wanted to do it without having an IV in my arm (which I did with dd#1 due to membranes breaking and having to finally induce with Pitocin after 36 hours of no labor)

I will not met my midwife until my 5th month when I move cross country but I will at least be prepared with all of the information I can gather here at MDC!

BTW, I am on a round of antibiotics and my Dr. said she will retest next month and every month (I think she said that) for GBS...so it must not be that expensive! I tend to not get yeast infections (cross my fingers) although I have only been on antibiotics about 2x in the last ten years.

Thanks for all the helpful info. people have shared.

~Deirdre
 

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Testing at 8 weeks is unusual, isn't it? Don't they usually test between 35 and 37?

Also, I was told the risk of illness is 1/100, but the risk of death is 1/2000. The babe would have a 4x greater chance dying of SIDS.

But, what is the chance of all of us dying in a car crash on the way to the hospital? (For us it was a 20 mile drive in the winter on a busy highway.) And what of the chance of dying from a hospital-acquired infection? I read it was the fourth leading cause of death among adults. How about the chance of a medication error? I had an IV; anything could have gone into it.

A 1 in 2000 death risk is not a chance I would like to take when it comes to my babe, but I think driving to the hospital is probably one of the most dangerous parts of labor; a very real death risk that almost everyone is willing to accept.
 

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Testing at 8 weeks sounds very whacky,as does testing via urine. But crazy or not, use this information and time to do the research. Your gbs status really doesn't mean anything until those last few weeks. If you get a negative at 37 weeks, noone is going to hassle you. You're given a 5 week "window" in which the medical world will view your results as negative. Which really doesn't make much sense anyway, since you can be positive one week, and negative the next, and vise-versa.

Hmm..Anyone ever heard those stories about women who give birth in their sleep? Wouldn't that be a heck of a lot simpler?
 

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Oops! I think my post was confusing! My Strep B showed up in a urine test not in the vaginal canal. I went to the lab a week ago and had a blood draw and urine sample taken (which I thought was normal 8 weeks or so)
: But then again I can't remember much from my last pregnancy, lost that half of my memory breastfeeding


So I went to the Dr. on Friday and was immediately told I have a UTI (which I had no idea I had as the only symptom I had was frequent urination which I just thought was caused by pregnancy). I then met with the OB who said my urine result showed I have Step B in my urine which means I have a bacterial infection. She prescribed treating it with antibiotics and said they would test again next month. She said they want to prevent a potential kidney infection. She then said that they would continue to test me and if it reoccurred (she didn't specify when exactly) I will have to be treated with antibiotics during delivery. She said because it is in my urine there is a possibility it will be in the birth canal also.

So I suppose I am putting the cart before the horse and really don't need to worry about L&D right now and just look at it as a basic UTI. It is just that the way the Dr. "presented" it it sounded like antibiotics during delivery was already a done deal. Anyway, she isn't the one delivering so I guess I will just take the matter up with my midwife when I move.

Thanks for all your input


~Deirdre
 

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hi~ this is some info from the CDC, you can find it by going to www.cdc.gov & search the alphabetical listings for Group B strep, the link for the report these quotes are from is
www.cdc.gov/mmwr/preview/mmwrhtml/rr5111a1.htm

Quote:
Intrauterine infection of the fetus results from ascending spread of GBS from the vagina of a colonized woman who is typically asymptomatic. Fetal aspiration of infected amniotic fluid can lead to stillbirth, neonatal pneumonia, or sepsis. Infants can also become infected with GBS during passage through the birth canal, although the majority of infants who are exposed to the organism through this route become colonized on skin or mucous membranes but remain asymptomatic.
In pregnant women, GBS can cause clinical infections, but most women have no symptoms associated with genital tract colonization. Urinary tract infections caused by GBS complicate 2%--4% of pregnancies (12,13). During pregnancy or the postpartum period, women can contract amnionitis, endometritis, sepsis, or rarely, meningitis caused by GBS (14--19). Fatalities among women with pregnancy-associated GBS disease are extremely rare.

Quote:
In the absence of GBS urinary tract infection, antimicrobial agents should not be used before the intrapartum period to treat asymptomatic GBS colonization.

Quote:
The presence of GBS bacteriuria in any concentration in a pregnant woman is a marker for heavy genital tract colonization. Therefore, women with any quantity of GBS bacteriuria during pregnancy should receive intrapartum chemoprophylaxis. Vaginal and rectal screening at 35--37 weeks is not necessary for these women. GBS can cause both symptomatic and asymptomatic urinary tract infections, which should be diagnosed and treated according to current standards of care for urinary tract infections in pregnancy. Women with GBS urinary tract infections during pregnancy should receive appropriate treatment at the time of diagnosis as well as intrapartum GBS prophylaxis. Laboratory personnel should report any presence of GBS bacteriuria in specimens obtained from pregnant women. For this to occur, labeling of urine specimens to indicate that they were obtained from a pregnant woman is imperative.
It was pretty interesting to read the CDC report for myself. It seems to me that from the above info, the risk of dangerous infection from contraction during passage thru the vagina is pretty low "although the majority of infants who are exposed to the organism through this route become colonized on skin or mucous membranes but remain asymptomatic." But intrauterine infection prior to delivery carries more risk. So why the push for intrapartum prophylactic antibiotics? I guess bcz they just don't know if a baby might already have an intrauterine infection & they are wanting the antibiotics on board ASAP? Hmmm, sounds like a good reason to avoid uneccesary internal vaginal exams to me!

Also, I think GBS is looked for in the urine pretty routinely along with other possible infections during initial penatal work-ups, someone with a urinary tract infection of GBS is considered symptomatic of colonization in themselves. The vaginal/rectal GBS swab that is done around 35 wks is to find women who are colonized but asymtomatic.

blessings, Maria
 

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Thanks SpiralWoman.

I will go and read the report but from the snippet you included it looks like the CDC is saying that it is a "done deal" (in their protocol) for me as far as intrapartum prophylaxis goes...unless I am misinterpreting? I have Strep B in my urine at 8 weeks.

Anyway, like I said I an going to try not to worry about this so early and address it later on with my midwife.

I am so glad to be able to come here and get so much information


~Deirdre
 
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