[crayon]

My doctor want to do a strep group B test on me today. I was wondering if anyone who has had a home birth has decided not to be tested for this? We are really planning an UC and I have read up on strep group B and they said even if tested positive it should only be given to women who:

When labor is premature;
When there is premature rupture of the membranes;
When there is prolonged rupture of membranes (>12 hours) before the baby is born;
If the mother has a fever (>100.4 F) before or during labor;
Women who have a history of GBS in previous births

Well, I am 37 weeks so I am not really premature now, and you will not know the others until the day gets here. It is also my first so cross the bottom one off.

I know it is not an invasive test but I am still planning on a UC and they will want me to go to the hospital for meds. DP thinks it is an invasive test. He is not comfortable having anyone touch or look at me down there. I have a woman doc and I am not real worried about that. Just needed some advice!

 

[lorijds]

Well, first of all, who is "they"? Usual protocol is to give antibiotics if someone is group b strep positive. The parameters you gave actually usually refer to people who tested negative (except for the history part).

If you are going to have a UC, why test? What are you going to do differently if you test positive?

If you want to test, the doc doesn't have to do it. At our clinic we have moms go into the bathroom and do it themselves. You just take the swab, insert it into your vagina about an inch or so, and make a circular swab. Then take the swab out, insert the same swab into the rectum, again about an inch, make a circular swab, then remove it and put the swab in the container provided with the swab. It is easy, and much less invasive if you do it yourself rather than the doc.

 

[crayon]

Okay, I decided not to have it done. Mostly because with a UC what is the point? I also have a very good doc for the baby and I will just let him know we decided against it. I felt it was stupid because even if I end up going to the hospital, it will do no good because I will be so close to the end anyway. My doc seemed very pissed off at me I must say. But, I am fine with my decision and take the responsibility for any complication for myself and my baby.

 

[Peppamint]

Hi Angela,

How did your Dr. take it? I have a backup OB and saw him once at 24 weeks and he was cool with me refusing the GTT and said I could choose whether or not I wanted the GBS test. Mw and I decided against it (or I should say I decided against it and mw agreed). LOL

Good luck with your UC!

 

[crayon]

So the doc was a bit upset with me

but hey what can I do

My job is not to make her happy! So, then she wanted to know why I haven't had a pap, because "you can never know 100% if your partner is telling you the truth"

: And he was right there!!! I told her I got a pap done before and I don't feel the need to get one done now. She was even more upset. I tell her everytime I see her that I am staying home as long as I can until I feel like I should be at the hospital (no way am I going there!

) I think she just wants to give me a reason to go. Sorry, not going to happen. I also was thinking that the chances are so small and the risk of false +/- it made it stupid to get. I havea great baby doc and I will just watch my baby for any signs that he/she needs to be checked out for anything. No need worrying myself over things I cant control.

 

[Peppamint]

Way to stand up for yourself!

You're a good momma to be so informed and willing to take flak for not doing it the Dr's way.

 

[elaine]

the only drawback is that if for some reason you did have to transfer to the hospital either during or after the birth, they may want to give you and/or the babe antibiotics, 'just to be on the safe side' if you hadn't been tested.

I was gbs+ and planning a home water birth. I took echinacea and propolis tinctures twice a day for two weeks as instructed by my midwife. I had faith that it would work.

in the end it didn't matter cause I transfered and had a c-section (with antibiotics, of course) I never imagined that would happen to me. and I had the best lay midwife in the area.

but good luck to you!

 

[moonlightinvt]

Sorry, I don't know what UC stands for so this response may be inappropriate.

My midwife let me take the test myself (just like "lorijds" did). I did test positive. She told me to take TEA TREE SUPPOSITORIES (purchased at my local food co-op) for six days prior to my due date--of course we didn't have a crystal ball so I was only able to do 4 treatments before I went into labor. No complications with baby!

Best of luck!

 

[bloodrayne]

My midwife has given me quite a bit of information on this. I'm still not sure what I'm going to do, as I want to talk to her a bit about it first.

Either way, I thought it might help if I posted some quotes from the information she gave me:

Group Beta Strep Colonization in Women, and GBS disease in the Newborn

6% to 25% of women are colonized with GBS.

GBS disease of the newborn is a very serious infection. GBS disease usually develops in the first few hours after bith, although symptoms sometimes take a week to appear. GBS disease often results in sepsis (an overwhelming infection), pneumonia (a lung infection), and meningitis (a brain infection).

Babies who develop signs of GBS disease can be treated with antibiotics (usually Penicillin), but treatment does not always prevent damage or death from the disease.

Six percent of babies with GBS diease will die and 20% of those who survive will have some kind of permanent disability such as hearing and vision loss or brain damage.

GBS disease occurs in 2 out of every 1000 newborn babies.

Detecting Group Beta Strep Colonization in Pregnant Women

Is is possible to do a simple vaginal/rectal swab at 35-37 weeks of pregnancy to test for the presence of GBS in the mother. Unfortunately, because of the nature of the GBS bacteria, cultures are not always accurate in assessing colonization.

It is possible for a colonized woman to have a positive culture one day and a negative culture the next. Some of this is due to difficulties with the culture itself, and some of it seems to relate to variations in the number of bacteria present at any specific time.

Cultures done at 35-37 weeks will detect 85% of colonized mothers. Unfortunately, that means that 15% of women tested will believe they are not at risk, when they actually are colonized with GBS, but the test did not detect it. Therefore, it is possible for a baby to contract GBS disease without the mother testing positive for GBS.

Remember also that testing positive for GBS colonization does not mean that your baby will get GBS disease. Only 2% of babies of colonized mothers will develop GBS disease.

Preventing GBS disease

Because treatment of newborns with GBS disease after they are born is often not enough to prevent major complications, pediatricians and obstetricians have collaborated to study ways to prevent as many cases of GBS disease as possible.

Possible treatment strategies that have been explored include simply treating all newborns or all newborns of colonized mothers with one dose of antibiotics (a shot of penicillin) shortly after birth. Because the disease usually develops in the first 12-24 hours of life, it was hoped that the disease could be prevented by pre-treating newborns at risk. Unfortunately, this treatment was not shown to prevent GBS disease.

The idea of treating all pregnant women who are colonized with GBS during the pregnancy has also been explored. Women who tested positive by culture for GBS were treated and most of them were positive again three weeks later. There does not seem to be a way to eradicate GBS bacteria from women's bodies.

Treating women during pregnancy did not reduce the rate of GBS disease in their babies.

Treating women during labor with IV antibiotics has been shown to prevent GBS disease in the newborn. The antibiotic must be given at least four hours prior to the birth to allow the antibiotic to pass into the amniotic fluid and treat the baby. If colonized women are given antibiotics during labor, 90% of newborn GBS disease is prevented.

Antibiotic Treatment to Prevent GBS Disease

If treating mothers during labor will prevent 90% of GBS disease, then why don't we simply give all laboring women antibiotics?

The answer is threefold. Some people are allergic to penicillin and will have a reaction to the treatment that could be worse than the disease, giving antibiotics to all (or most) pregnant women will lead to the growth of bacteria that are resistant to antibiotic treatment, and treatment is expensive and logistically difficult to give to all laboring women.

Prenatal Testing Strategy

If all pregnant women are tested for GBS and those who are positive are given antibiotics during labor, 27% of all laboring women in this country will get antibiotics. This will prevent 90% of GBS disease.

Using this strategy, all women will be tested during pregnancy and those with positive cultures will be recommended to have IV antibiotic treatment during labor.

 

[MossbackMeadow]

I am still unclear as to where GBS comes from - who is at risk? Is it a multiple partner thing? I can't seem to find any info on this.

FYI - this was posted on a UC list I belong to. Maybe it will help someone.

Here are some alternative therapies for the treatment and prevention of Group
Beta Strep:

At 35 weeks:

Take 100 mg additional vitamin C daily.

Take 25 drops Astragalus Tincture, 3 times daily.

Eat raw garlic every day.

Take sitz baths or rince your vaginal and perineal area using a peri bottle,
with the following herbal infusion. This will help restore vaginal flora
while reducing bacterial counts. Infuse equal parts of thyme, calendula,
yarrow and rosemary, using 4-6 tbsp of the mixture per quart of water. Steep
for 30 minutes. Strain into a clear jar. Add 1/4 cup sea salt and 10 drops
essential oil of lavender. If you are taking a sitz bath, add the entire
quart to the tub. If you are using a peri bottle, fill the bottle and
refridgerate the remainder of the infusion.

Visualize our vaginal canal as pink and healthy, a nourishing place that our
baby will pass through on his or her own journey.

At 37 weeks:

Insert one "Y-stat" vaginal suppository at night.

Take "nutribiotic" liquid or caps, two times daily as directed on the label.

 

[lilyka]

I was GBS + I am unclear where it comes from but lots of people have it and like yeast it is onlly a problem if there gets to be too much there ans you pass it on to your baby. it is rare but very serious if your baby contracts a GBS infection.

I had every intention of getting the antibiotics and went in to talk with my MW about treatment options. Luckily I had Ava during that prenatal (go figure) and never made it to the hospital so treatment was impossible. They just watched her and did a blood count )which came back elevated for other reasons and caused a whole mess of blood work but that was all reletively unrelated to GBS) The risk of transmition to her was very slight since my water broke 5 minutes before she was out. Anyway, like the OP said there are signs you can look for and so long as you act quickly on any of those symptoms then you and baby should be just fine.

Oh, and it definitely isn't a multiple partner thing. I know three people who are positive including myself and we were all virgins who married virgins so there really truely is no other partners in the equation anywhere. I htink it is just a normal flora run amuck.

 

[hazeldust]

i am very skeptical about this. my paranoid theory is that hospitals need an outlet for blame if a child contracts a disease from the hospital and gbs is it. every thing about it (except treatment) is so vague. After i had my daughter, our pediatrition gave us a hard time for wanting to leave the hospital the day i had her, because i had not gotten tested for gbs and they wanted to keep an eye on her. he said things to the effect 'the baby can pick up all kinds of things when passing through the bc' inferring that it is a dirty disgusting place, and trying to scare us with ' we only had one other case like this where the parents left and as soon as they left with the baby, the baby had severe complications and died'. Funny thing is, i was talking to a local lay midwife last time and i asked her about this. she said she doesnt test forgbs and has never had a problem out of over 550 births. i still do not really know what to think but we all know that antibiotics that are not necessary can be bad. whats a homebirth mam to do?

 

[ramlita]

Hello!
I've been reading Ina May Gaskin's new book, Ina May's Guide to Childbirth, and much of her information is right in line with what bloodrayne posted.
Ina May writes:
About 20% of women have beta strep living in their vaginas.
Of those women,
about 50% of their babies will be colonized at birth,
but only 2% will actually become infected.
She says that when infection does occur, it is serious, and of those infected,
10% will die.
She says 2 babies in one thousand will become infected, so it looks like chance of dying is 1 in 5,000.

Usually, there are no symptoms caused by beta strep. Sometimes there will be urinary tract infections, and very rarely an infection can develop in the placenta that could lead to premature rupture of the membranes, leading to premature labor.

(edited to add: UC is Unassisted Childbirth- homebirth without hired help)

She writes that treating GBS+ women with antibiotics has NOT reduced the number of babies who become ill. Only women who had UTI's caused by GBS seemed to benefit from antibiotics. (I wish she had been more specific about the details of how and when these women were given the antibiotics)

"You can slightly decrease the risk of your baby becoming infected by declining as many interventions as possible (including vaginal examinations, especially when your membranes have ruptured) and by having everyone wash their hands frequently before touching the baby during the newborn period. (Some group B infections develop during the first three months of the life of the newborn.)"