I would like a homebirth but need a private midwife in North London, where do I find one????

[MinkyBorage]

I am in North London, and the reason I need a private midwife is that I have strep B and need iv antibiotics before birth, which the NHS midwives are not prepared to administer. I have no idea where to look. Any ideas?
tia

[thegingerwhinger]

You could try here

Good luck

[MinkyBorage]

Great, Thank you.

[Howdie]

Hi Minky

Not wishing to do an IM out of a job, but please remember this phrase:

There is NO SUCH THING AS NOT ALLOWED when it come to your body and your baby.

Certainly it is not considered all that safe to be giving IV antibiotics at home but a) there are women who homebirth without having any antiobiotics and b) there are women who have oral antibiotics. Please read very carefully into the risks of GBS and take this on board when planning your course of action. The risks may not be as scary as they appear.

I have a client at the moment who is Group B Strep positive planning a homebirth and we are arranging for her to have oral antibiotics at home. I posted about Group B strep recently near the end of the thread which is called something like "what kind of infections can babies postnatally?"

[Howdie]

Don't know how to post a link to a thread so will re-post what I posted on that thread below:

"The thing with GBS is that a huge proportion of women carry it (around 20-30%)without it ever actually causing them a problem. In the UK, if a woman tests positive for GBS in pregnancy then she is recommended to have IV antibiotics during her labour. However, if you look at the statistics, a TINY proportion of babies born to GBS +ve mothers end up being actively infected - around 1% - and of those babies who contract the infection, around 10% of them become ill and require treatment and 10% of them will die. So although GBS is a common infection we are talking about around 70 babies a year who die.

Now it sounds very harsh to say that this does not warrant routine testing but if you consider that a) not all cases of GBS infection are prevented in babies by having IV antibiotics in labour b) A HUGE number of women have GBS in their system and we never know about it and it doesn't cause their babies any problems and c) You have a higher risk of having an anaphylatic shock reaction to the IV antibiotics that you have of your baby contracting an infection that will make them ill.

Personally, I think that rather than routine GBS testing of all women (which is expensive), resources would be better placed in better postnatal care, postnatal education and in informing women of how to know when their baby is unwell from any infection, not just GBS. "

[Mintpurple]

Just a thought for you Minky -

In our trust in central London, if a GBS+ woman has a baby without the IVABs, for example, labour is too quick, she refuses them or any other reason that the mum does not get 4 hours of IVABs, then we offer to give the baby an injection of Benzylpenicillin within 1-2 hours of birth, and this provides almost as good cover to the baby as IVABs to mum.

The benefits of this are that the baby will not be sensitive or allergic to penicillin (having never been exposed to it to develop a sensitivity) and will not have a reaction to it, and its quick and easy to do. Negatives are that its not quite as effective. But bear in mind that most GBS+ women have never even been screened.

Incidentally, is it your first baby and you have been screened and found +ive in this pregnancy? If you were +ve last pregnancy and -ve in this pregnancy from a urine and a vaginal culture, you do not need IVABs in labour according to our latest policy.

Might be worth checking with your NHS m/w if your hospital has these guidelines also - get her to look it up as they are always changing!

For what its worth, I would be ok with giving you IVABs at home if you never had any sensitivity previously, as its extremely rare to have a reaction. More likely to have a cord prolapse IMO! (and no I dont have the stats)

Hope this post hasnt just muddied the water - good luck whatever you decide.

[susie100]

This may sound too lentilweavery for you but I got rid of GBS by inserting garlic wrapped in muslin where the sun don't shine, not for everyone I appreciate but won't do any harm!

[MinkyBorage]

Thank you very much for replies. I haven't digested them properly yet, so will no doubt be back to ask daft questions later, but for now, I was wondering if you could help me with the following:

Howdie, why is it considered to be not that safe to administer iv abs at home? Is it because of anaphilactic shock?

I guess I'm low risk for having problems associated with gbs as I have had very quick second stages with both deliveries, and both times my waters needed to be broken by a midwife just before delivery. However, it still makes me worry. My current thinking is that I will test twice, once at 36 weeks, then again at 38 and a bit weeks.

susie100, I heard exactly this from a midwife today. How funny. I need specifics on method! How many cloves? How long did you do it for and when did you start, and how long did you leave each insertion.....em..inserted for? The midwife I spoke to said that the people whom she knew that had done this had lost the cloves of garlic for a while, so I am liking your muslin idea!

Mintpurple, dd1 ended up having ivabs as they didn't get enough in to me before she was born, and that was really traumatic, they couldn't find a vein, and her little hands looked like pin cushios after a while. Hmmm, I know what you are saying though. The midwife I spoke to today said that if I decided not to have ivabs, then they would closely moniter the baby, checking on him/her every day, but I was under the impression that strep b infections can happen very very quickly, so this wouldn't necessarily be much use.

I don't know. I hadn't really considered not having the ibs, but your posts have made me think. I know it's low risk, and I'm low risk within that, but still.

Thank you.

[MarsLady]

Hi Minky

Sorry I'm away from home this week and don't have my list of IMs to hand.

However do listen to what Mintpurple says. Mintpurple is one of my favourite mws (though sadly where we live is not within "catchement").

Also, I agree with Howdie. It's about what you allow! Being informed is a wonderful thing and helps us make the right choices for ourselves.

Have you spoken to the Whittington HB team? There's a homebirth Cafe that meets in Finsbury Park on Wednesdays I think. Sorry, can't be more specific because I'm away. You can email me if you like so that when I get home I'll remember and send you through some information. My email address is on my ad and of course I didn't mind the hijack

[nappyaddict]

Would you consider oral antibiotics?

[Mintpurple]

Minky - maybe I didnt make myself clear about the baby having antibiotics - its not given to baby IV in our trust anymore (as far as GBS is concerned, unless you have had a temperature or are preterm). Its given as an IM intramuscular injection to babys leg, just like the Vit K, and the midwives in our labour ward give it as it is safe.

Maybe your NHS midwives would be happy to do this as it is shown to provide almost as much protection for baby as you having IVABs.

The reason for not giving you IVABs at home is in case you have a severe anaphalactic reaction, yes, but it is incredibly rare (1:10000 or 0.0001%) and the NHS is generally a bit more risk averse than the indie midwives.

There is some very interesting reading of an audit by the Royal College of Obs and Gyn which lists statistics, risks and an outline of current recommended practice as regards GBS, and even just skimming it, it would be worth a look.

HTH

[Mintpurple]

• sorry - should read ...if you have a temperature of >38C in labour, or are preterm,
  
  .....too early in the morning.....

[susie100]

I used one clove at a time wrapped in muslin and left it for about 3 hours. I did this about 3 times a day for 3 days and that seemed to do the trick (I then went in to labour).

I have no idea how it works other than that garlic is meant to have some antibiotic properties! It was my indie midwife who suggested it! Good luck and I am glad you have had some more scientific suggestions as well!

[MinkyBorage]

Mintpurple, Thank you, that's really brilliant. I'm going to see the hospital Obsteatrician in a week or so, and will talk about the IM injection and will be armed with the Royal College report. Had never heard of it, so that's great. Also, if my test show up negative and I don't have atemperature in labour, then I will chill out a bit!

Susie, I shall soon start my gynaecological seasoning programme, many thanks, might even help me remember to do my pelvic floor excersises.

Thank you, Marslady, that's really helpful, and I may email you too. Armed with all my lovely new info, hopefully the obsteatrician will put me down for a home birth, and I'll get to talk to the home birth team then.

I found a couple of lovely independent midwives locally, but we just can't afford to go down that route! 3k?!!!!!! Aahhhhhh! I can understand why it costs that much, just can't justify it for us. Anyway feeling a little more confident about the Whittington midwives accepting me for a home birth after talking to you all.

Thank you again!

[MarsLady]

Hey Minky. I'm home.