Are you 35-37 weeks, or coming up to 35-37 weeks..?

[legallyblond]

If so, just to remind everyone to screen themselves for Group B Strep ASAP (sent my test off this morning - am 35+3).

GBS testing is not available on the NHS in most areas but it is vital that everyone is screened for it.

GBS Support gives links to two private medical labs that will send you a testing kit and send you (and your midwife/consultant) the results. The screening costs £32 and results are available within 48 hours (at least that is what it was for me - I used Mullhaven Medical via the GBS support website).

www.gbss.org.uk/

I am probably preaching to the converted - but it is useful to be reminded!

Hi LB, sorry, why would I do this, if I haven't been advised by my mw?

I'm 36+4 with DC2, and have never been told about this test...!

Blimey, second that - never ever been told about this by MW. Will certainly ask her now!

I'm just about to do this.

The NHS does not offer routine screening for GBS (hence NHS midwives will not advise you to get screened privately) but the reasoning behind this is contested. My GP (who has lots of experience of antenatal care) thinks that we should be routinely screened for GBS. The reason is that it can save some babies' lives. Lots of women carry GBS. Most of their babies won't contract it, but of those that do contract it, some will die. These deaths can be prevented if the mother knows she's a carrier and has antibiotics in labour.

Obviously I'm not a medical professional, but that is my understanding of the situation based on advice from my doctor and reading the gbss site.

I think it's useful that LB has posted the link so we can all have a read/ ask our mw/dr and decide for ourselves if we want the screening.

Exactly as 2ndDestiny says.... Your midwife will not tell you to screen as it is not offered on the NHS. However, there is a poster in our midwives' waiting room, which promted me to ask my midwife. She said: "Well, I can't tell you to get it done as the NHS does not consider it necessary, but it only costs about £30, the GBS infection is carried by a high proportion of women and for some of those women, the infection will be passed to their baby in childbirth causing complications and sometimes death. It is up to you to decide what to do, but.... (lots of raised eyebrows!)".

If you do have GBS, I understand that you are usually given antibiotics 4 hours before/during labour or, if labour is v quick/there is no time, your baby may be given antibiotics. this greatly reduces (although does not 100% eliminate) the baby picking up the infaction and getting complications.

Do have a look at the link to know more - I am no expert!

Arrgh! Sorry about the typos!

I was routinely tested by my GP and the results showed that I have GBS, this means that I will have antibiotics during labour and the baby will be monitored afterwards.

Without knowing you have this infection you can't do anything about it, it may mean there are no problems at all and all is fine. But on the other hand if the infection is passed onto the baby it can be fatal, having the antibiotics removes/massively reduces this risk.

I was unaware that you could get tested privately and for any other pregnancies I will definately ask/get this done!

Hope this helps!

Just so that I have it with me and so that I can refer to it when dealing with medical professionals if needed on the labour ward, I plan to print this and keep it with my notes (if my results come back positive, obviously!): www.gbss.org.uk/content.php?section_id=3&sub_id=11&content=Prevention

GBS comes and goes, so you can have it one week and not the next.

I had prolonged rupture of membranes in my first labour, we didn't know I had GBS and my son was born with it on his skin. Luckily he didn't catch it, but it was close. I've also tested positive for it this pregnancy, after a bleed, so will be on antibiotics during labour.

Ta! Done!

I've been told the reason they do not routinely test for it is that it comes and goes, as someone above pointed out. Therefore a negative result does not actually guarantee you do not have it and a positive one doesn't mean it will still be present at the birth.

To be on the safe side they seem to administer the antibiotics during labour if you ever test positive at any point. I happened to test positive for it during a routine smear test before I even got pregnant and was told to tell the MW if I ever did have a baby. I had to have the antibiotics on a drip during my labour (which btw rules out homebirth or even water birth in birth centre). I was also told I would have to have it again for any future pregnancies.

Most posters above are missing a crucial point - The reason lots of NHS areas don't screen for it is as Aendr says above - just because you buy your private screening kit online at 37 weeks and its negative doesn't mean you won't GBS when you deliver your baby at say, 39 weeks - unless you are tested within 48 hours of the point when you deliver your baby you can't rely on the screening result anyway. Obviously the labs who offer the test won't point that out to you as otherwise they wouldn't make any money!
I have no difficulty with paying for a private test - but in this case, a negative group B strep result a few weeks prior to your due date is totally worthless to you unless you happen to go into labour shortly after getting the results. Similarly a positive result a few weeks prior to labour can result in a totally unnecessary course of strong IV antibiotics during labour because you may well not be carrying it at the point when you actually go into labour.

sorry - cross post with Cocobean who is quite right.

Based on ILDD and Cocoabean's posts, I'm dubious about this...

I've pushed hard for my home birth, and my local hospital are trying to find excuses for me not to have it - I'm very wary about handing them excuses on a plate to drag me in!

Totally understand that parkj83. The most important thing is that everyone has access to the info (e.g. at www.gbss.org.uk/) and then makes their own informed choice. There isn't really a right or wrong answer - its just that a LOT of women have no awareness at all of the isuue.

Good luck with the homebirth!

Cool, I appreciate the heads up! And thank you :)

I was just about to post about this on my antenatal board. Hope you don't mind if I link to this?

I was going to get the private test this time round (until they found it in a routine swab anyway ). The private tests are (for some reason) a lot more accurate than the NHS tests. I was told my the private company (The Drs Lab) that their test stands for 5 weeks from the date of the test. I think I would be nervous leaving 5 weeks, though. Also the NHS tests have a high false negative rate, which is also why they don't test.

The thing is, even if there is a small risk of a false negative, a positive result is important to know about. Antibiotics in labour reduce the risk of infection in the baby from 1 in 300 to 1 in 6000. Some people do refuse the antibiotics as there can be implications of taking them, but then it is their choice to do so.

ILoveDonaldDraper - that's very true. But if you test and get a positive, then you will always be treated as having a had a positive result for that pregnancy regardless of it possibly going. (Last time I was tested positive at 7 weeks after tests taken for early bleeding).

A negative result might be a false negative, but a positive result is really, really important to know about so you can may the choice then of what to do.

Please to everyone who does test now and gets a positive result - don't be scared by it. The knowledge you have it is the important thing.

Thanks for listening!

Just wanted to add my experience and encourage others to get the test done.

I have just tested +ve and am 38.5 weeks. As a previous poster has said, it is possible for a result (either positive or negative) to have changed by the time I give birth, however at this stage it is highly unlikely that i will test negative before giving birth (I think statistically it is just a few percent).

I will be treated with IV antibiotics during labour, which i am fine about, which will reduce the risk to my babay to about 1 in 6000 I believe.

Also to reiterate, the reason the NHS do not advise or suggest you get this test is because it does not offer it as yet, and it would not be deemed appropriate to suggest people get tested for something that the NHS cannot offer. It would be very expensive to use the accurate testing that private clinics offer and at present NICE feel that the 'risks' outweight the benefits. The 'risks' in this case seem to relate to increasing womens anxiety during pregnancy, and the potential 'risks' of offering all GBS +VE women antibiotics in labour. The evidence would suggest that the actual risks from the AB's are very very low.

What it boils down to is that most women who carry GBS will give birth to health babies, but a few will not and very sadly a few of the affected babaies will die. hence knowing you carry the GBS will at the very least allow you to make an informed decision even if you decide to decline antibiotics in labour (and opt for increased observation of babay after birth for example).

Thanks moonstorm and guilty for adding your views/experiences. The most important thing is AWARENESS.

I am a bit concerned at doing the test at 35 weeks (just done at 35+3), but decided to do it early (although recommended is 35-37, so not too early) becasue I have a family history (i.e. ALL the women on my maternal side, inc my mother) of first labours being on the early side (36-38/9 weeks-ish) so I wanted the results in time. If nothing has happened by 38 weeks, I might test again. I don't mind for £32, even if the risks are minimal!

Guilty -exactly what my (NHS) MW said re the NHS. She couldn't tell me to get the test done as the NHS has decided it is not needed. But she left me in no doubt and told me about the website!

Well, all this is good enough for me - I rang up and ordered the test kit today.

I just phoned my obstetrician about this - I am not under midwife care as am 'high risk" for totally unrelated reason. She said that there is no point in any test based on a sample taken outwith a 7 day period from when you go into labour.

I then phoned the doctors lab people who said that they categorically DO NOT advise that their test covers you for 5 weeks and that if you are not sure when to do the test you should ask a doctor - I said I had and my doctor had said not to bother altogether!

I have requested a kit from the doctors lab people and will wait to send it in until at least 38 or 39 weeks and hope that isn't too late - clearly if you send it in earlier than that you can't rely on the result.

Obviously we all want to err on the side of caution - I would happily pay at least ten times the price of this test for a private investigation which I thought was actually reliable! But, erring on the side of caution also means not subjecting your baby to totally unnecessary IV antibiotics. Plus, lots of midwife led units won't take you if you have to have a drip in labour, so it can make a huge difference to your birth, which obviously is fine if you need the antibiotics, but not if you never needed them in the first place!

This is what the Group B Strep Support organisation says about the reliability of the private test (NOT the NHS one):

"Research has showed that, when the ECM test was performed within 5 weeks of delivery, a negative result was 96% predictive of not carrying GBS at delivery (4% of women acquired carriage between the test and giving birth) and a positive result was 87% predictive of carrying GBS at delivery (13% of women lost carriage between performing the test and giving birth). The test can be done earlier, but then isn?t as reliable at predicting colonisation status at delivery. It can be done later, but the chance of the baby arriving before the result increases."
(www.gbss.org.uk/content.php?sub_id=10&section_id=3)

I can't see the reference for the research cited though. But I would guess this is where the 5 wks comes from - the laboratory can't guarantee that the test covers you for 5 wks, as apparently 13% of women who test positive will not end up having GBS, and 4% of women who test negative will. But the test has roughly the above levels of accuracy if conducted at 35-37 wks.

I am also worried about being denied my active waterbirth in the midwife-led unit as a result of this - I think that's a very valid concern, but at the moment am still wavering towards it cause GBS seems quite scary if the baby does contract it. Will discuss with my dr next wk, but for me there are no easy answers to this one.

Best of luck everyone whatever your decision.

It was the lady on the phone who gave me the 5 week timescale. Maybe she was talking about the reference above and I misunderstood, so I am sorry of it has caused some confusion.