GBS + in previous preg, must I have IV antibios this time?

[narmada]

I was GBS positive in my previous pregnancy ( discovered when I had PROM at 38 weeks but failed to go into labour spontaneously).

I then had IV antibiotics during labour as advised. However, now my midwife has told me that I must also have the antibios for this delivery too, no testing or anything, they will just go straight for the antibiotics. This was presented to me as a no-choice matter...

However, I am not keen on IV antibios if they are not really necessary. Had a medicalised birth last time and do not want the same again. As far as I can tell, from the GBSS support group website the advice is to retest for carrier status at around 37 weeks and then if negative in this pregancy, I don't need the antibios.

Obviously I am loath to put my new baby at risk, but on the other hand I am a bit that they are proposing to IV me without even checking my status this pregnancy.

Any advice??!

[Mummyofmax]

hi
i had gbs in my last pregnancy and had anti b's. ive been retested this week because I asked to be (im only 33 weeks) my midwives say they dont give anti b's just because i had it last time but in my mind I should as its better than having a poorly baby.
let me know how you get on
xx

[ragged]

I looked at this closely in my last pregnancy. Basically I wouldn't have had antiBs unless I met one of the other risk factors (33% of women have GBS when giving birth, but only a tiny tiny proportion of their babies become ill from it -- why is that?).

This article and this one mention the risk factors.

GBS + Homebirth link.

[ragged]

ps: You know that it's always your choice, btw, about how you give birth. They haven't the right to tell you anything else!!

[narmada]

thanks ragged and mummyofmax. I am a little less assertive than I'd otherwise be because I know two people whose neonates contracted GBS and were quite poorly, but....nevertheless, yes, thanks for the reminder that it is my choice and for those articles. I think I will pay for the (more reliable) private GBS test and only have the antibios if it comes back positive.

[littlemisslozza]

I had GBS in my first pregnancy but didn't find out until a swab of my stitches afterwards so didn't have antibiotics. Second time round it was in my notes, they did a swab at 36 weeks which came up negative so I did not need antibiotics when DS2 was born.
Just because you had it in one pregnancy does not mean you still have it now, or even at delivery. I would ask to be swabbed at 36 weeks if I were you.

[narmada]

littlemisslozza that's great, thanks. I think you are completely right. It seems bizarre to me that the NHS will not pay for GBS testing but will happily just bung the IV antibio drip in without a second thought!

[mumatron]

ds, + test iv antibio's and 24 hour stay in hosp.

dd, - test but had the iv anyway, also 24 hour minium stay.

dd2, not being tested but have been told by mw that i wont have the antibios. baby will just be monitored for 24 hours after birth. i'm checking this with every mw i come across as i really don't want to go back onto the cons led unit at my local hospital. and they wont let me have a waterbirth with the iv.

[Moominfamily]

Hi, I also had GBS in first pg, was told I had no choice about IV antibiotics in 2nd labour. They failed to administer the IV in labour because it wasn't in my notes although I had put it in my birth plan so they didn't bother to read that!

The senior MW, consultant, and special care nurse had a 40 min argument in special care with DH holding DD over whether she should have the antibiotics. They decided to give her them after all, just in case, but the consultant was violently against this as he felt the detrimental effects of the antibiotics outweighed the risks of GBS developing. He said I should have DEFINITELY been tested during pg to avoid this situation.

I would insist they test you again after you are 34 weeks. If they refuse say you will not agree to antibiotics being administered (I agree with you absolutely they can have complications, had severe oral thrush with both babies and they really suffered. I did not mind with DS but DD was put through that for no reason as she later tested negative after treatment).

Good luck, I have just found out I am pg again and will insist on being tested this time before I agree to antibiotics being administered.

[narmada]

moominfamily thanks for posting your exerpeice, and congrats on the new pg! I will pay for a private test and decline to give consent if I'me negative. Really hope I am as I want to have a waterbirth.....

[narmada]

Good grief, in case anyone is following this thread (unlikely) I had the talk with the midwife and explained my position. She said that even if I tested negative I would have to have a consultant appointment and get them to agree to me not having antibios this time around. And this in an administration that doesn't even routinely test for GBS status! How ridiculous, given the time pressures on the NHS and current budget cuts....

[Tangle]

Didn't see this the 1st time round, but caught up now. Can't believe they're taking such a ridiculous line on this :(.

They can offer you an appointment with the consultant, but you are not obliged to attend. And as has been said, the consultant can advise but its up to you whether or not you agree to have IV AB's - if they gave them to you against your will you could sue them for assault! (Not that you necessarily want to tell them that, but I find knowing it helps me to stay assertive on points I feel strongly about )

You might want to read these phrases by Mary Cronk and keep them in your pocket. This guidance from the RCOG might also be handy - they state that:

"If you carry GBS in your vagina, you should not need antibiotic treatment...
... if GBS was detected in your vagina in a previous pregnancy and the baby was not affected"

You sound like you've already done a lot of research and have made an informed decision. Depending on what you'd find least stressful, you might want to write a letter to the consultant now that summarizes your understanding, states that you are planning a private test and what action you propose to take with each outcome - and that given you have now discussed this in detail with the MW on however many occasions you do not with to waste his/her valuable time with an appointment unless they are aware of any more recent research that contradicts your understanding...

Hard to know which course of action will lead to the smoothest path without knowing the consultants :(. Fingers crossed you are -ve and have a straightforward, AB free waterbirth :)

(btw - is it there policy that you "can't" have a waterbirth if you've got an IV in? It's worth querying as I was told in January that they wouldn't recommend a waterbirth due to the infection risk but as long as I understood the risks they wouldn't stop me. I think they were looking into waterproof dressings to cover the insertion point to try and reduce the infection risk, and I was going to try and keep my arm out of the water. Could be worth investigating...)

[narmada]

tangle thanks very much for that information, and all the useful links. I think it's time I stuck up for myself a bit more. I know it's dangerous to think you know more than medical professionals, but hell, sometimes.....you do!

[Tangle]

I don't think its believing you know than medical professionals, but wanting to understand why they are making their recommendations (peer reviewed research, hospital policy, personal experience) and whether or not you personally feel the benefits of ignoring their recommendation outweigh the risks.

With my last birth I wound up taking pretty well all of their recommendations - but I made damn sure I understood exactly why they were making them and that I understood why they were applicable to me rather than A. N. Random-Woman. Even though I had a lot more intervention than I would have chosen, I came away feeling as though I'd been in control of the situation all the way.

[sassie23]

Hope you don't think im trying to hijack this thread but asked in previous thread any thoughts on GBS and an impending sweep? Its on my notes but Doc didn't mention any problems with doing the sweep. However the GBBS website says their medical advisory board would not recommend giving sweeps to women with GBS??? thanks

[Tangle]

Are you confirmed as GBS+ve in this pregnancy, or not confirmed -ve after a +ve test in a previous pregnancy? I can see them being less concerned in the latter situation, although would have wanted them to check...

If it were me, I would print the pages from the GBSS saying that sweeps are not recommended if you're GBS +ve and ask for the Dr's reasons for going against this advice. Based on his reasoning I would either accept or decline his offer of a sweep. You have the right to decline at any point - including once they've started.

Good luck :)

[sassie23]

yes tested positive in this pregnancy thanks for your advice tangle will do this

[narmada]

Oh bloody hell, tested positive again, severely pissed off.

Has anyone been allowed to go to the midwife-led unit while having IV antibiotics? I fear the labour ward beckons....no MW appt till next week but will ask then.