tested positive for strep b and considering refusing antibiotics in labour

[snowangels1]

Tested positive for strep b during a routine swab for thrush. Mws now all up in arms about me having antibiotics through IV in labour.

I've been reading up on it and it seems lots of people refuse antibiotics. When I tried to discuss this with my mw last week (who is newly qualified and is lovely but can be a bit unsure about anything other than the obvious) she looked as if it was extremely unusual thing to request not to have in my situation.

Has anyone been in this situation? Were their mws supportive of them?

From what I can find out, chances of anything nasty passing to baby because I have strep b is very unlikely anyway (but, if it does, it's very serious). It also seems that having antibiotics in labour doesn't eliminate the risk, infact, side effects such as thrush in nipples (mw hadn't heard of this though) can casue problems with bfing.

I'm just not sure what to do. My reasons for not wanting antibiotics are as my body hates them - I always get lots of side effects accociated with taking them and the last thing I want is having to cope with that and post birth issues and a new baby. I'm also very suseptable to thrush (have it pretty much permenantly in pg) so the thought of having trouble establishing bfing due to having it in my nipples is not a nice thought. I also want as few medical interventions that I can manage without.

I am aware that I may have to stay longer in hospital afterwards because of monitoring the baby, which I'm ready to cope with (I hate hospitals).

If anyone has anything they can add or any thoughts it'd be so welcome as I'm feeling a bit pressured into having antibiotics but with a mw who can't really explain the statistics/reasoning behind how useful they are.

[Fleecy]

I had strep B and had decided to have the ABs but labour was too quick and there wasn't time.

So when DS was born they took him away for a few minutes and gave him the ABs directly. I felt awful and thought it wasn't a very nice way for him to start life but figured better that than the potential alternative. I knew I wouldn't forgive myself if he had become ill.

What are the chances of your DC reacting to ABs if you react yourself? Would you consider your child being given ABs after the birth?

[hellymelly]

I had anti-B sas I had a c-section and they give them as standard.I did get probable thrush in my ducts too,and it was painful,but I would have thought it is worth risking it if the possible risks to the baby are so serious.I would take the anti-B's and tank down pro-biotics at the same time,personally.

[stanausauruswrecks]

I can only tell you my experience- My labour was so quick I didn't have time to have two doses - so DD had to have them instead. She ended up staying in hosptial and on IV antibiotics for a week because her inflammatory markers carried on rising after birth. Within 24 hours of finally being discharged home, she developed a raging temp (39C)and got readmitted for another week of treatment.
No bugs ever grew from the samples they took(blood cultures and three lots of lumbar punctures)
I can't say that none of this would have happened if I had recieved antib's, but it's no fun watching medical staff poking needles into your baby, plus I had a DS who couldn't reallhy comprehend why his mum and baby sister weren't at home.
So I suppose if I were to go through it all again, I would be in hospital with the first contraction demanding my IVs!

[nellieisstilltired]

Fristky I think you should book in wth the GP for a more in depth chat or ask to speak to a more senior mw who can discuss this with you in ore depth.

This sounds as though it is your first baby?
Fwiw I can assure you that there is nothing worse than having a sick baby and having to hold them and comfort them whilst they are cannulated or worse have a lumbar puncture. Believe me I've been there.

[nellieisstilltired]

more not ore.

[claricebeansmum]

When I had DS there was not testing for Strep B. He ended up in SCBU having intravenous antibiotics. When I had DD for me there was no choice. I understand your reasons but IMO you have no choice. Could you bear knowing that you could have prevented your baby suffering?

There are various antibiotics around - can you talk to consultant about the options?

[anonandlikeit]

not sure about antib's etc BUT i can assure you watching a seriously ill baby in SCBU with strep B is devastating & the complications for such a serious infection in a new born can have life long consequences.

Trust me nipple thrush is nothing compared to watching you baby fighting for life in scbu.

When ds2 was born 3months prem a baby came in to scbu with strepB (Mother wasn't screend) the baby was v poorly, got a secondary infection, blood poisoning & meningitis. The baby survived but suffered brain damage & is profoundly disabled for life.

I would urge you to follow the recommended course of treatment unless the known risks to your health are greater than the possible risks to your baby.

[snowangels1]

Yes, I don't want to put my babies life in danger so feel bad even considering refusing them, but, at the same time, something like 30% of the population have strep b and yet the number of illnesses etc is so minimal that the chance is so slim, and npthing is ever completely safe, any numbr of things could go wrong in childbirth anyway etc.

I'm just a complete anxious mess (have anxiety issues and mild ante natal depression) and also now apparently high blood pressure and this is just something else that if I know I need to have will stress me out even more. They say chances are if the baby is going to get an infection it will start within the first 48 hours and is only serious if it isn't spotted and treated, so surely keeping him in hospital to check him (for something he's likely not to have) seems fair/sensible. Surely the only time problems occur is if they don't pick up on the infection? In my case they will be on red alert to pick something up if it's there.

Giving baby abti biotics on birth I hadn't thought of but not sure of effects to baby - might look thatg one up.

[snowangels1]

gosh, xposted to the max there!

nellie my GP is even less knowledgable than my mw - I was teaching her about it when I saw her (and I only knew basic google search stuff!).

clarice yes I see what you mean and I hadn't thought about different antibiotics - I might look into that

anonandlikeit that's a terrible story and makes me feel really bad even considering not having the antibiotics...

[claricebeansmum]

Have a look on the GBSS website here

[HelenLG]

My waters broke and then I had to be induced. They did a swab, but didn't get the cultures back until after DS was born. I'd already had to have one dose of AB's cos it was over 48 hours from waters breaking to delivery.

When he was born we were both running mild temperatures and then the culture with Group B strep came back so they then gave a different set of AB's to both of us.

The next day, DS still had low blood sugar and a mild temp, so they did a lumbar puncture to try and get some spinal fluid to test for specfic infections, but that failed as his spine with so tiny they couldn't get the needle in, so ended up spending over a week in the hospital with him going up and down to the SCBU to have IV AB's.

Looking back, it sounds horrific and I feel horrible that he went through that, but at the time I would rather have let the Dr's do what they felt best and be over cautious.

[anonandlikeit]

Not trying to make you feel bad, sorry!
Putting a canular in to a newborn is an infection risk in itself, so waiting to see & then treating has risks all of its own.

The secondary infection that caused so much distress & damage to my friends baby was most likely through a canula being used to treat the original infection.
Youa re right, there are so many risks, but if you can deal with the known risks at least you are lowering them.

Most baby's are born perfectly healthy with no problems. Sorry if alarmed you but any time in SCBU is not nice.

[snowangels1]

hmm, interesting reading clarice and I'm now edging towards feeling no option but than have the anti b, even though my only risk factor currently is resting positive at 22 weeks.

Wonder if anyone out there has refused and their thoughts behind it.

[ExistentialistCat]

I chose to have IV antibiotics in labour because I had a strep B infection (not just positive) in pregnancy. I knew the odds of passing it onto DD2 were small, but the potential consequences were too severe for me to take even a very small risk. That said, devastating as the stories of very ill and dying babies are, it is important to remember that this happens to a tiny, tiny percentage.

Unfortunately the MW didn't get the antibiotics into me quickly enough, so we had to go to hospital for monitoring and 48 hours of antibiotica for my DD2. That was fine but not how I envisaged the end of my otherwise very straightforward home birth.

If I'd had ONE other risk factor present (in addition to no antibiotics) - running a temperature, labour before 37 weeks, or prolonged interval between waters breaking and birth - the hospital's protocol was a lumbar puncture for DD2, just in case. I couldn't bear that thought and wanted to do everything to avoid such an invasice procedure.

Absolutely your call, of course. The GBS website and the Royal Society of Obs and Gynaes has some good papers that you could download and quota at your health professionals.

Good luck with your birth!

[arudolf]

I was told I'd tested +ve for group B strep as I was leaving the postnatal ward with 2 day old DS . They had apparently got the results on my 3rd day in labour but forgot to mention it to me. luckily DS is fine, but it's going to be on my list of things to shout about with DC2.

[hellymelly]

Really,having read the other post too I would take the meds.My DD had to have i.v. antibiotics at two days old and it was horrible,(she had an eye infection that started to look quite worrying).My DH had to hold her while they put the line into her tiny hand and she was screaming, as other posters have said it is far worse than anything you might go through as a result of taking the antibiotics.Also as soon as your child is born that is all you will care about,you won't be remotely bothered about anything you might have to deal with,you will just worry about the baby.As I said earlier I had thrush in my ducts and it was painful but nowhere near as dreadful as hearing my new baby squealing as she had the line put in.

[NewYearsResolution]

I don't want to add to your stress but in a way maybe it would be less stressful just to decide to do what the midwifes ask and not worry about making this decision. You can do lots to solve possible thrush etc.

I met a woman at a baby group recently introducing her adopted baby - she had lost two babies to strep infection. I wouldn't take the risk.

[Dexterrocks]

You may actually have to fight to have the antibiotics as well. I was supposed to have them. I was told to contact them as soon as in labour to let them know, which I did. They didn't seem at all interested. We kept phoning and they kept saying to stay at home. Eventually we got so anxious we just went in anyway.
They took me into the prelabour ward, took one look at me and rushed me to the delivery room.
Someone appeared and put the tubes ready for the drip into my arm and then nothing more happened. Ds was born and I still had an unused tube sticking out of my arm.
We ended up in hospital longer than necessary waiting to see if ds was ok.
It was a complete farce!

[IhateSunday]

I nearly lost my niece to GBS in March this year. She developed breathing difficulties at an hour old, it was picked up very quickly, yet we so nearly lost her. Her poor parents were told one night that if the units of plasma there were about to give her didn't stop the bleeding in her lungs she would bleed to death- There was nothing more they could do. Unimaginable. She survived, but no-one is quite sure how.

The risks of my sister passing it on to my niece were very small, yet my niece was affected- what makes you think YOUR baby won't be the unlucky one?

If you had seen the way my niece suffered you would be grabbing every anti biotic you were offered trust me... I'm sure you will be able to put up with a little bit of thrush. Please think about it seriously it really is a matter of life or death.

[Blu]

If you are only 22 weks, get tested again closer to term, because I think Strep B can come and go.

I was tested during labour, as a routine protocol once it was 24 or 48 hours (?) since my waters broke. Once ds was born they came back and said the swab was positive and they very very strongly advocated that ds be put on in abs. It was quite simply horrendous. You just don't want to see your newborn babe cannulated, and abs pumped in twice a day, screaming and screaming. Plus there are long term halth risks associated with abs for newborns. I was a fully fledged NCT would-be no-ntervention waterbirther - laboured for hours and hours with TENS and pool, no g&a etc...but had I known that if he had been born quickly, swiftly after the waters broke, and would have been spared the risk of Strep B and the abs, I would have grabbed every labour accelaration intervention possible. My GP said I had done the right thing, though, given that we didn't know I was carrying it, she said she had seen many tiny babies 'just go, so quickly' if they cauft it.

Talk to your GP, get tested later on, ask if there are alternative abs you could take. But if there is any risk - better you on abs than your baby.

Good luck.

[me23]

you only tested positive at 22 weeks! so there's a chance you won't be postive at term. If I were you I would certainly get tested again at 37 weeks and make my decision based on that result.
Group b strep is a transient infection you can be positive one week and negative the next.

[IhateSunday]

think it has a life cycle of about 5-6 weeks- so even if tested at 37 weeks and was neg, it could come back by term. Better to be safe than very,very sorry.

[hackneyzoo]

Its worth getting retested after 36 weeks, I have tested GBS+ in the past and in each of my pregnancies the head of MWs advised to get a test done privately at 36+ weeks as NHS tests are unreliable. Many places do them, you can test at home and send off for results, thier are links here:
private tests

This website has some very interesting references and links to RCOG articles and provides quite a comprehensive overview of your birthing options with regard to taking IV abs or not.

I thinks its a very personal decision to make and you have to way up the pros and cons early. In my previous 2 pregnancies I have tested negative at 37 weeks and had homebirths without ABs and monitored the baby carefully. However, I am 36 weeks with DC3 at the moment, I will test next week and if it is positive I will probably go down the AB/ hospital route, if not, go ahead with a HB.

Different hospitals have different policies, so it is worth speaking to your local hospital's lead midwife/ consultant midwife as they will be the ones who are clued up on latest best practice and hospital policy.

AIMS Journal Article

RCOG Guideleine

Good luck with your pregnancy and your decision.

[snowangels1]

yes, thank you all, you are positively swaying me to taking all the abs I can get!

I sort of (feel bad about this) wish I had never had the thrush swab as if I didn't know I was positive for strep b I wouldn't have to have all this worry/stress about what to do. I realise though that having that test could have been the luckiest miracle managed if DC were to potentially be the unlucky stat and I could prevent it with abs.

These stories really bring home the real risks I might be putting my perfect little baby in. Hopefully I'll get retested and then make a decision from that

[snowangels1]

Thanks hackney that's really useful - my mw has only suggested testing at 35 weeks again but not after that (not sure why). Think I will defo do that private test at about 36/37 weeks if NHS can't/waon't do it.