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Birth years after positive GBS test? (Oxford JR Hospital in particular).

(9 Posts)
LimesoakedMadeleine Mon 19-Nov-12 17:31:57

I'm expecting my first child. A couple of years ago I tested positive for Group B Strep during a routine check for something unrelated. This information isn't in my maternity notes yet and I want to be fully informed before I broach it. As I understand it, GBS is present in a large number of women generally, but isn't routinely tested for in pregnancy in this country; it can come and go in an individual, and while the risk of transfer to the baby is low, the worst-case scenario if it does happen could be very severe. I'm worried about unnecessarily medicalising my labour for what is essentially a small chance, but obviously I don't want to put my child at risk.

Perhaps I'm missing the point (I'm hoping this post may help!), but the fact that many untested women, some of whom will have GBS, are allowed to give birth without intervention, whereas someone who has previously tested positive but may or may not have GBS at the time of birth would be given antibiotics, seems a bit confusing.

Does anyone have any experience of labour at the JR in Oxford after a positive GBS test? Would be v. grateful to know what to expect in those circumstances, and also for any insights anyone can offer into the whole GBS question. Thanks!

RubberNeckerNicker Mon 19-Nov-12 17:47:17

Don't know if this will help but...

I tested positive to GBS from a home testing kit done at 37 weeks, yet I still went on to have a successful home birth with the full support of my midwives, obviously without any ABs (only offered for hospital births).

The positive test enabled me to research and discuss all the options with the community midwife team. I was fully prepared to forgo the home birth in the presence of any risk factors - fever, PROM, prolonged labour and especially prematurity. As it was the birth was easy and quick and I was fully briefed on taking 2 hourly observations on the baby and all the danger signs to watch for.

I am aware how dangerous GBS can be, but medical management is not always necessary - as you have said it comes and goes and many women give birth carrying GBS with no problem.

trafficwarden Mon 19-Nov-12 17:59:53

Have a look at the gbss.org.uk website for comprehensive information.

As you say, lots of women have GBS but are not aware of it. The testing in most NHS hospitals is targeted at higher risk women (preterm labour, pre labour ruptured membranes, previous GBS colonisation). If you inform them of your previous status they will most likely test you. What you would do with another positive result is ultimately your decision but you are likely to be strongly encouraged to have IV antibiotics in labour. Speaking with a Supervisor of Midwives would give you the opportunity to discuss where you would like to give birth and how the risk would be managed for you as an individual.

It's not an easy decision as nobody wants to put their baby at risk of anything. You just have to decide what level of risk you find acceptable and what you can do to monitor your baby's health after birth.

leddeeburdee Mon 19-Nov-12 18:07:12

I do. I have had two babies at the JR and tested positive for GBS both times. First time they put me on an antibiotic drip - I was being induced at the time so they did the two things concurrently. It was medically managed in the delivery suite.

The second time I got to the hospital quite late into my labour but had been previously told I would have to go to the delivery suite again, on an antibiotic drip. However, when I got there the delivery suite was full so they sent me to the Spires (the midwife led unit at the JR which was my initial preference). DD was born within an hour of arrival (apparently IIRC they need at least 3 hours before the baby is born to start the antibiotic drip to make sure it works effectively, but I have fairly hazy memories to be honest so this may not be entirely accurate!). Because of the GBS they kept us in for 24 hours and did regular temperature checks on DD, and discharged us after that.

pinkbuttons Mon 19-Nov-12 18:08:00

Hi Lime
I gave birth to my DS at the JR in 2011, I had spotting throughout my pregnancy and was therefore tested and proved positive for group B strep.
The only difference it had to my labour was that they decided to keep me in when I was only 3cm dilated rather than sending me home as Ive heard they do normally.
I also had to have two lots of IV antibiotics during labour so had to be still while I was getting these. As I remember there is a certain amount of time in between need for antibiotics so if labour is quicker may only need 1 session of getting antibiotics.
Could always ask for a current test so know whether its still an issue. Either way the JR are fantastic. They can give baby an injection of antibiotics after the birth if you dont have IV antibiotics during labour. I read up on the possible risks when I found out I had it and IMO its a benefit to have been tested and to know you have it rather than having any complications, there are people who argue that it should be a routine test. Hope Ive helped in some way.

Spiritedwolf Mon 19-Nov-12 18:27:50

I tested positive for a GBS UTI in pregnancy (my first). I decided to opt for the IV antibiotics at a large CLU in a hospital an hour away rather than the MLU waterbirth in my town. I got the impression that it was my decison, though I'm not sure how much opposition I would have got had I decided differently (I suspect my midwife would have supported me to give birth at the MLU, but not sure about the consultant).

My waters broke at 41 weeks so I went into hospital antenatal ward for antibiotics. When they were about to administer them, I had a contraction in front of them (hadn't really up till then). They told me to stop pushing(!) and rushed me down to the delivery suite to give birth, which I did shortly afterwards. I didn't have time to have the ABs, let alone to have them 4 hours before giving birth. I didn't have time to have pain relief either My baby was healthy, had more post natal checks for the first 12-24 hours or so but was fine.

I also know a woman who didn't know she had GBS, but whose baby needed to be admitted to special care because of it. (Her baby is also now fine).

In future, I would give birth either at the MLU or home if the pregnancy was healthy (even with GBS) and the baby not premature, because I'd be unlikely to get to hospital in time for antibiotics.

I guess I'm saying that even the best plans go astray. Its also worth noting that there is a range of risk factors for GBS infection in babies which might affect what you are advised and what you decide. For instance, I was advised to have the AB because of GBS in my urine (not just a VS) during pregnancy, had it just been a VS, they may have offered AB but the would have been less insistant.

Spiritedwolf Mon 19-Nov-12 18:41:58

For clarity, I had had contractions up to that point, but they were irregular and not in front of HCPs who had left me alone whilst they read my notes and went to fetch the ABs.

MagiMingeWassailsAgain Mon 19-Nov-12 19:13:22

I can't link from phone but google the greentop guidelines for birth with GBS too, I found them really interesting when deciding what to do.

FWIW I had gbs when I had DD but didn't find out until a year later when I got a copy of my notes, she was fine btw and I had EMCS. I decided not to test in 2nd pregnancy and wasn't asked to have ABs. He was also fine and also EMCS. I would however have asked for or accepted ABs if I had risk factors like fever, prolonged ROM or GBS in urine.

LimesoakedMadeleine Mon 19-Nov-12 21:21:34

Wow, thanks so much everyone, I didn't expect such a speedy and comprehensive response! This is really useful and it's reassuring to know that a previous positive test doesn't mean my choices in labour will necessarily be very limited, and that if I do have ABs it shouldn't mean I'll be prevented from being active. I'll have a good look at the resources suggested here and will feel a lot more confident proceeding. Thanks!

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