Homebirth and IV antibiotics for GBS

[Mintpurple]

I cared for a woman in labour ward recently who had been denied a homebirth due to the fact that she was GBS positive and she couldn't have IV antibiotics at home.

As it happened, she had a nice straightforward (induced for SROM) birth.

I understand that there is a small risk of reaction to IVABs, but still think she got a bit of a crap deal , and I personally would not have a problem giving IVABs in a homebirth situation.

Out of curiosity, I would be interested to hear if anyone out there has had IVABs at home, were they using indie m/w or NHS, who supplied the ABs etc.

[belgo]

I had a home water birth and was given IVABs. I live in Belgium and had two independent midwives, both with about 20 years experience.

I don't think they had a prescription for the antibiotics, because it was only realised I had GBS about two days before the birth.

My membranes ruptured only when dd2 was born.

After the birth a midwife regurely came to my house to check me and dd2.

[belgo]

i think one of the midwives just had a supply of the antibiotics because she owns her own birthing centre.

[j20baby]

i'm not even allowed to go to the local birthing centre, only the hospital! it is unfair, my mw said she keeps trying to get the birthing centre to allow those who are GBS + to go to the centre, but no luck so far.

[belgo]

I think as long ads the pregnant woman is aware of the risks, then I think it should be allowed.

I actually had the safest possible birth - two highly experinced midwives, IVABS, and my waters didn't break until DD2 was born.

[Mintpurple]

so it doesn't sound very common then.

thanks belgo and j2obaby

[MrsFogi]

I was due to go to a birth centre and they couldn't give me IVABs there or at home. In the end I persuaded a GP to prescribe ABs to be administered intramuscularly and the indie midwives were willing to administer these. Lots of stress sorting all this in the last week of pregnancy!

[maxbear]

As a mw myself I would not be very happy to give IVabx at home even though it is a small risk that someone would have a reaction to them. I had a gbs swab with dd and after spending many hours in the library reading articles about why you should or should not have ivabx I decided only to have them if there was a problem at the time ie waters breaking before labour, having a temp in labour. I also decided to deliver in a birth centre attatched to a hospital in case a transfer was needed as originally I had planned a home birth. I ended up having a lovely waterbirth, waters broke somewhere close to the end, (although it is difficult to tell exactly when, when you are in a birth pool). With ds I did not even worry about it, again I would have transferred straight away if there had been any sign of probs at all but he was born without any problems at home. Another factor in my decision is that I was ?allergic to penicillin and the alternative antibiotic is much less effective (something like only 75% instead of 95% can't remember exactly) so I decided I didn't want to risk it in case I was allergic to that as well.

[ahornuk]

I wouldn't have antibiotics just for being GBS positive; unless there are additional risk factors (fever in labour, prematurity etc) then there's no evidence that this reduces overall mortality as, though GBS infections in the babies fall, infection with other, serious, penicillin-resistant organisms seems to rise. References for this are on www.homebirth.org.uk/gbs.htm ; the RCOG recommendations are just that antibiotics should be discussed in this situation, but the potential problems should be considered.

I know of a couple of NHS midwifery teams which offer IV antibiotics at home, eg the Albany team (tied to King's College Hospital). Also heard of some midwives offering an injected antibiotics during labour at home (but not IV).

[paysdegex]

Hi, could you possibly tell me any more details about the NHS team(s) providing IV antibiotics at home? Do they now offer this routinely?
In my last pregnancy they found GBS in my urine at 37 weeks (UTI), scuppering my planned home birth as I was told that I'd have to go to hospital for IVA during labour.
This time round I've got a bit more time (I'm only 9 weeks pregnant at time of writing) and I want to put up more of a fight. I feel strongly about having a home birth, and there doesn't really seem to be any good reason why the IV can't be administered at home.
My midwife has said that although she would be able to put in the IV, the difficulty is that they share out of hours care with another team, who may not be appropriately qualified. Any advice or information on NHS teams that offer this elsewhere in the country (I live in Leicestershire) would be very helpful, as it would show there's a precedent. Many thanks in advance for anybody with any advice!

[GingGangGooley]

Have a read of this hun...
www.homebirth.org.uk/gbs.htm

Good Luck x

[paysdegex]

Thanks - if I can manage to find this post again, I will let you know how I get on. Well, put it this way - I'm not holding my breath, but if I have any success I'll be posting all over the place so that other people know it's a possibility.