Group B Strep - a few questions for anyone who's tested positive

[lapislazuli]

In my first pg, I went into labour at 34+6 and was subsequently told I tested positive for GBS. As a precaution, I was given antibiotics at the onset of labour and my son was also treated after the birth.

This time around though, I am now 37+3 (hurrah, got past the pre-term date!) and have just received results that I have tested positive for GBS again.

So my questions are these:

My midwife has pretty much told me that as soon as labour starts I'll have to go in and be given antibiotics, this means no water birth option for me (I gather because they will electronically have to monitor the heart beat amongst other reasons) - however having read around the subject of GBS & birthing options, it should not necessarily rule out a water birth (or even home birth).
Does anyone have any experience of this?
I so would love to have a different experience this time round (water birth), as with DS he was whisked away pretty much right away and I didn't see him for a couple of hours, and then spent 12 days in SCBU.

Does GBS always automatically mean a restrictive birth and SCBU afterwards? Or how quickly will they be able to assess the presence or absence of GBS infection in the baby after the birth?

I don't see why a water birth wouldn't be possible as there are no other risk factors at this stage.

I'll of course be asking these things to my midwife next time I see her - but it probably depends on my hospital's practices?

Anyway I just want to know if anyone has any relevant experiences first.

Thanks.

[chinateacup]

No relevant experience (sorry) but in similar situation and interested in any responses to your questions..
I am only 26+ wks so daresay you'll find out all the answers before me anyway . . . .
Good luck with the birth.

[AngieM2]

Hiya, you are treated as 'GBS' if its detected in the current pregnancy or you had a previously affected baby. Obviously this includes yourself. You will need IV antibiotics in established labour. I'm not sure if this excludes you from using the pool as you could have the IV's and then get back in. Not sure about continous EFM but again they may want to do it when you have the IV's and subject to a satisfactory trace, discontinue it. Of course, you could also have the attitude 'to hell with it' and arrive at the hospital when its too late to have the IV's anyway. Oh, and for the IV's to count, they have to be given in you 4 hours prior to delivery. Loads of women arrive at hospital too late for the IV's to count and all that happens is that the baby undergoes 12 hours of observation post delivery (temp, heart rate and resp rate). Hope this helps. A

[moregranny]

I think it would be a bit silly to take the " oh to hell with it " attitude with something as serious as Strep B, because if you are too late your baby will have to have antibiotics and could suffer a very serious illness as a result.

[edwinbear]

I tested GBS +ve with DS and have already discussed this with my (private) midwife as I would like a water birth possibly at home with DC2 due in November. She has advised there is no reason I can't have a water birth I would just need to keep the IV needle out of the pool. If I want a home birth, she will put me on a course of antibiotics before labour, I think she said she would start them 4 weeks before my due date.

With DS he was checked after delivery, but I think more as a result of the forceps delivery but he didn't go to SCBU.

[Wafflepuss]

Please ignore the "to hell with it" advice. GBS infection can overwhelm a newborn very quickly and if treatment is not given quickly enough GBS can lead to permanent disabilities, even death.

[reikizen]

I can only tell you what the protocol is in our unit. If GBS identified in this pregnancy then we would aim to give you IV antibiotics as soon as labour begins, however you could certainly argue that you should not fall into the category of CTG monitoring, especially if your membranes are intact. If you do agree to continuous monitoring, unless your trust has some super duper new equipment I'm afraid this will rule out labour or birth in water. As far as water birth is concerned, you would not be able to have this in my trust as the midwives who work on the birth centre (where the birth pool is) do not give IV antibiotics. It may be impractical to keep your cannula out of the water depending on how long your labour is, I don't know. Interestingly, I did read about some research suggesting a lower rate of babies contracting GBS following water births but can't remember where sorry.
We keep babies in for 24 hours for 4 hourly obs (heart rate, respiration and temperature), but unless baby is actually unwell, they stay with you. The midwife will perform the usual check at birth and a suitably trained mw or paed will perform the normal neonatal examination sometime in the first day.
Of course, many women labour too quickly for IV antibiotics to either be administered or be effective, you may be one of them! Good luck.

[gastrognome]

I tested positive for group b strep in both my pregnancies. Birthing pool wasn't an option the first time but the second time round I spent a couple of hours in the pool, and also managed various stretching and breathing exercises on a ball (till I had an epidural that is) so it wasn't restrictive at all despite the fact I was hooked up to a drip the whole time!

Luckily, although I was also connected to the monitor, the sensor pads were wireless and waterproof so could keep them on in the water. This was in a hospital in Brussels.

[Tamashii]

Thanks for posting this question. I tested GBS pos in my first PG and got the fetal monitoring throughout birth along with IV antibiotics for me.

This time round I have tested +ve again but I am only 24 weeks at the moment. They are going to give me antibiotics now to try and kill off the GBS as I have been told they no longer treat with IV antibiotics routinely during labout in the hospital I am booked into.

I am now terrified. I was initially told I would not even be tested for Group B Strep but had some bleeding and therefore they tested me for a tonne of things that have apparently included Group B Strep. I will investigate further at me next antenatal appt as I am now terrified that I will get no treatment during labour and will just worry myself sick about the baby.

[reikizen]

Tamashii, please don't worry. GBS is transitory so the chances are you won't have it when you go into labour anyway. IV antibiotics are extremely invasive and we don't even have conclusive evidence that they prevent GBS transmission to the neonate. Just be vigilant (as all new mums are) and ensure that you act on any signs of ill health.

[lapislazuli]

Thanks for your responses everyone.
I am fully prepared to go into hospital to be given antibiotics as soon as labour starts - waters in tact or not - so hopefully this will be at least 4 hours before delivery. I would never risk anything else if it could be avoided.
However what I'm not clear on is why you do or do not fall into the CTG monitoring category? So if I understand correctly, as long as I have my IV antibiotics, can avoid keeping the cannula out of the water, and there are no other signs of distress, why would they need to monitor the fetal heartbeat continuously?
I have a feeling though whatever I say, even with favourable opinions re water birth, my hospital will not be accommodating - probably because since the GBS thing has been the focus of many of my vists, birthing options have not even been discussed as if there simply are none.

[CitizenOscar]

The midwife led unit at my hospital has just started accepting women who've tested positive for GBS and they said the birthing pool should be fine. So I think the protocols vary from
place to place.

[ShushBaby]

I tested positive for GBS and laboured in a birthing pool in a birth centre (I had to get out before delivery but that's another story, and not related to the ab drip!). All it meant was that I had to keep the hand with the drip in out of the water, which was fine. Poor DP on the other hand got horrifically wrinkly hands, and had to beg to get out after four hours as he could no longer feel them!

I certainly didn't consider not having the antibiotics. Since then a friend has delivered a baby who had a GBS infection (she wasn't tested in pregnancy) and it was horrible. I was so glad that I found out I was positive during pregnancy.

[PotteringAlong]

I found out yesterday that I've tested positive for GBS so no helpful advice but marking my spot to listen to wise words!

[BarbaraBar]

Make sure your hospital/birthing unit know you are group B strep. Reiterate it when you get there.

I tested positive for it with ds1 (had em section but he was fine) and then when I went into prem labour with ds2 when I haemorraghed (we had to call an ambulance etc but that had nothing to do with GBS). They got my notes muddled up with someone else and did nothing about the GBS (same hospital as for ds1) and I was so out of it to think of metioning it. Luckily ds2 was ok (in scbu but not because of GBS) but it's just not worth the risk.

[edwinbear]

My DS wasn't monitored until I had my epidural put in, then they monitored his heartbeat as a result of this rather than the GBS/IV ab drip. I'd had a couple of doses of IV ab's before the epidural when he wasn't monitored.

[lapislazuli]

So I've found out it's definitely a hospital policy thing so varies a lot depending where you go. I asked my mw the other day (38 weeks and first time "birth plan" even came up!) and she confirmed that at my hospital as the delivery suite is on a different floor to the birthing unit, a water birth would not be possible.
She tried to console me that they do have a bath on the delivery suite that I could use - but obviously that's nowhere near the same! And provided there are no other risk factors, I wouldn't need to be continuously monitored so could move around if I wanted.
Anyway tis a bit sad, because it means if I have any more pregnancies (and still live round here) it will always be the same scenario.
I have also acquired a big fat yellow GBS+ warning sticker on my notes now too, so as soon as I go in, they can't miss it!

[Thornykate]

I tested + & had IV ab's given as bolus (not constantly on drip ) I was going to go on pool but didn't have time, no restrictions or continuous monitoring. Hope you get the birth you want

[Thornykate]

Sorry x post but hope it goes well all the same.