Group B Strep & midwife led units / water births

[slowshow]

I'm 37+5 and decided to get myself tested for GBS for peace of mind. Well, far from giving me peace of mind I'm now in turmoil because the test came back positive, and it's thrown a spanner in the works re. my birth plan.

I wanted to have a water birth in the MLU, and now I'm assuming it's going to be an outright no? I've been doing some research, and it seems that the only issue would be that I'd have a cannula in my hand to receive antibiotics every four hours or so (but I wouldn't connected up to an IV the whole time) so I would have to be careful not to get it wet. If the waterbirth specifically is a problem, I would be reasonably happy giving birth in the MLU without getting into a pool. I just want to avoid the pokey rooms / being confined to a bed on the consultant led unit.

Thing is, I know MLUs have extremely strict entry criteria, so I'm expecting bad news when I call them later this morning to check. Thing is, I've been doing some research and I'm not sure there's any real evidence that I should be excluded from the MLU - it really depends whether GBS / having to administer antibiotics is considered a serious complication.

Does anyone have any experience?

[AllyB2]

I think that there is regional variation in hospital policy on this.

I have had GBS in the past and am currently waiting for results from a recent test (I am 39+1). According to my midwife, if the result is positive it won't have any bearing on using the MLU or the pool - as long as I am willing to get out of the pool to have the IV every 4 hours. I hope it will be the same policy in your area.

[slowshow]

Yes, you're right re. regional variation, which is why it's so frustrating. Who makes these decisions, and using what evidence?

Well, I rang my MLU and spoke to a (lovely and understanding) midwife who said that yes, GBS+ is usually an automatic no, but she would get the lead midwife to contact me. So I'm waiting for a phone call to discuss everything.

The ridiculous thing is, if I hadn't chosen to pay for and carry out my own test, no one would be aware of my GBS status and no one would question a MLU birth

[AllyB2]

I agree, it seems very haphazard. I told midwife at very first appt that I needed to be tested, and then mentioned it at every subsequent appt but was fobbed off every time because 'GBS can come and go' and only tested at 37w - who knows what happens if I go into labour before the test results come back (two weeks and counting)... very frustrating.
I hope the Lead mw is helpful and you get the outcome you want.

[slowshow]

Are you being tested on the NHS? With my private test, I swabbed myself, put them in the last post on Friday and got a text message yesterday with the results. I was pretty impressed with the speed of it all - especially getting the results on a bank holiday.

Anyway, hope you get your results through soon and thanks for replying

[slowshow]

Well, the midwife who called me back was so reassuring! She said that they can, and do, allow GBS+ women into the birth centre, and even let them go into the pool. The only difference is I wouldn't be allowed to keep a cannula in my hand (it would be an infection risk if it got wet) so they would have to remove and re-do the cannula every time I needed a dose of antibiotics. Not fun, but not the end of the world. She said they customarily use a narrower cannula than usual to minimise discomfort, but this does mean the antibiotics take a little longer than usual to drip through.

So that's a massive weight off my shoulders. Still no guarantee that I'll be able to use the birth centre (can't have high blood pressure, can't go there if I need an induction) but my plans haven't been thrown out of the window just yet.

[AllyB2]

Excellent news - hope all works out the way you want and you get to use the pool.

[auroraday]

I thought they had stopped giving ABx for routine cases of GBS these days? I thought it was only if you were high risk (GBS in urine, previous baby infected, PROM) that they still did it?

[Kezzamo]

Hi slowshow,

I had exactly the same problem. Tested for peace of mind and came back positive then had to fight for a water birth.

The consultant midwife came up with the below scientific paper if your into that sort of thing. It basically says that the water may lower the incidence of GBS infections as it may have a "washout" effect.

www.ncbi.nlm.nih.gov/pubmed/16208480

Good luck! (I am 41 weeks now and looks like I will have to be induced so no water birth but I hope it works out for you!)

[slowshow]

Hi Kezzamo, thanks for the link. I happen to be a librarian at a medical school so I'd already managed to track it down and download it

I have a meeting with the lead midwife next Friday to discuss my birth plan - assuming baby doesn't come before then!