Would I be unreasonable to have another baby (after 1st was critically ill with GBS (Group B Strep))?

[winnieinpooh]

I was looking at baby photos of my DD (nearly 3) yesterday and it hit me that I'd really love to have another baby.

My DD is fine and healthy now, but was critically ill from septicemia caused by a GBS infection at two weeks old. I also had pre-eclampsia at 37 weeks and she was born by ELCS so I really don't know if I was a carrier or if she picked it up from someone else handling her - I guess that I'll never know.

When she recovered I read about GBS (see here if you want to read about it. I'd not heard much about it before DD was born) and realised how much of a lucky escape we had, that she had survived and had no lasting effects. Other parents have not been so lucky .

At the time, I thought we should just stick at one and not push our luck any further. The risks also increase if you've already had a child with GBS to 1 in 100 (it's about 1 in 1000 with no prior risk factor).

I'm 35 soon, and both DH and I would love another, but I'm scared.

Would I be unreasonable to try for another given that I carry an extra risk and I already have one DD? I'd hate to make another baby suffer/ die/ have long term problems.

Should I just stick with one to be on the safe side?

why not ask medical advice from your doctor about the risks and whatnot

You could have a 1 in 100 risk of your baby having GBS.
Looking at the article, if you were that 1 in 100 family, you would then have about a 1 in 7 chance of your baby dying or being left with problems and a 6 in 7 chance of them surviving without problems.
Someone brainier than me could do the maths better but personally, I would take the risk and try for another baby.

Yanbu to have another baby, sounds like you need to come to terms with what happened though. I had counselling to help with this kind of decision (though different issues) and during the next pregnancy, also medical advice, it can really help to hear a doctor explain the risks and what can be done to manage them etc.

I now have DD2!

1 in 100 chance isn't that great a risk when statistic show 1 in 4 pregnancies end in miscarriage (I believe). If people worried about the statistics no one would ever try for a baby.

If you're known to be at risk there are some ways to manage it - i'm sure I've read of ladies being given IV antibiotics during labour as a precautionary measure.

YANBU to be concerned about the risk - DD was very ill at birth with suspected GBS. YWBU to dismiss it without exploring all your options if you really want to add to your family.

Best of luck :)

My DS also had Group B Strep (came from me, they tested the placenta) and was luckily ok after a week of strong antibiotics. In the months after I gave birth, I also thought 'I couldn't go through that again'.

However, I believe Group B Strep in the mother can come and go so if you had it previously, you can be tested before birth to see if you still have it. They can also administer antibiotics during labour, which I believe helps prevent the transfer to the baby.

You are not completely powerless, there are actions that can be taken to minimise the risk. I'd talk to a midwife about it before making a decision.

Personally, I will be trying for another child.

I agree with banana you should talk to a medical professional about it. I carry group B strep (it's actually quite common to be a carrier) once they know you carry it they will give you antibiotics in labour to prevent the baby catching it, the danger with group b strep is mainly not knowing about it, once they know you carry it and treat you for it the risk to the baby is practically eliminated. I was given this info from a consultant obstetrician but I think it's important that you speak to a professional about your particular concerns rather than just go off what I say iykwim. good luck whatever you decide

I'm very sorry to hear about your experience and I am glad DD came through it.

You can buy GBS testing kits, most people on my antenatal thread on another forum got them. I didn't, had an infection and when I chased up the results, yes, it was GBS.

I had an antibiotic drip during labour and all was fine was DS thankfully.

You probably know all this already though and as a previous poster said, perhaps you might need to talk to someone as it isn't always about practicalities but about support.

Good luck in whatever you decide to do.

I really don't think it's such a biggie if you are aware of it, make the health team aware of it... it will probably preclude your having a home birth, as they will want to get you into hospital and onto a drip in any case.

I have to be honest - we researched a LOT into this when p/g with third child. Second child couldn't be home birth because I came up postiive for GBS. We did a LOT of work on it - husband is a qualified pharmacist, so knows his stuff... and came to the decision that the NHS has a totally woolly-headed and mixed up approach to GBS. So we had our third child at home with no complicaitons.

However - if it goes wrong, it can be very nasty. So decide what you want to do, but for HEAVEN'S sakes don't let it stop you having another child. Absolutely no reason for that WHATSOEVER.

Good luck.

There is an increased risk that a second baby will be affected but because we know of this risk we do everything we can to prevent the new baby being affected. As you have had a previous child with invasive GBS, you will be treated with antibiotics in labour and your child will be closely observed and may even be given antibiotics just in case once they are born. This is a given, whether you test positive or not, so don't worry about getting tested. (I'm a paediatrician and this has been policy everywhere I've worked)

Thanks all. I will definately be talking to my doctor before we TTC, but I sort of need to get it right in my own head first before going down that route (iyswim?).

I think because it was so late on (she was 18 days old), I was never tested and it was never discussed. It's left me a bit confused.

I'd want another ELCS again, so I guess that helps to reduce the risk.

Rationally, I think that a 1 in 100 risk is not too bad, but then I never thought that I'd be the one in the 1000.

Sometimes I think I'm stupid to even consider it.

It is awful that so many people are not aware of GBS and that isn't your fault. You are not stupid; you are being a responsible, concerned and loving parent

The fact that you've had one experience with GBS means that you can be medically better prepared for it a second time around.

My ds1 was hospitalised with an infection after I tested +ve after his birth. He was fine after a few days of ABs. When I was pregnant with ds2 I wasn't even tested for GBS as it can come and go. I was induced late (again!) and had ABs during labour but there was no evidence of it second time around.

If you hadn't had this experience the first time round you probably wouldn't have hesitated at all in trying for a second. You could then have had experience of GPS with your second pregnancy.

At least this time you'd know what precautionary steps need to be taken. Good luck!

My DS is 11yo and in the few days before his birth -he was 41 weeks- I was really ill, vomiting constantly, high temperature, had to be admitted and put on a drip (fluids, antibiotics, anti-emetics, painkillers)
They did loads of tests and after DS was born, (NVD, thankfully ok) they admitted they couldn't find any cause.

When I had DD (now 9) it was in my records that I'd carried GBS. I'd never heard of it.
I had swabs and the usual blood tests.When I was in labour (she was 40+4)I had IV antibiotica then she had blood tests, though she didn't have any antibiotics herself apart from from me (milk).

Paed said she was 'a big girl and + for dates' so her risk was lower.

I think now hospitals are more aware of GBS so you will be screened more.
HTH, good luck!

Thanks again all of you. SallySparrow, if you read this thread again - is that always the case with ELCS too? I was a bit confused reading the information on the GBSS website as to whether they do offer it during CS? Thanks for your reassurance.

I didn't know at the time that GBS is one of the main causes of meningitis in newborns ( presume bacterial menigitis).

Yes, it is Lord of the Flies. My DD just had it in sepsis 'mode' so just in the blood. She had to have a lumbar puncture and the fluid was tested for the bacteria. Thankfully she didn't have it.

If you undergo a planned caesarean section in the absence of labour or ruptured membranes you won't routinely be given chemoprophylaxis. In all other cases you will receive it.

Of course YANBU!

Nobody gets tested, as far as I am aware. You have to arrange this yourself, privately. It costs about £40, I recall. I only knew to bother testing because a woman in my ante-natal class had a friend whose baby died from GBS. I received no information about this from midwives/hospital, I don't think anyone does in this country (a cost outweighs benefit issue, I think).

I tested positive for GBS before both my births. You can send off for a tester kit (got mine via a baby website, might even have been Netmums) which you take between 38 and 40 weeks. You return the test (a couple of simple swabs) in the post and you get texted the results in the next couple of days. The test doesn't always come back positive, you can carry GBS but not be infectious, ifswim. The lab will send the results to your hospital too, and get the midwife to mark the front of your notes if you are infectious, so they know from the outset of the birth.

Prior to the birth (12 hours before, I think) I received several IV doses of anti-biotics. This didn't really cause any problems for the actual birth experiences (eg, I could have used the birth pools, if I'd wanted to). My DCs were checked for infection afterwards but were fine.

Don't let what happened with your little one put you off, now you know you are a carrier, you can take the appropriate precautions. Good luck.

Thank you all - I may start thinking of it properly when DD turns 3ish, but may make an appointment to see the doctor to discuss soon. I guess that would be ok and the GP won't mind? I very rarely go to the surgery and in 12 years have only gone for pregnancy/antenatal/postnatal related stuff.

Guess it's scary to think about a second one anyway without any extra complications! Then again, there's no guarantee that no.2 will come along anyway.

Thanks again.

Hi there, completely feel for you - the decision to try for another baby is very difficult if you've had complications before.

My circumstances were different in that I went into labout very prematurely the first time and wanted to avoid that at all costs again - so had some serious thinking to do to get my head around that experience before we thought about TTC again.

I am also a GBS carrier (nothing to do with the 1st premature birth). One of the other posters has said that you're not routinely tested for this - I was during my first pregnancy (perhaps it varies by area) and was on an IV drip for antibiotics throughout the labour.

With my 2nd pregnancy, as others have said, I was told that there was no point in testing as it can come and go throughout the pregnancy, if I had a "history" of GBS I would automatically be on antibiotics for the labour.

As it turned out however, my 2nd labour was very quick (2 hours) so I didn't have antibiotics. They did however keep me and the baby in hospital to be monitored for 24 hours to watch her to see if she displayed any symptoms of infection.

My advice would be to speak to your GP if you want some advice before you start trying to conceive, but also flag your concerns up with the midwife (at your first booking in appointment) so your antenatal care can be planned accordingly. I pushed for a consultant referral and extra appointments / scans - particularly around the time when I went into premature labour the first time - anything that settles your worries. Perhaps get an appointment a couple of weeks before your due date, or visit the ward if you can to discuss the routine testing. I think if you've had a traumatic time, the medical team are often accommodating in trying to put you at ease.

HTH

I completely feel for you. My poor neighbour's daughter died of this during pregnancy.

But the good news is you have the heads up, and you will be monitored and given ABs if appropriate.

Thank god we live in times of antibiotics.

One thing to check with the doctor is the type of Group B Strep your baby developed.

There is two types early onset which develops 24/48 hours after birth and is linked to mother's strep B status especially if other risk factors were present during labour (PROM, Fever in Mother, Prem baby)

I understand if the mother is positive for strep B AND has already has had a child with early onset strep B, then she has a greater chance of future children having the same infection. However many cases can be prevented by antibiotics in labour or direct to baby after birth.

The other type is late onset and this is when a baby develops group B strep after a week or more. If your baby was ill at the two week mark, this is likely to be late onset version. The important difference is that the experts are not sure how babies get late onset group B strep. It is not necessarily linked to mothers status, there is talk of environmental factors and other possible causes.

As late onset strep B has not been linked to the mothers strep B status, would this make it less likely a second child of yours would develop this late onset infection ?

Winnie

I also had a baby with late onset GBS (at 21 days), she is now a very healthy 2 1/2 year, but I know the emotions you are going through. I also had pre-eclampsia, but had induced delivery. I was never tested for GBS either when pregnant or afterwards. The one thing I have been told is that if I ever have another baby i will have to have antibiotics during birth.

Do not let it be the deciding factor in whether to have another baby or not. If you want one, go for it

Thanks to all who posted. It's been very helpful to hear your views and experience. I think up until now - I've just thought 'NO' to having another baby, I'd just ruled it out as I wouldn't want to go throught that (or worse) again. I think the fact that I am getting older and DD is growing up is making me think that it's my last opportunity now and maybe I should look into it.

Babieseverywhere - I'm pretty sure she did have late onset GBS, she was 18 days and in the first 18 days was healthy and home with us. I had no signs, but I had the pre-eclampsia and she was fairly small (5.12lb) born. I also had slight bleeding from 15 to 24 weeks but they put that down to cervical erosion. Will check with the Dr though, perhaps she can send for DD's notes.

I think that the fact that environmental causes can cause the late onset GBS confuses me as to whether it came from me or somewhere else, she barely came into contact with my waters as she was whipped out in a planned C-section. Then in the maternity ward and at home I was meticulous about hygiene. So if it is late onset and it came from elsewhere - I'm not sure what it means (in risk factors) if I do have another baby.

With DD, it came on very suddenly with a few hours of crying (which we thought was colic) and then she stoppped crying and was struggling to breathe/ going very white -greeny blue colour. Ended up in hospital on broad spectrum antibiotics whilst they did lab tests, Dr's told us to expect the worst as she was more or less in a coma state with her heart rate/breathing rate going off the scales, blood had high levels of CO2. After a few days we found out it was GBS (as they'd grown cultures fom it in the lab) and I think on that day she turned a corner, she woke up and started feeding. Tested for meningitis which came back negative thankfully. Stayed another week whilst she had antibiotics.

Lobsters: strangely enough, since DD got over the GBS, she has been very healthy too. Would you like another baby or has it put you off?

Thanks all, I'm grateful for your replies.