To think Strep B tests should be offered to all pregnant women?

[plinkyplonks]

Hadn't even heard of Strep B if it hadn't been for Bumpfest.

My midwife says Strep B tests are not offered as standard on NHS!

Please, please, please consider signing this petition if you think this is a test that should be offered to all pregnant women:

epetitions.direct.gov.uk/petitions/60515

No i don't think it should.

My first baby died from GBS infection.

I think anyone that has been found to have GBS in a previous pregnancy or a previous baby infected with GBS should be offered antibiotics.

Anyone else should be based on symptoms, for instance a high temp in labour etc.

I refuse antibiotics during labour and for my baby. I have quick labours anyway. I symptom watch. I know what to look for after watching my first baby slowly die of it and having no one listen to me.

"But...routine testing is a big deal. it does have implications beyond some arbitrary 'fear of medicalisation' - the are good reasons to avoid any intervention that isn't absolutely necessary and they have nothing to do with airy-fairy fantasies about natural birth."

Routine testing is not an intervention, nor is it a big deal. It provides information on who is most likely to need a relatively minor intervention. Ultimately the mothers who are at risk have the choice to turn down the intervention even though ABs have the potential to greatly benefit a vulnerable group whose risk of death or catastrophic side effects, or massive post natal medical intervention, is quite high without the intervention.

You really are hung up on the idealised natural birth experience if you think a priority of maternity care should be to 'avoid any intervention that isn't absolutely necessary' and are prepared to dismiss death and serious illness of babies (more than just one baby) because that is not a good enough reason for intervention when stacked against the interest of facilitating the ideal natural birth experience.

Mathanxiety - I think it's skewing the facts to state that routine testing isn't a big deal because it only leads to a minor intervention, and denouncing 'idealised natural birth'.

It's only a minor intervention if antibiotics are actually required. But a lot of the times they are not required. We are over using antibiotics to such a scale that we are going to build up resistance to them, and eventually they won't be of any use to us.

I don't know what it's like in England, but here in Australia there is a huge skew to giving neonates IV antibiotics. At risk babies get 48 hours worth of prophylactic amoycillin and gentamicin - and the doses continue if they have a high septic score while the blood cultures are taken and cultured. I would absolutely accept this if my baby had any symptoms, but this is being done on babies without any signs or symptoms of infection. I don't think parents are made aware that they can refuse. I would not be happy for my brand newborn baby to receive antibiotics that weren't required that their immature bodies would have to process. Gentamicin particularly can have some terrible long term effects.

Just a quick note to anyone that said they are going to pay privately for a test, I got one when my waters broke without any asking or moaning, so I would say its worth an ask before you go and pay.

Great petition, will sign.

Thanks CharleyFarleyy - Will definitely ask - worst they can say is no!

mathanxiety The evidence is not there for routine testing. The incidence of GBS in babies in the UK is the same as in the US, so routine screening and AB in the US do not reduce the liklehood of your child suffering. (see link from RCOB upthread).
AFAIK testing cannot be done whilst in labour as there is not enough time to get a result.

caroldecker - Why do you think women should not be informed about Strep B and offered the choice whether they want the test? The NHS offers DS screening, this doesn't impact mortality rate yet it is offered anyway?

Sorry I won't be signing. It would cost nhs huge amounts and I don't believe it would help that many people. There are so many conditions that are harmful to pregnancies, we simply can't test for them all.

plinky Because non-risk based screening offers no benefit. It is just another thing to worry about.
How would you offer it:

We have a test which may worry you unnecessarily, may give you false reassurance, may cause unnecessary intervention at birth and will make no difference to the chances your child will be ill. do you want it?

If you have a baby privately they ask you to do a swab on yourself (vaginal) at something like 37 or 38 weeks. They obviously think it minimises the risks if it's positive at this stage (I think they give you antibiotics). I know strep b comes and goes but it must reduce the risks to the baby or they wouldn't bother. Because it's not absolutely foolproof the NHS on balance maybe can't make a case for doing these tests but I think they are important.

Echo you are misunderstanding the situation. The NHS is not saying it needs to be foolproof or that it is useful but expensive.
The NHS are saying it is of no benefit.
Litigation concerned groups, such as the US and private hospitals may do it so they can cover themselves, but they do many excessive unnecessary tests in the US and private hospitals to cover themselves.

I'm slightly confused as I have just been tested at 8 wks. Midwife said I will be tested again at 36 weeks. If necessary a vaginal swab will be taken then too.

I haven't had this with previous pregnancies. I did have strep b in previous pregnancies but she wasn't aware of that at this point in conversation and said it is new and is offered to all.

nutelladipper - I think each trust may have different policies on it. Unfortunately, that option is not offered to all :(

caroldecker - I'd rather know than not not know - should we not offer HIV tests, STI tests to women because it may stress them out more than remaining ignorant? Not sure how a test at 37-42 weeks is likely to give false assurance/reassurance - many women do not get any symptoms at all with strep b - so it is it a huge shock to find out that their baby is seriously ill or stillborn due to an condition they didn't even realise they had! Why should we deny women to opportunity to be informed?

Oh I see. I've had one baby privately as work insurance paid for it as a medical emergency and the second one on the NHS. The only extra test I got offered privately was the Strep B one.

Postcode lottery again then plinkyplonk

Carol, it is not done in the US purely for litigation reasons. To imply this is the case in GBS testing and other testing is to grotesquely misstate the basis of US policy. Your argument is completely dishonest.

It is done because it saves the lives of babies and leads to huge cost reductions for hospitals dealing with babies in NICU.

''may cause unnecessary intervention at birth''

And here we go again.

This is a fetish.

We are over using antibiotics to such a scale that we are going to build up resistance to them, and eventually they won't be of any use to us.

As I stated before what we need to do is stop using ABs for the common cold and the flu, not refuse to test and then use them when they can save the lives of babie.

Do you really not understand that saving babies' lives is important and that there really is a place for antibiotics?

I have serious reservations about screening so won't be signing. For several reasons including the fact the we have the SAME rate of GBS infection (in babies) as in the states and they screen.

And I am well aware of the consequences of GBS infection (doctor in paediatrics at present)

When I had DS (he's now 15) I went through a textbook pg to being violently ill at 40+3.
I ended up on a drip, vomiting even water.
Protein ++ and heading for pre-eclampsia, my kidneys were affected on the day he was born at 41 weeks.
They tested me, asked me questions,
One of the midwives told me (after I asked outright) that I "could've lost him".

Never heard of Strep B until, when I had DD in 2002 , I was given a swab and an antibiotic when labour started. We were kept in hospital for 5 days until it was sure she was ok (she was 40+3 and a good size)

Very worrying time.
I found out later that the prescence of GBS is a major cause of meningitus in newborns.

Do you really not understand that saving babies' lives is important and that there really is a place for antibiotics?

Of course I do. Do you really not understand though that there's no evidence to prove that screening and antibiotics improves outcome?

Typo - screening for antibiotics i.e screening for GBS to see whether Abx are required.

"I think terror of 'medicalised birth' and the fixation on 'options' is getting out of hand in the UK."

What?

Can I just remind you that far from the medical establishment trying to avoid medical interventions in birth, they're actually doing more and more of them every year?

There are hospitals in the UK now where more than 50% of births involve forceps, ventouse or caesarean section, and where 32% of all labours are induced?

I wouldn't sign the petition.

BUT I would like women to know about GBS and the reasons for and against routine testing.

Re: "may cause unnecessary intervention" - women who are required to give birth in a CLU because they need antibiotic prophylaxis are more likely to end up having a prolonged labour with ruptured membranes, and this in itself is a risk factor for Gbs. I also don't think it's unreasonable for women to want to avoid giving birth in setting with high rates of emergency c-sections and forceps deliveries, particularly when these aren't associated with better neonatal outcomes.

this is a useful article.

If that were the case then of course I would understand it. But that is simply not the case.