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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

To ask about your experience of group b strep in subsequent pregnancies

52 replies

GettaWound · 11/04/2015 10:07

Sorry, looking for a wider audience.

My hospital has a policy that is you were group b strep positive in one pregnancy you get antibiotics in all subsequent labours, no further testing.

This is against most advice online and even the leaflet they gave me.

Can I ask what happened to others? Is this common, I've found quite different policies online. I'm a little down to face another grimlabour ward birth rather than the birth centre.

OP posts:

ThisToo · 11/04/2015 11:49

Hi. I tested positive for group B strep with my 1st pregnancy and had IV antibiotics during labour (midwife led unit). I had to pay for a private group B strep test in my 2nd pregnancy as it was no longer part of the screening offered by the nhs where I live. It was negative. Had it been positive I would have had a course of antibiotics and IV during labour again. Why the nhs would cover this but not provide the test in the first place, I have no idea. Certainly there was no policy to give automatic antibiotics with no testing. Have you asked to be tested?

Original poster

GettaWound · 11/04/2015 12:05

I hadn't thought of private testing. It was just informed whilst sticking big yellow warning stickers all over my notes, when I asked I got a quick answer alone the lines of they presume you are always a carrier once you've had it as it doesn't go away.

It was a fairly crap booking in to be honest, I had actually researched alone before policies and expected to have low risk... But have been given three high risk and consultant led care. (Previous pph and preterm but not early preterm)

OP posts:

tortoisesarefab · 11/04/2015 12:09

I have had antibiotics in my 2 subsequent pregnancies and wouldn't risk it. I have a friend who's newborn died of group b strep, it's a very serious infection in a newborn. I think they are right to presume you still carry it and err on the side of caution

seaoflove · 11/04/2015 12:17

I managed to have a water birth in a MLU despite testing positive for GBS. I had a meeting with the lead midwife and she drew up a plan. Basically, I had a cannula (which I wasn't allowed to get wet) and had the antibiotics before getting in the pool. I delivered before I needed the second lot. I also refused IV antibiotics for my baby (which that hospital gave as routine) because I just didn't want to inflict that on my newborn. They monitored her temp for signs of infection instead. She was fine.

Having done a bit of research prior to the birth, the GBS issue is a tricky one. Transmission rates are very low, so giving all women who test positive IV antibiotics is a bit like using a sledgehammer to crack a nut. However, GBS infection in newborns is so dangerous, not many women are going to refuse antibiotics.

I would definitely ask for a GBS test, OP, or pay for one.

ThisToo · 11/04/2015 12:22

I was under the impression that GBS can come and go which is why testing should be done late in pregnancy as being negative early on doesn't mean you will still be negative by the time you come to deliver. I think there is some debate as to the reliability of the test but we still felt it was worth it for us, given how serious GBS is for newborns. I think preterm babies are at greater risk. Maybe they think with your history and the possibility of an inaccurate test result it is better to recommend the IV antibiotics than take any chances?

SomeSortOfDeliciousBiscuit · 11/04/2015 12:25

I have nothing to add to the OP's question, but it seems like a good thread to ask this on: What happens if someone has tested positive for group B strep, but needs a planned section in the future? I tested positive for it after the birth (issues with 3rd degree tear and I was swabbed). I've always wondered.

ThisToo · 11/04/2015 12:27

Have you tried the group B strep support website for info? They are a UK based charity who campaign for routine screening in pregnancy for GBS.

ThisToo · 11/04/2015 12:30

I'm relatively new to MN and I haven't worked out how to post links yet I'm afraid but there web address is gbss.org.uk

Discopanda · 11/04/2015 12:30

I had GBS first time round so they're just going to give me antibiotics this time round, no screening. There NEEDS to be something done to encourage routine screening, I wasn't due to have a screening 1st time round, I just got swabbed at 20 weeks because I had a minor bleed.

AbbeyRoadCrossing · 11/04/2015 12:32

I had GBS and an emcs Biscuit and they didn't do any antibiotics or anything. I think the infection risk is very low with a cs.

SomeSortOfDeliciousBiscuit · 11/04/2015 12:35

Thanks Abbey and ThisToo. That website says the same thing, not really needed with an elective section as long as it's done before labour starts. I have a very complicated medical history so I forgot to mention the group B to my midwife, but I will at my next appointment.

LittleBairn · 11/04/2015 12:35

I tested Postive in my first pregnancy I was only tested because my DS had died. Nothing to do with GSB so nothing needed to be done.

DD1 also another late term loss but I was tested again and was negative for GSB. I did pick up septicemia from the hospital and had huge amounts of antibiotics.

DD2 currently 39 weeks. I've been tested at least 3 times in this pregnancy all negative.
One midwife said she would want me to be on antibiotics throughout the delivery because of the septicemia.
I spoke to my consultant who said this was uneccesary I had recently tests negative for GSB there I was fine.

Since that first test I have always been negative but it can come and go. My current hospital has always been fine about retesting me but that may be because of my history. The first hospital had the same policy as yours I made it clear unless they provided me with evidence (a Postive GSB swab) then for a live birth I wouldn't be accepting the anti-biotics.

Personally I wouldn't accept the blanket policy of we will be giving you them. I would make it clear that unless you are tested close to your due date and are Postive then you will not be allowing it.
I find hospitals sometimes seem to view their policy's as law and forget the patients aren't obliged to abide by them. Once you are assertive with them you will find they are much more willing to compromise.

I don't have the details to hand but I know you can get testing kits to do at home when I looked they were around £50.

AbbeyRoadCrossing · 11/04/2015 12:38

Just realised I didn't mention it to the midwife when booking in either for my current pregnancy. Will have to do that next appointment

tortoisesarefab · 11/04/2015 12:38

As far as I am aware, group b strep is usually transmitted during vaginal births, not c sections as the baby can pick it up as it goes through the birth canal.

I totally agree that routine testing should be available on the nhs and part of everybody's antenatal care. I am a nurse and have seen several families lives torn apart by this horrible infection

LittleBairn · 11/04/2015 12:40

Forgot to add I did ask my consultant what happens if I were to be Postive and didn't have the anti-biotics. He says the pass rate of infection onto babies is low therefore not a major concern hence why its not routinely tested for in pregnancy a lot more women are GSB than they realise.
He said the most important thing would be to keep a close eye on the baby after birth and react quickly if they were showing any signs of infection which should happen as a matter of routine anyway.

missmakesstuff · 11/04/2015 12:43

I tested positive for GBS in my last pregnancy and although it wasn't an issue then (elcs due to breech) this time I assumed it would be. I did not want anti-b unless absolutely necessary, as it can give you thrush, would have meant giving birth in hospital and would have severely restricted my chances of a vbac, a cannula in your hand can restrict movement and having had one with dd which they refused to move 'just in case's fir 3 days and the pain and annoyance it caused, I decided to read up on the actual risks if GbS.

It is of course a horrible thought and I can't imagine what it would be like to have transferred it to a newborn, but there ate certain risk factors like waters breaking 24-72 hrs before baby born, 72 is what NICE suggest is a maximum I think but my hospital went with 24, which I was fine with. If it's a swab that is less worrying than a urine sample showing it. The test is very unreliable anyway, I didn't bother having another as I could have still had it and had a negative test. If the mother shows a temp, signs if infection etc, there should be a policy that shoes the risk factors and then you can decide what you are happy with. I also took lots of garlic and vit c which is shown to reduce the chances of an active infection.
I worried and researched more than I needed to, the midwives looked at my risk factors, of which I had none, and it wasn't even mentioned again. As long as you are aware, lots of people will tell you your baby could die etc, but when you weigh up the actual transmission rates, the fact that loads of people have it and have no idea and have no problems, then you can make a reasoned decision. Saying that, I kno. How hard it can be to not let tiny risks ( I had vbac so had the tiny scar rupture risk as well, plus had never laboured, to worry about) play on your mind.
I had a fairly quick labour, at home in water, waters went when pushing, as they often do, so minimal risk, there wouldn't have been time for antibiotics anyway and I obviously didn't need them.

What your hospital ate offering sounds wrong, plus remember it's an offer, which you can decline. Good luck with your pregnancy.

missmakesstuff · 11/04/2015 12:46

Sorry for God awful typing, feeding 8 day old ds!

Guyropes · 11/04/2015 12:48

Haven't had gbs in a previous pregnancy, but in a bv infection last year. It has been noted, and mw said she would do a urine test later in this pg as if its showing up in urine, it's a more systemic infection.

ThisToo · 11/04/2015 12:50

Apparently I can't post links or use correct English! *their website not "there"

tortoisesarefab · 11/04/2015 12:55

Unfortunately it's not always the case that you can keep and eye on baby and treat if needs be. My friend was discharged with her healthy baby who rapidly deteriorated, by the time she got to hospital, it was too late. I am sorry to harp on about this but it is so serious, I just don't know why anyone wouldn't just have the antibiotics, rather than run the risk, however small it is

LittleBairn · 11/04/2015 13:00

tortose I believe they can test the baby before you leave hospital was your friend not offered this?

seaoflove · 11/04/2015 13:00

Unfortunately it's not always the case that you can keep and eye on baby and treat if needs be

Well, it is, because that's the course of action I chose. DD's temp was only monitored for 24 hours (we were in hospital for four days so could have been monitored for longer) and I took that to mean that evidence showed GBS shows itself quite quickly after birth, if it has been transmitted.

It's ansoluty tragic for your friend tortoises, but it seems likely that her baby was discharged with an infection brewing, and it wasn't detected.

CastielsClevererBetterSister · 11/04/2015 13:02

I was not tested when pregnant with DD1. GBS Was passed on to her. I was in hospital anyway due to severe Pre-eclampsia. She was in NICU for 10 days on stronger antibiotics than those given in labour. I had antibiotics with both my subsequent births. They are 8, 7 and 4 now. DD1 has ASD the other two are NT.

CastielsClevererBetterSister · 11/04/2015 13:05

I'm not saying that is the cause of the ASD by the way just that my other two are perfectly fine and I had the antibiotics. Their births were fine. Had to be induced so was a hospital birth anyway. Wouldn't have chosen the midwife led unit anyway due to what happened to DD1.

tortoisesarefab · 11/04/2015 13:08

All that is offered is observation of the baby, if observations are normal after 24 hours you can be discharged. It does not mean the baby definitely doesn't have the infection. My friend is a very experienced paediatric nurse, she would recognise a poorly baby. The infection can take hold very quickly. I understand it's rare but it can happen. I will stop going on now because I don't mean to scaremonger, I just wouldn't want anyone to go through what my friend has.

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