To be angry at doctor over GBS testing.

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I'm not sure whether to say something or complain or whether I'm just being angry, defensive and hormonal. Two weeks ago my MW sent me to the docs for a prescription for codeine to use in labour. I had discussed group B strep testing with my MW the day before and she had given me some links to take a look at and wanted me to come to my own decisions as to whether to be tested. Baring in mind that 1 in 5 women carry GBS at any time, and the instance of it causing illness in a baby is 0.57 in 1000 (so 0.057%) reduced down to 0.22% with testing and IV antibiotics, these figures seemed extremely low. In addition, testing positive one day doesn't mean you will be positive the next, and vice versa, as the virus works its way out over the course of 6 weeks, but if I were to test positive it would require a hospital birth for IV antibiotics which had a high chance of being unnecessary. Anyway taking all this into account we chose not to have the testing, which wasn't even available on the NHS in our area anyway.

So goes along to the docs for this prescription and GBS testing happened to come up. Told doctor we had looked at everything and decided against it. She says she wants to speak to the practice midwife about by codeine prescription and could she call me the next day to confirm she would be issuing it. Fast forwards the next day, the weekend, and we're on Monday and I went I to the practice as I hadn't heard from her. She then contacts me to say she will be issuing the prescription but proceeds to ask had I reconsidered GBS testing. Again informed her I had decided against it and she made a comment about how "as long as I knew I could be missing out on vital results which could result in the baby become very ill" which miffed me as it was scare mongering but I left it at that.

That was until my MW arrived yesterday for my appointment and told me that the doctor had telephoned her and said "are you aware your patient has declined group b strep testing". My midwife gave her a lesson in pretty much the same reasoning I had and the conversation finished with the doctor thanking my midwife for the education boost however I'm pretty miffed that for whatever reason the doctor found it appropriate to discuss this with my MW, without my permission, and that even before the baby has arrived I am having my decisions doubted. She's really got my back up.

To make matters worse I'm not having to wait on another prescription for codeine as she only issued 2 tablets which is only a single dose in labour. I'm expecting her to call about this and don't know whether to say something about the whole GBS issue, to fill in the NHS would you recommend this practice survey they send and mention it in there, or to say nothing. Our practice is usually really good and they run open surgeries 3 days a week which I often use rather than booking an appointment however I could be allocated this doctor at one of those and I'm really not too keen on that now.

Am I over reacting?

"yesterday's quote was about humans being the only species capable of doubting their ability to give birth"

My Grandpa was a farmer. He got rid of the cows who didn't cope with childbirth. Mother Nature manages the rest of the animal kingdom in much the same way.

You already have far more medical equipment and coping strategies set up for your home birth than I actually used in any of my hospital labours. Not saying you are wrong at all for being properly prepared but I would like to counter your implied lack of trust in the hospital system.

We nearly lost DS1 to GBS. The MLU were all set to discharge us, but one midwife wasn’t happy with DS’s behaviour. She called in the Paeds team, who said they could see nothing wrong, other than a slightly increased resp rate, but that they’d observe him overnight. Midwife insisted on a blood test, having a stand-up row with Paeds, which revealed a CRP level through the roof. DS was whisked off at less than 24 hours old for a lumbar puncture and a chest x-ray, and ended up in SCBU on IV antibiotics for a week.
When my midwife suggested a GBS test when I was pregnant with DS2, I bit her arm off. I tested positive. I didn’t have an invasive, medicalised labour. I went into the MLU, had a dose of IV antibiotics whilst using a birthing ball, had some gas and air, and got in the pool. Stayed in for 24hr obs on DS, and then went home. I’d always advise a GBS test.

Also human babies have proportionally bigger heads compared with other mammals

Jesus Christ my baby got pneumonia at hours old because of strep B. He very nearly died I’ve been left with PTSD, why the fuck would you decide against it??? He’s 6 and still has affects from having pneaumonia at such a young age.

You sound like the anti vaxxer type. If there is any form of risk, whether is 1 in 3 or 1 in 3 million. There is a risk, you baby could be that one in 3 million. Why would you chance it.

YABVVVU. GBS is devastating.

@SleepingStandingUp but even if I hadn't had the conversation with my MW and had come to that conclusion myself, the fact I had said I had looked at facts and statistics and come to this conclusion based on these reasons which I am well within my right to, doesn't mean I should have that thought process questioned and doubted. The fact I chose to bring up that conversation with my midwife, and to seek an expert opinion on it should be enough. To have my GP then question it in such a way feels undermining.

@howabout I dont distrust the hospitals and if for whatever reason I needed to have a hospital birth, then I would trust that that was the best place to have my baby and that would be that. But I would do that based on a clinical necessity for it, not a test which means I could potentially have or not have a bacteria which could be prevented by IV antibiotics, and again may not.

@MoominMamaBear the fact you were in the care of a wonderful experienced midwife who knew what to look out for is brilliant, but even with testing prior to labour she or he may have still been the saving grace as your test may have come back negative.

@Deadbudgie for the reason directly above. The test is not definitive, your baby can still get ill. If there was even an option whereby a test came back positive and it means you WOULD still have it at labour then I would go for it even with the low risk of it making the baby ill, but the fact that you are in essence none the wiser, is the reason why the f* I would get it done.

Really - midwives have a Calendar saying humans doubt their ability to give birth. How fucking insensitive (although after my experience of midwives and those of many people I know have suffered birth trauma it’s not surprising!) although I suppose I didn’t doubt my ability either upto the point I was cut open without anaesthetic because of confusion over whether I’d had an epidural. But probably my lack of positive thinking🤣

@APositiveMind not at all, all vaccinations and standard testing done. On what basis are you making that judgement?

Quite frankly if there is a risk, however small of passing something onto your baby and there is a way to protect against it you should take it! The thing that happened to me was a 1 in 250000 chance- someone has to be that 1!

@Deadbudgie so why not give every mother in labour IV antibiotics just in case then?

I still don't really understand why you are feeling offended. I think your doctor was being extra thorough for the sake of you, your unborn child and her own knowledge. Good for her.
Ps I agree re codeine... will it be useful?

Well, despite that German ob calling NHS antenatal care 'third world ' to a PP, the test is also not routine in Germany for the reasons cited by numerous posters.

Here it's not even about funding, but about cost/benefit for the health insurers. Basically the test doesn't yield enough result for it to be worthy. And Germans are thorough.

It would also very much surprise me if you could kill an infection in a few hours flat with ABs.
At any rate, gratuitous use of ABs should be avoided at all cost. Not to mention that routine AB administration in newborn babies for no reason is an absolute no-no.

My niece died due to GBS.

Please have the test.

Having had a newborn baby in PICU due to gbs I’d say you are incredibly naive. It’s not an invasive test and does not impact on your choice of birth.
It seems naive and abit stupid

@yikesanotherbooboo thank you. That's literally all I'm after is am I being unnecessarily offended and getting my back up.

also it's a bacteria not a virus!

This. The fact that you mixed them up makes me wonder how good your understanding is, tbh.

If you want to refuse testing then go ahead - your choice.

@yikesanotherbooboo tbh I'm usually quite picky with these things however I didn't honestly see what relevance it had to the overall picture.

YABU for 2 reasons. Firstly the GBS. Perhaps your GP has seen a baby have a respiratory arrest and die from GBS sepsis? I have and it was fucjing horrific. One of the worst things I have ever had to deal with. Secondly, your GP is not obliged to give you any codeine or indeed any other analgesia for labour. It was made clear to GPs a number of years ago their input into antenatal care was not wanted and services were decommissioned. It’s the responsibility of the midwife to sort out your pain relief through the obstetric team she works for (community midwives are not employed by GPs) not provide it themselves. It would not have happened at all in the area I work in.

My DD nearly died due to GSB and spent 8 days in nicu. However my understanding was its only accurate for a 24 hr period. I would get the test.

@Poppyred85 not entirely sure how the second reason is me being unreasonable seen as that wasn't the purpose of the post anyway? And your reason 1 doesn't make much sense either given that a GPs POV and personal experience should not come into it. Given she then changed her perspective after speaking with my MW I highly doubt this was the case.

All these people saying your irresponsible for not testing because their LO nearly died from it, why didnt they get them selves tested then?

You just sound really silly and like an uniformed first time mum. Full of ideas of how the hospital is all medicalised, you think gbs is a virus?? Good god. I mean that's basic isn't it? Antibiotics are used for bacteria not viruses. There's a reason we health care professionals dare to question decisions made, and it's because of lack of comprehension like you have shown. No, we do not offer tests "just because they're there", it costs the NHS a lot of money to offer tests, do you know how much a simple full blood count costs? (I know the gbs test isn't on the NHS I was addressing what you said about tests. I mean the thing is, with some people it takes something horrible to happen before they open their bloody eyes and see that medicine isn't evil.

The GP was covering her arse. So you couldn't blame her if something went wrong. You need to let it go.

@MrMakersFartyParty as previously stated I do apologize for getting the two mixed up however in the grand scheme of everything else I have stated, the statistics, the fact that a positive (or negative) now doesn't mean a positive or negative in 24 hours time. The fact I'd rather not have a baby treated with antibiotics just as a precaution and would rather be under the care of a midwife who knows what she is looking for, well if that makes me look like a 'silly first time mum' then so be it. The fact this GP wasn't even aware of half of the things my MW went on to tell her about, and people like her and apparently yourself think you know it all because "us healthcare professionals" always know best. I sought advice from a healthcare professional, my MW, who evidently knew a damn site more than the GP, but back on your high horse where you left off educating us "non-healthcare professionals" about the difference between viruses and bacteria