To be angry at doctor over GBS testing.

[FirstTimeBumps]

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?

Geknock

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

Never heard of it, testing wasn't available. Shit! Nasty way of addressing women who've lost or nearly lost children.

Also, good luck on the birth. Try to be goal orientated about it and not too bothered how you get there. My birth plan ended up being a million miles from what actually happened but I was ok with that.

The NHS doesn’t offer this test as standard. So by the reasoning of some posters on this thread, any woman who chooses not to pay, out of her own funds, for a test that the health service itself doesn’t deem necessary for all expectant mothers is a crazed anti-vaxxer imbecile loon.

Don’t bother- OP obviously knows best. Foolish idiot.

Well yes, as a midwife I would say I know a hell of a lot about it, I wouldnt expect a gp to know much about it really, its not something they will be dealing with.
Fwiw, your midwife knowing what to look for won't necessarily help, your baby could become symptomatic 12 hours after the birth, plus sepsis isn't always easy to spot.

@MrMakersFartyParty it's the fact your sat there on your high horse like I've gotten all my information from Dr Google when I did indeed consult a HCP, my MW. And you feel that as a HCP, rather than educate and inform, you feel your own opinion on GBS testing is the most important, and that you should back that up by ridiculing a mix up between virus and bacteria, which I had previously apologised for, not that I should have to, and that as a HCP, you find it appropriate to refer to someone, making an informed decision based on her own research and the advice sought from her MW as sounding like a "silly first time mum'".

And @greendale17 you obviously know best that you feel the need to call people idiots because they're of a different opinion yeah?

You keep saying I'm on a high horse, very bizarre. Look if you want to complain about your gp, go ahead, many serious incident investigations have found that the cause has often been because of lack of communication within the multidisciplinary team. I'll leave it there as you seem a bit hysterical.

The problem is, it's all subjective. Even on this thread, you've got some HCPs saying yes, some no. It's all down to interpretation of the facts. If you'd had a MW who felt differently, you'd be making a different decision. But ultimately all you can go on is what you have, and if it's something you feel strongly about OP, and you feel you have made an informed decision, then go with it.

If you’re a GBS carrier there is a 1 in 200 chance your baby being affected. I chose not to have private GBS testing prior to my DS1 being born for roughly the same reasons as you. Unfortunately, it turned out I was a carrier and he was that 1 in 200 and he became very poorly when he was a couple of hours old. Luckily he was ok but I was retrospectively very cross with myself for not looking into it further. It’s useful to know if you’re a carrier, you don’t necessarily have to have antibiotics or an ‘overly medicalised’ birth if you test positive but the risk management approach currently used has been shown to be less effective in preventing GBS infection than routine screening.

I’m also a bit concerned about your MW coming across as being so vociferously against screening. I’d hope they’d be more open minded and discuss issues with the GP not browbeat them into agreeing with their view (which isn’t necessarily correct).

@FirstTimeBumps please stop being so rude.

OP- why so aggressive? You've got a good mix of opinions here. A lot are from midwives and medical professionals.

If you weren't doubting yourself, you wouldn't have posted on here in the first place.

Ultimately- it's your baby and your decision. But unless you're prepared to hear a mix of opinions, doesn't ask the question in the first place.

Good luck with your birth.

Many people here are giving good, reasoned, medically based explanations of reasons women might refuse GBS testing.

And many people are popping their heads up just to say “why wouldn’t you?! + bad experience”

Why not read the good, reasoned, medically based explanations that lead to the decision not to have testing. The ‘“why wouldn’t you” is being explained and explored repeatedly on this thread. If GBS testing is important to you, if you know or have had babies affected by it, I’d suspect you’d be up to date with the guidelines and research surrounding it which doesn’t support routine testing. And I’d suggest directing a campaign at awareness of the symptoms of early onset and late onset GBS - rather than haranguing a pregnant woman for her choice. Her choice which is hers alone to make, in line with current NHS guidelines, and based on research showing that routine testing does not improve outcomes.

Just read the thread!

You should be having the GBS test OP. The test is done close enough to viability and gestation that if you are positive there is a high likelyhood you are GBS+ at the time of delivery.

Why WOULDNT you want the test?

Have you seen what can happen with a GBS+ baby in the first 48hrs?

Christ.

YABVVVU. For the sake of a bloody antibiotic drip during labour FFS.

Just FYI, GBS will show up on standard vaginal swabs. If you think you have excess discharge, the doc or midwife will send a swab and if GBS is there it will get processed as you are pregnant. If not pregnant it is usually ignored, unless you have another condition that it may be significant in. Just FYI.

The GBS test does not cause harm to the baby. It's a swab of the lower third of the vagina and also the rectum.

The fact I'd rather not have a baby treated with antibiotics just as a precaution

I think it's this attitude that people are finding irrational. Of course you'd treat your baby with antibiotics as a precaution if there was a significant risk of harm. It would be neglectful not to. Just as you'd put them in a car seat as a precaution or give them a vaccination as a precaution. You may think that the risk is low enough in this particular case but your other arguments are clearly wrong. The testing DOES reduce the risk and DOES save babies from getting incredibly sick. This is fact. If you think your research disproves this your wrong. A midwife is very experienced in some areas but isn't an expert in neonatal peadeatrics.

I wasn't offered the test my little boy ended up really poorly with sepsis. He pulled through but 17 month on his lungs are still shite. I had to call 999 at 3am Tuesday when he couldn't catch his breath it was awful.

@MorningsEleven I'm not about to sit here and have people of a different opinion call me stupid, silly and ridiculous due to me not agreeing with their opinion, especially those, who claiming to be HCP should know better.

@SmallButFierce that's a good point and I suppose then at least I could know what to look for whilst also baring in mind that the odds were still low. My MW didn't dissuade, she just told me that a positive would mean a hospital birth with IV antibiotics and that a positive/negative doesn't necessarily mean the same at time of birth. She specifically said she wanted me to go away and look at it myself and come to a decision.

@AnastasiaVonBeaverhausen it's the fact that some of the HCPs who are of a different opinion find it necessary to act belittling and imply that any opinion other than theirs is stupid, silly and whatever else derogatory they want to say. Surely as a professional there's a way to conduct yourself to sway people to your side of thinking and ridicule isn't really the way.

@FirstTimeBumps that’s the thing, what if I hadn’t had an experienced midwife, who was able to stand her ground against a paediatrician? What if it had been a newly qualified midwife who deferred judgement to the doctor? We would have been discharged, and DS would have become very ill very quickly.
I know the test isn’t very reliable, but sometimes neither is relying on HCPs in a busy hospital.

@PermanentlyFrizzyHairBall the risk is lower than what the NHS deem as "high risk" for genetic abnormality screening, and if it was high enough they would surely be offering it along with the basic screening they currently offer? Even looking at the risks of home birth Vs MLU Vs hospital, the odds of adverse outcomes are higher than the 0.057% risk of a baby developing GBS infection. That's where my issue lies and I can't honestly call that value a high risk when compared to other things the NHS deem as low risk.

They didn't test for GBS routinely when I had mine but DD was hospitalised pyrexic and grunting at 2 weeks. Because they'd already commented IV antibiotics before blood tests they couldn't conform GBS but strongly suspected it.

I've also had a cord prolapse which I also hear is extremely rare.

Of course you can't eliminate all risk but I don't ever think it won't be me any more...

Also OP your midwife is full of shit. It does NOT automatically mean a hospital birth.

It's that they advise you to have one as a precaution. No one can 'make' you have a hospital birth. So know your own rights for one FFS.

And again... if you test positive you are highly likely to be positive at the time of delivery. You are reading and being fed misinformation.

Also yes you are coming across as a silly first time mum, just like we all did at one point. But we are people telling you from experience, because we are on the other side - have the bloody swab!

I was going somewhere with that post

I felt really helpless, I couldn't fix DS it was one of the worst experiences of my life. I thought I was going to end up having to do CPR. I've never felt so useless as a parent.

(DS is fine now, he has croup. Oxygen in the ambulance and steroids on the children's ward sorted him out)

Actually Bonnie has a really good point. They can't 'make' you do anything. If they try go to the supervisor of midwives.

Personally I would get tested for my own peace of mind so if it's +ve you can watch out for signs in the baby. But you wouldn't get me in hospital if it's not what I wanted to do.

There are other options but ultimately it's your decision at the end of the day.

Geknock when I had my child no test was offered. When you’ve seen your baby fighting for every breath maybe you feel duty bound to give others the advantage of your experience so they don’t have the same experience when they are given the Amazing opportunity to reduce the risk of seeing their baby in nicu hooked up to machines and drips or worse burying their child