Group B Strep positive & denied C -section

[CJ2010]

I'd like some advice please plus I just want to let off steam about a very frustrating and upsetting hospital appt with my doctor yesterday.

Im 4 mths gone with 2nd DC and because I had a traumatic birth with DC1 I was referred by midwife to speak with doctor.

First birth was a nightmare. Found out I had Group B Strep during preg but was reassured that I would get IV antibiotics during labour, however in the event I laboured so quickly that I never got the recommended 4 hrs dose, plus I was stitched up incorrectly after the birth and got rushed into theatre to have a blood clot removed. It was awful, though I was going to die. Plus I had high blood pressure towards the end of the pregnancy so I had to be monitored. I was 'high risk' and under consultant care.

As I didn't get my antibiotics during labour, DC1 had to go to Special care unit, twice a day, for 7 days, for doses of antibioitics. Her infection markers were high. I had to fight to get her treatment, as the doctor wasn't going to treat her. Got told afterwards, off the record, by a midwife, 'Good for you, you did the right thing'

I really don't want a repeat of last time, it was traumatic for me and DC1. So, I said to the doctor: 'Will a C-section eliminate the risk of Group B Strep' and she said, 'Yes, but you can't have a C-section. If you developed pre-eclamipsia or baby was breech, then yes you can have one. Group B strep is not enough reason for a C-Section'

My question to you all is this, can I question this decision? Do I not have a choice? I am also experiencing flashbacks and bad dreams because of the blood clot (it took a while for doctors to realise there was something wrong with me, even tho I was bleeding loads and my mum & partner kept trying to get them to help me) I told the doctor this and she is referring me to the hospitals Womens Health Counsellor. FFS!!!

Sorry it's along msg and sory for spelling errors. All advice gratefullly recieved.

Request to see another doctor. Firmly. Over and over again if you have to.

You can have a CS for former birth trauma.

Am I imagining this, but isn't there such a thing as birth choices??

BTW, I forgot to add in OP that doctor said I can have a C-Section, if I PAY for it!!! FFS!!!

I was really upset last night and burst into tears but today im just so ANGRY!

You need to see another doctor.

Google Birth Trauma Association, too, to get some more help.

I wouldn't have thought that a cs would be necessary, but there does need to be a plan in place to ensure there isn't a repeat of your last experience. Perhaps a planned and managed induction to allow enough time for the ABs? It definitely sounds like you need to talk it through with someone else though.

Have you been tested for group B strep in this pregnancy? You won't necessarily still have it just because you did then.

Birth trauma/ problems with stitches should be a valid reason for CS though.

Thanks Explain Scotland will google that site.

I'm normally quite a strong person but I felt really vulnerable in that room with doc. However, im not prepared to take this lying down. My baby will not suffer because they wan to save money. My family are being great, but they don't really understand what Group B strep is. I just need some support from other mumsnetters. I feel like shite, really down.

Are the doctors always difficult when peps ask for C -Section? Are they told to try and put peps off or is it just my hopsital?

You are entitled to ask and be referred for a second opinion - do so.

CJ2010, it's a confusing picture for CS's and the NHS. NICE Guidelines say that maternal request it not in itself a reason to perform a CS. So putting it brutally, no, you can't have one if you ask for one - it's not that simple.

However, expatinscotland is quite right, and CS's can be 'granted' [you do need a consultant to agree to do the op] if you have trauma from a previous birth. This can be physical or psychological.

(I had an elective CS for my 1st DC this year because of primary birth phobia (i.e phobic about childbirth, not from a previous birth, but for other reasons).)

Unfortunately, there doesn't seem to be a standard way of dealing with elective CS for previous trauma across the NHS. It varies hugely from place to place - it depends on how sympathetic your MWs, Doctor or consultant is - and how much pressure there is on an individual hospital to keep their CS rates down.

It's very rare AFAIK that someone is ultimately refused a CS for previous trauma - but mothers are quite frequently kept waiting until the very last minute before their C section is agreed, which obviously puts a lot of mental and emotional pressure on a pregnancy. It also often means several meetings where women have to argue forcefully, or beg, for a C section. For mothers who feel very fragile about previous experiences, or who find it very hard to talk about, this can be very traumatic in itself.

When you say you saw a doctor, I can't tell if you mean a GP or a consultant. You certainly can request to see another consultant if you feel the one you're dealing with isn't giving you a fair hearing.

You will find people here who were able to get a Csection by being very assertive with a consultant. My own recommendation would be to try and get medical professionals 'onside' to help you. There's a big difference between you saying you are traumatised and asking a consultant for a C section, and a psychiatrist and GP agreeing you are traumatised, and recommending to a consultant that you have a Csection, IYSWIM. So if you can get a referral to a counsellor, fast, as you are already 4 months pregnant, fine. The Women's Health Counsellor might actually be able to help you in this respect - although it's worth finding out more about what they actually do. If they are simply a referral service, you might need to move things on a bit faster.

I'm trying to be as neutral as I can be in this post - it's a very emotive subject, as I'm sure you will find out. While it's true that counselling can make a big difference for some women, and I'm generally pro-counselling, if you go through it while you are pregnant, it's a bit of a 'ticking clock' pressure, and I think there's a slight danger a poor counselling service becomes a way of coercing women into accepting VBs when it's not what they want, or what is right for them. Personally I support a woman's right to make an informed choice about birth, whether it's elective CS or homebirth, and I find the idea that women with PTSD have to beg for a C section abhorrent. Others will disagree.

I hope you get some useful advice here - I've seen expatinscotland be well informed and supportive on other threads!

Sorry you had such a traumatic experience. You were v fortunate your baby was treated with abs. Mine passed away as nobody detected she was ill. I was never swabbed before the induction.

In this preg, I made it clear to my obstetrician at 12 weeks that I didn't want a natural delivery and he agreed straight away. As you know, strep B is not a reason for CS but trauma should be taken into account. A lot depends on how sympathetic the consultant is.

I really hope all works out.

Sh77 - so so sorry about your daughter. Congratulations on your pregnancy and very best wishes for all going well.

CJ2010 - was it a consultant you saw? Do be assertive about getting a second opinion and try to find out from MWs which consultants are most likely to be sympathetic to your request so that you can be referred to them. Hope you get your cs. It is a bit out of order that the same doctor will agree to it if you pay. A CS is either clinically indicated or not, ability/willingness to pay should not come into it.

As far as I am aware there are still risk factors for GBS even with a c-section. Basically as soon as the waters are ruptured then there is risk of infection - and this can happen during a section. In fact I have definately come across a sad tale of a baby lost to GBS following a section. I'll see if I can find any links.

Also I think there are additional risks to the mother if GBS is present during a c-section - it can colonise the wound or the womb and cause infection problems. Which may be another reason they don't routinely advise it.

i think u need to articulate yr reasons for a cs v clearly. U asked the dr for one because of gbs which isnt grounds for a cs. But if you want it because of birth trauma thats sth different and more likely to be agreed if you can put the case forward. Also you should retest for gbs, you may not have it now.

Before you do anything you need to know if you have GBS in THIS pregnancy. GBS is a normal colonisation of the vagina. It is transient, meaning it can come and go. You can be GBS positive at 28 weeks then negative by the time you give birth. It is present in 1/3rd of all pregnant women. Obviously not all of those are tested so lots of babies are born without antibiotics and are absolutely fine. No one knows why some babies that are colonised from their mums go on to get infections from this.

The reason the dr's wont do cs for gbs is because the risks of cs are much higher than giving birth to a baby vaginally when they can give Antibiotics to babies that need it.

I'm sorry that you're going through this.

The doctor that you saw seems not to have realised that you want a CS for more reasons than 'just' possible GSB. The referral to a counsellor might not be such a bad idea, if you get some support and possibly someone to advocate for you.

Ask to see another doctor; maybe contact PALS to do the hassling on your behalf. I can understand that you would like a final decision now, but antenatal clinics do tend to delay these types of decisions for as long as possible.

Hope that the rest of your pregnancy and birth goes smoothly.

i had a traumatic GBS experience too, I was positive in my second pg with ds2, tho i repeatedly asked for the anti'b's they wouldn't give them tho i explained could labour quickly as i had with ds1.

In the event i didn't have enought anti b's and had to keep on pestering for obs on ds1 was really stressful. Fortunately he was fine.

Felt very concious of GBS thoroughout pg with DS3 but couldn't get tested and had wanted homebirth. Finally got test very late on and was clear.

You should definitely be entitled to the birth you want, sounds a very traumatic experience.

Thank you for all your reples, really appreciate it.

Sh77- so sorry to hear about your daughter.

I am aware that a C-section is a big trauma on the body but if it means my baby will be safe from GBS then I want one.

What is frustrating me is that no-one in the NHS is very clued up on GBS. I phoned the GBS support grp after the hospital appt and the lady there said that a C-Section will only REDUCE the risk, not ELIMINATE it. The doc at the hospital told me a c -section would eliminate the risk, plus she also said that the NHS GBS test is 'very reliable' hmmm, I've heard otherwise.

I'm just fed up of the BS from NHS doctors. I'm far more inclined to the trust the GBS support grp than the NHS staff.

When I think back to what that doc said to me: 'If you want a c-section, you'll have to pay for it' The fucking nerve of her!! It's not like I want a C-section coz im scared of my fanny getting stretched!!

Hi,

I had GSB at around 39 weeks in my 1st pregnancy - it caused my waters to break before any sign of labour starting and 2 days later I had an EMCS (I didn't know I had GSB at the time).

2nd time round I was offered the chance of a VBAC with antibiotics during labour or an elective c-section if I went passed my due date. In the end I went past my due date so had the c-section, I was not tested for GBS and no anti-bs were given as my consultant said that only a vaginal birth would expose the baby to GBS.

However, perhaps it's worth thinking about whether you want a c-section because of the GSB factor or because of your traumatic experience with the blood clot, stitching etc etc? From what I understand from other posters this alone would give you a strong case for a c-section.

Not sure if this helps but good luck with everything.

I was positive for GBS with DD2. I had a planned induction at 38+3 as I naturally labour fast. I had my antibiotics as planned and all went well. That should be a good compromise.

It sounds to me like there are a couple of separate issues here.

1. Hospital promised they would deal with GBS by IV but did not because of speed of labour. There is no guarantee the same won't happen again.

1. Hospital failed to treat dc 1 with antibiotics without fight - that sounds like negligence to me

1. You suffered trauma as a result of birth consisting of incorrect stitching and further operation - leading to a lack of faith in clinical competencies of hospitals.

If you put it like this it seems clear that 2/3 of the traumas were entirely the hospital's fault and a strong complaint should still be made and 1 is a risk of VB that they can't guarantee against.

I take it there's no other hospital near you you could transfer to? If it was me I wouldn't want to step foot in such a place again. I had a bad experience with a mc in a different hospital from where I had ds and as a result I've gone back to 1st hospital on the grounds that even if they have faults at least I know how to get the system working for me whereas the other one's system was so awful it is a number of negligence actions waiting to happen.

If you want to continue with this hospital I'd suggest taking someone with you to an appt so you feel supported and outlining all these points and ask them for an explanation of your previous experience and how they can guarantee the same won't happen again.

The issue then isn't vb v cs but how to guarantee that you and dc receive a proper standard of care which is what they should be providing anyway.

If they are dismissive at that point make a formal complaint to PALS and any other body you can find and do what you can to switch hospital.