Birth Experiences on IV antibiotics (Strep B)

[Spiritedwolf]

I was hoping to have a MLU waterlabour/birth on minimal pain relief. I really wanted to labour at home as long as I was comfortable then going to the lovely MLU 5 mins from home for a calm, as private as possible birth followed by skin to skin contact with my new baby and establishing breastfeeding. Yes, I realise that realistically I may not have got this, as baby's plans might have been different, but that's what I was aiming for.

I had a routine urine test at 28 weeks which showed I might have a UTI. The sample came back positive for group strep B. I have a meeting with a consultant next month to discuss things, but I have been advised that I'll need to go to the CLU an hour away because I'll need to have IV antibiotics during labour. When I asked if that meant I wouldn't be able to move around during labour, I was reassured that they put in a canula and give antibiotics every 4 hours, so I wouldn't be connected constantly to an IV.

I'm happy that the IV antibiotics are important for baby's health but obviously I'm now trying to work out if I can still have the kind of birth experience that I'd like, despite the antibiotics. I've read that its possible to use a birthing pool in labour as long as the canula is kept dry, but in practice, I don't know if the CLU has a birthing pool or if they would allow me to use it if it was available.

I do have anxiety issues and I was fairly confident that at the MLU my preferences would be supported, mainly because its the type of birth that is normal for them. I'm not confident that I will be able to articulate and argue for things that are important to me during labour, in a more medicalised CL environment, especially if my partner isn't always able to be present. I'm particuarly wary because I know I'll need to go in early in labour for the IV, and am worried about being rushed into interventions to 'speed things along' when I'm quite aware that first time labours can be long.

So I really want to know what to expect from a CLU. I really don't want to end up stuck on my back, out of it on pain relief, vulnerable, and then for my husband (who I am rarely apart from) to be sent home because of strict visiting hours and have a newborn to look after alone whilst I'm not yet recovered enough to take care of one (have heard that the ward is busy and noisey so don't know how much help will be available, or how assertive I'll need to be to get it).

I'd like to be able to transfer to the MLU or home quickly if the birth is straightforward and baby is healthy so that I can be in a quieter more settled environment to bond and learn to feed baby. I've heard babies born to mothers with Strep B are often kept in for observation for the first few days to make sure they haven't picked up the infection, but I don't know if this is just when there hasn't been time to give enough antibiotics during labour.

Obviously the hospital's proceedures regarding Strep B are something I'll need to speak to the consultant about. Is there anything else I should ask?

What were your (hopefully positive ) experiences of giving birth as a Strep B mum? Will this affect birth choices in future pregnancies (was hoping to have future MLU or home births)?

This may or may not be complicated by my allergy to penicillin and needing an alternative antibiotic.

Sorry for the length of this... must be more anxious about it than I thought.

I had a bad experience with DD2 and ended up with a C-section after having tried to labour for days and being forced to lie on my back wired up to everything. And then they took DD away immediately I didn't even see her face, couldn't breast feed etc. However, I did then go onto a normal ward with other mums and babies and actually found that really helpful as we all supported each other.

Looking back, I was trying for something that medical staff would not support me to get ifyswim, although my consultant was fantastic, she wasn't on duty in the end so I got whatever I was given. I know that for both my DDs if I'd lowered my expectations of the birth experience I wouldn't have been so low afterwards.

Discuss it with staff on the delivery suite if you can, keep asking questions - who is coming in for labour with you - partner, mum?

With DS I tested positive for GBS in my urine test at my booking appointment. My experience was rather confused! I was told that I would be tested again at the start of labour to see if GBS was still present and I needed the ABs but that I could still use the hospital MLU (as I had planned), use the pool etc. Once labour started and I phoned the hospital (multiple times - took a long time for things to get going) they ignored the fact I had GBS and told me to stay at home for as long as possible. When I finally got myself admitted I was told that I would automatically receive the ABs and that I couldn't use the pool as the cannula would mean I had an open wound in my hand. I was on an IV drip for about half an hour, but could still be mobile, just within range of the drip, after this they just injected the ABs every 4 hours so I was completely mobile. I was then allowed to use the pool with a surgical glove on the cannula and keeping my hand out of the water. I did transfer to the CLU after DS who was in a rubbish position got very stuck so needed forceps but this was obviously completely unrelated to the GBS. After the birth it was sprung on us that they would do a gastric aspiration which involved putting a tube into DS' stomach to take a sample to see if he had picked up the GBS. I wasn't allowed to try BF until this had been done and it took them 2 hours to get round to it! We then had to stay in hospital for observations for 24 hours but luckily DS was free of GBS so we transferred to the local birth centre for PN care which was fab.

I am now 10 weeks PG with DC2 and had my booking appointment last week. I am waiting for the results of my GBS test but have been given the following info. If I am GBS +ve again I will have to go to the CLU and have the ABs (I should never have been allowed in the MLU last time). If I am GBS -ve I will be encouraged to give birth at either the MLU or CLU at hospital because the baby will still have observations for 24 hours post-birth because I have been a GBS carrier previously. I can however, argue my case for homebirth or birth centre (both of which I was considering this time) and possibly transfer to hospital for 24 hours post-birth (not ideal but one option at least).

If I am GBS +ve this time and have to go to the CLU (same worries as you, concerned about higher likelihood of cascade of interventions) I plan to get in writing from them whether I should come to hospital as soon as contractions start, or whether I should be trying to stay at home for as long as possible, whether I can use the pool, if CFM will be required (if no other risk factors), if I can be mobile, and if tests can be done asap after birth so I can have skin-to-skin and start BF straight away. Above all, I want my questions answered before labour starts and not to have bits of info sprung on me between contractions and while the placenta is being delivered

I think the best thing you can do is talk about your questions and concerns with your consultant now, it's so much easier to get things clear in your head while you can think clearly than when labour is in progress and it's all a blur. I can see that your situation is not your ideal, but getting things as straight as possible now might help you to wrest back some level of control.

Good luck and PM me if you have any questions

I don't think it was for Strep B, but I was pumped full of antibiotics during labour as I had a high temperature the day before and they were concerned about infection. I gave birth on the CLU - no choice really as I was only 31+5! But I was supported the whole way through by my caseload midwife.

Although I had a cannula in, and was being monitored very often on the CTG, I was very much encouraged to move around / use the birthing ball. I only ended up back on the bed out of choice because I hadn't slept for 48 hours and couldn't stay upright

No idea about the water birth, but just because your birth may not be what you anticipated shouldn't mean you can't do any of the things you hoped to do.

I second the posters above to keep asking questions - in my experience the staff who looked after me were all fabulous and very happy to answer questions and offer support.

It must be hard when you are feeling anxious, but I honestly think the best thing you can do for yourself is to stay positive and calm - my labour would have been a completely different kettle of fish if I had allowed my fear to get the better of me (which of course it did at times, but with the support of my MW and DH, I could stay grounded).

In the end, I think there are just some things about birth which are out of your control, depending on the particular circumstances at the time - I trusted that the staff were only acting in the best interests of me and my baby, and without them we probably wouldn't both be here.

Hope that is a helpful perspective?

I was GBS+ with DD3 - I chose not to have prophylactic anti-biotics (i.e. just in case anti-biotics) but would have had anti-biotics if I had any of the additional risk factors (high temperature, premature rupture of membranes with no onset of labour, premature labour, etc) as I was worried about the risk of an allergic reaction to the anti-bs (risk for anaphylactic shock/death from anti-bs was given as 1 in 100,000 which was higher than the risk to the baby).

I know that sounds horrible and I will probably get flamed for this but DD1 & DD2 needed me far more than they needed a new sister and as I carried a higher risk of death than the baby did, I couldn't take the chance on the anti-biotics without good reason. It saddened me greatly to make this decision though.

Funnily enough I have subsequently had a reaction to a one off small infusion of IV anti-biotics so I dread to think what might have happened to me with a longer IV infusion. Even more complicating is that I can't have anti-histamines due to a inter-action with my other meds as when taken together they can cause central nervous system depression (heart rate and breathing slows/stops) so I had to be sedated for the duration of the reaction instead of having anti-histamines to stop it.

The MWs were happy with my decision as they knew I would go ahead with the anti-biotics if they were truly indicated and there was no indication during DD3's birth that I needed to take them (her birth was a planned home birth but we transferred in to hospital due to mec. in the waters). I am pg with DD4 and will be going with the same decision again (though this time no penicillin based anti-biotics can be used due to my previous reaction) and again planning a home birth.

I'm a carrier too. Sadly it wasn't picked up in time and cost DS1 his life. :(

With DD1 I was planning for ABs in labour but only got to hospital 23 minutes before she arrived, hardly had time to get trousers off let alone IV in!
She (and DD2) had 5 days of a cannula and daily ABs, it's a lot to put a LO through.
I'm too old for another (whew!) but if I did I'd always rate the ABs as more important than having an ideal birth. I wouldn't want to have any more experiences like my first.

But good luck whatever you decide.

I had b strep in a previous pregnancy, I haven't, been tested this time but have been told that I must go straight to hospital at the first sign of labour for a cannular and ab.
I have also been told that I won't be allowed a water birth.

cambridgeferret, so sorry for your loss :(

TruthSweet, can I ask did your DD3 have the 24 hours of observations after birth and if so, did you need to stay in hospital for this? And will your DD4 need the obs too? I'm also worried that not once was the risk of a reaction to the antibiotics mentioned to me.

PleaseChoose - I find it so confusing the different approaches taken by different hospitals. I will only receive the ABs if I am GBS +ve this time around but the baby will still have the obs in any case.

Sorry for slight hijack OP!

I tested positive for group B strep in pregnancy and, although I couldn't have a waterbirth, I still had an active birth as I only had the antibiotics every 4 hours.

There was lots of merconium flying around when DS was born so he was whisked off to SCBU (although I was allowed a cuddle first!) and he had got the strep infection. He then had iv antibiotics for 48 hours and had to be monitored for 24 hours after that with his bloods being checked to make sure the infection had gone.

Because he only needed the antibiotics every 8 hours the hospital have me a private room and I was allowed to keep him with me - fir the first 24 hours the midwife's took him to SCbU for the drugs; forth second 24 hours I took him.

He is now happy and healthy and 6 months old!

Everything was explained to me at every step of the way and, for me, because my DS showed signs of infection I don't regret anything about it because I know ultimately he was better so fast because of the drugs I had in labour.

Thanks for sharing your experiences. Sorry for your loss cambridgeferret :(

Although it might have sounded that I'm quite particular about how I'd like the birth of my DC1 to go, I have always been very aware that baby might need interventions to be born that I might not like. As both my mother and sister's birth experiences have been mainly CS for one reason and another, I knew I'd be lucky to end up with a MLU waterbirth.

In a strange way, at least I have time to readjust my expectations for birth and amn't going to spend the next 10 weeks or so worrying that something might come up last minute. My sister for example, was planning a low-risk MLU birth until her baby went towards 2 weeks overdue, she was induced, had a long labour followed by an EMCS. I think the shock of this change of plans made things difficult for her to process the whole thing afterwards, and of course, she still had a gorgeous baby to love at the end of it.

I'm confident that for me and this baby, being on the IV antibiotics during labour is the best thing. Its just working out what else is likely to happen around that (such as health checks afterbirth) so that I'm prepared for them and knowing what is optional so that I can still make choices and feel reasonably in control (not of the situation, or baby, but of my own reactions and any choices that come up).

Besides a healthy baby, I really want to give baby and I the best conditions I can for bonding and breastfeeding after birth. Managing my anxiety by being prepared for different situations that might occur is part of that.

Thanks again xx

Reg - No observations taken of DD3, we were just on the normal post-natal ward and discharged in about the next morning with no follow up advice re. EOGBSD.

My Obs. Cons. is happy for me to HB again with this baby with the caveat that I have seizure control (I have epilepsy and the neuro has been tinkering with my meds. to ill effect - 2 1/2 weeks seizure now so looking good now I am off the dodgy drugs! Obv. if I don't have seizure control I am birthing in hospital). No mention was made of GBS testing or DD4 having any special treatment/observation period post birth.

Interestingly enough the Cochrane Review on Group B Strep doesn't recommend prophylactic anti-biotic treatment (and given how tight my local NHS Trust is this will save them money if they don't treat all GBS+ women who don't have additional risk factors) so this may explain why I wasn't pushed to have IV anti-biotics.

Thanks TruthSweet. The whole GBS issue was one that I didn't really think much about last time as my MW was very much 'don't worry about it, leave it to us'. I'd much rather have the info clear in my head before I go into labour this time so I avoid last minute surprises as much as possible. Good luck with DD4!

SpiritedWolf - I think you're right about it being good to adjust expectations in advance. I must have learnt something from DS because the very idea of CLU last time would have thrown me into utter panic and now I have much more of a 'yeah, whatever' attitude and at least if I am GBS +ve this time I'll know exactly which bit of hospital I'm headed in labour and I'll know that they're doing everything in their power to up the chances of the baby not getting infected. I had a look at www.gbss.org.uk earlier and it's very clear and explains things really well.

Hi op, I was strep b + when I had ds, so couldn't have him at mwl unit, had antibiotics every 4hrs, and was on my feet etc for most of labour. Didn't ask about water births tho..... Stayed in hospital for 2days, my choice to help establish bf. ds had his temp taken regularly during first 24 hrs, but no other 'extras'. Think the concerns of strep b outweighed my need for mwl unit, am happy all went ok.

That sounds reasonable Redhairmum.

I had my 30 week antenatal appointment with my midwife this evening, first chance I've had to talk with her about the Strep B thing. She reckoned that I still have options depending on how the rest of my pregnancy goes. She said that some women choose not to have the IV antibiotics, and that even if I do that we can sort out a birth plan for that situation (she even said she'd write on it in big letters that they have to pay attention to it! ) and make sure that I get transferred back to the MLU shortly after birth so that I can be closer to home.

She was really understanding of my concerns and I feel more confident that we'll come up with a good set of birth preferences. I think it'll help if my DH is involved in that so that he can help me assert those preferences at the CLU if necessary.

It sounds like you'll be fine Wolf - your midwife sounds a gem.

The thing I found worse with DD1 was hearing the consultant go through the details of C's death every time he came in with his students. Plus seeing it on the cover of my records.

Even nearly ten years on it's still painful. But things move on and I've got my girls. :)

I tested +be with dd2. They didn't give me anti biotics in time as just as I got to the water pool room (90 mins) dd2 was born.

Anyway- they were fine about a water birth but just didn't have time to fill the pool

Dd2 then had obs taken and anti biotics for 5 days. Which I'm glad to be honest as it gave me a break from dd1 and bonding time - I did really miss dd1 though

DH has just sent me a link to this GBS birth story

8 min unplanned Homebirth

Which I suppose reminds us that this baby might have other ideas about how to be born. I don't think DH is desperate for this experience though, as from what he has said previously, he's a bit nervous about how he'll react to the birth anyway (is worried about seeing me in pain, and goryness) so can't imagine how he'd feel about delivering the baby alone!

My best friend's baby is 3 weeks old tonorrow and he was delivered by her husband at home after a 14 minute labour :o

Makes my labours of 83 and 73 minutes look slow..........wow.

I've recently found out that I tested + for GBS - this is my 2nd pregnancy, wasn't tested for it when pregnant with DS.

The advice I was given was that I'll be under Consultant care, rather than MW and that they advise I take IV anti-biotics in labour.

I asked the MW if any of this will impact the baby's ability to breastfeed and was told that he or she should be able to feed as normally and will most likely be able to stay with me. Hope that is true, as bfing is really important to me!

Will be having a meeting with Consultant next month to discuss things further about treatment, observation etc.

Needles, FWIW I recently gave birth and was pumped full of the antibiotics during labour for my GBS and my baby had no problem breastfeeding from the start ... having the cannula in my hand was a bit of a pain, but the baby was fine and things were quite normal once she was out.

Hello
Cambridge ferret sorry to hear this.
OP I tested + for GBS for DS1 and laboured in MWLU
And DS2 born safely but unexpectedly at home details here if helpful
Best of luck to you

Hi,

I tested positive for GBS when I was only a few weeks pregnant-my Dr told me there was no point in re-testing as the safest thing would still be to have the antibiotics in labour.

I was told that I would need to have delivered 24 hours (pretty sure that's right!) after my waters broke as the baby would not be protected in the water. Unfortunately my waters breaking was the first sign of labour for me, and after not a lot happening for 12 hours I was induced and then had to have an epidural (though wasn't totally effective so could still feel to push and move positions etc!) did mean I was bed bound though.

We had to stay in hospital for 48hours after the birth so that the baby could be monitored, temperature checked etc. All was well and we came home.

To be totally honest, my birth didn't go exactly as I had hoped and planned but I don't think I know anyone who did have the exact birth they wanted. But the most important thing was that at the end of it I was healthy and so was my baby...