If you had Group B Strep in one pregnancy but not in subsequent pregnancies, did you still have to have antibiotics in labour?

[RegLlamaOfBrixton]

In my first pregnancy GBS was found in my urine at my booking appointment. I received antibiotics through a cannula in labour and DS was fine. Now 20 weeks PG with DC2. I have not tested positive for GBS this time. I have so far seen 2 MWs antenatally who have each said the opposite. The first said that if I test negative this time (which I have) then I will not have antibiotics although they would prefer to monitor the baby in hospital for 24 hours after the birth. The second MW said that because I carried GBS last time I would have to have the antibiotics this time anyway. I am seeing a consultant MW in September to hopefully get the definitive answer but just wondered what other's experiences have been. Also, the GBS Support Website suggests that it's more conclusive to do the test between 35-37 weeks, although my trust don't do these I might be able to get a private one. Hope someone can help lessen my confusion! Thanks!

I would take the antibiotics anyway. I know two people whose babies have died shortly after birth due to GBS. Why take the risk?

I'm with Gemma, don't worry about it now and just take the antibiotics at the time.

But that's just the thing, if the first MW is correct, I won't be offered the antibiotics because in her view it is against hospital policy if GBS has not been found in this pregnancy. So it's not a matter of me choosing to take the risk, it's the hospital deciding for me. Which is why I'm worrying about it now, because I don't want to turn up at the hospital in labour and have to have a debate about whether or not I should be having them.

I tested positive by urine in Dd pregnancy 2008, I had ds last week, throught my pregnancy I was told I would have antibiotics in labour. I was never tested during this pregnancy. At 36 weeks I was told that they no longer offered antibiotics unless the previous baby had been treated for b strep.

I wasn't offered them during labour but ds and I stayed in for 24 hours for him to he observed.

I found I got a different answer depending who I asked, I rang the labour ward in the end and asked them.

Good luck.

As with you, I tested positive (urine) in first pregnancy and had intravenous AB during labour. This time, I was initially told I couldn't be tested again on NHS and would automatically have the antibiotics. Was later told they had hanged policy and I could be tested. The results were clear.

I'm now 40+2 and planning on a midwife unit birth (which wouldn't have been an option on antibiotics). For me, risk is now the same as if I'd never tested positive and very glad to be avoiding unnecessary intervention at birth! You'll need to double check with health professional, but if you're clear then you should be fine without (that's certainly what I was told).

I'm now 40+2 and planning on a midwife unit birth (which wouldn't have been an option on antibiotics).

Why not? I had a home birth on antibiotics.

I see- that makes it hard.

My first son was very ill when he was born, and there was a suspicion that it was through GBS. I tested negative all the way through my second pregnancy, which makes me think he caught it from the hospital, as I didn't have it during first or second pregnancies. I still had to have antibiotics through the second labour. My DS also had to have IV antibiotics because my labour was very quick. It was OK, but I didn't raise the birthing unit, even though I wanted to go into it. I wish I had, if it was possible, as I was very disappointed not to have gone into one.

Gemmapompom - then you are lucky with your local services. My only option was the local hospital if I were to have IV antibiotics in labour - they don't offer them here for either midwife unit or home births.

Gavotte, this was many years ago. I was given oral antibiotics to take the moment I went into labour. I kept them at home and as soon as I had the first twinge, I took them. They were oral, it was not an IV drip.

cakebot I always wondered whether I caught in the hospital- didn't have it for DD1, but I was hanging around with lots of pokingfor nearly a week before they induced me with DD2; I certainly had it by then.

It's not much help for the OP, but I can't remember whether I had it for DS- 3rd birth.

It depends on the trust. Some still insist on antibiotics in labour if you tested positive in a previous pregnancy, even if not in this one. However that goes against most current guidance, and the Group B Strep Support charity doesn't advocate this approach either.

Thanks for all of your responses. So sounds like it depends on your trust and that they change policy a lot. I was really keen to go to birth centre or have homebirth this time because my hospital experience with DS wasn't great. I know I definitely have to go to hospital if I'm recommended the antibiotics so I guess I'll just wait and see what the consultant midwife says in September before I get my hopes up that I might avoid hospital this time.

There's some info about this on the Group B Strep Support website - the link is www.gbss.org.uk/content.php?section_id=3&sub_id=15&content=FAQs#17

hi ladies - was the test a private one (ECM) or the standard one done in NHS trusts (SDP)??? and was it a vaginal swab or just a urine test?? the most accurate test is the private double swab as it is solely GBS they test for where as the standard NHS one looks for allsorts and is fairly inaccurate.

look on the GBS website for information - unless you test positive in this pregnancy or had a prevous baby infected with GBS then antibiotics are not necessary.

my son had GBS and had 10 days of aggressive antibiotics so I have to have penicillin with each subsequent baby, last time I didnt have then within 4 hrs of del so baby had to have 48 hrs of AB's before her result came back negative and hopefully with this baby I will get the AB's in time as i want a pool birth.

good luck with your pregnancy x

I tested positive for GBS with DD3 but didn't have the anti-biotics in labour through choice as I had no additional risk factors. The Cochrane Review (world standard review board who perform meta-analysis on all studies on a given topic) don't recommend prophylactic anti-biotics for 'just' testing positive for GBS, they recommend if you have the additional risk factors though (e.g. prem labour, premature rupture of membranes without labour starting, high fever etc).

I was also worried about the risk of anaphylactic shoock for me (IIRC the death rate from prophylactic anti-biotics was higher than the death rate from neonatal GBS infection). This wasn't because I was worried for myself but because I had 2 other children who needed me.

As it happens I had a lowish dose penicillin based IV anti-biotic last year and had an allergic reaction to them which lead to me being sedated (I can't have anti-histamines in any useful dosages due to other medication I take - they can cause central nervous system depression when combined aka stop breathing/heart stops) so I am kind of glad I didn't have IV anti-biotics during labour as treating the reaction would have been interesting to say the least.

Luckily I have tested GBS neg. this pg so won't be taking/offered the anti-biotics unless I have any risk factors but then I would have to have the alternative less effective treatments due to the penicillin reaction.

Hopefully the Cons. MW will be supportive of a homebirth but you do have the right to have a HB what ever she says.

I tested positive for GBS infection in my last labour. Both my son and I were given anti-b's after birth. This time I have to see a consultant at 36 weeks and get tested again. I think if comes back negative then I get to deliver on the MW led unit and if not have to go under consultant.

I tested positive for it and had antibiotics with both pregnancies, they're not even testing with this one and apparently don't give antibiotics if you've had them
In previous pregnancies I am not happy about it tbh.

After dd1's birth (8 yrs ago) & I had already gone home from hospital I was told swab had picked GBS. Luckily the birh was quick & she had no problems.

I was swabbed during pregnancy with ds1 (5 yrs ago) as I'd wanted a homebirth. Test came back negative & I had a wonderful homebirth.

I went on to have dd2 at home too (1yr ago).

Thanks for your responses. I've had a good read of the GBS Support website this time around so am a bit more armed with the info for when I see the consultant MW next month. I've only had the urine test (-ve) at my booking appointment this time which I understand is pretty unreliable. I see on the GBS website that you can purchase a more reliable postal test to do around 35-37 weeks so I may give that a go, although my MW (the one who thinks I won't have ABs this time) warned me that because this is a private test, even if it is +ve the hospital may not act on it and may not give me the ABs

I discussed my concern over gbs at my bookong appointment this week as my son was born with sepsis from group b- thankfully he is absolutely fine now, but was seriously ill at birth. The midwife said that the hospital (uhw in Cardiff) keeps changing its policy over whether to administer antibiotics in labour, but because I am now high risk, having had a child infected with gbs, I have to be consultant led rather than have a mlu birth. I will be really unhappy if I am denied iv antibiotics in labour as the gbss.org website experts advise this if you have had a child with gbs. I have a consultant clinic appointment at the end of September to discuss this further and will be attending armed with the latest scientific evidence.
I am also going to have the test privately around 36 weeks if im not offered it on the nhs. Hopefully if this is positive it will strengthen my case for having antibiotics and if negative, will reduce a few of my fears...

DD tested positive, I had antibiotics in labour and DD had full strep screen and IV antibiotics, SCBU for 4 days just in case as I had a v. fast labour. I was amazed at how seriously it was taken.

I tested negative with second DC and so didn't get antibiotics in labour, even though DS was born very prem at 26 weeks. In practice I had chorioamnionitis so he was pumped full of the strongest antibiotics available in any case, so it probably made little difference, but even so I was surprised that it just wasn't on their radar at all after all the fuss first time round.

Interested to read all this. I tested postive for GBS in my 4th and last pregnancy but it was discovered by accident as I thought I had thrush. This was now 7 years ago, and I had never heard of it. I was also planning my 2nd home birth and a fast labour was expected (my 3rd arrived during the rush hour and before the midwife!). On being told I would now need 4 hours of antibiotics in labour so could no longer have a home-birth, I was terribly upset - especially as everyone agreed that I had probably had GBS through all my pregnancies but noone had been testing for it that long ago. Eventually my consultant agreed that as I was unlikely to be in labour for 4 hours and I lived 8 miles from the hospital, the whole antibiotics thing was unlikely to be successful anyway, and that I should just stick to the home birth and, as an experienced Mum, they trusted me to bring baby back to hospital promptly if I saw any signs of illness.

Afterwards, when all was OK, family and friends put the whole thing down to over-zealous doctors and the latest thing they had discovered to test for and that, really, the whole thing had been a bit of an unnecessary storm in a teacup. Seven years on, I'm amazed that this seems to be a major part of pregnancy and that antibiotics are being handed out so freely to mothers in labour and to new-borns. Are so many babies really dying fom an illness that seems so new?

Early-onset GBS affects about 450 babies a year in the UK and many of them will die or be permanently disabled. Just because awareness of it is low does not make it a 'new' disease! Get the risks in perspective, yes, but 'oh it's just the latest thing 'they' have discovered to test for' is just ignorant - 'they' are clinicians trying to reduce neonatal mortality and the issue in the UK is actually that there is no routine testing for GBS status when really there should be. If your baby is one of the ones affected if would certainly not seem like a storm in a teacup.