Group B Strep/ Fast previous labour / when to go to hospital?

[poppynic]

Hi. I'm currently 41 weeks. Got checked and had a sweep today. Apparently cervix is soft? and I'm 2cm dilated. No sign of contractions though.

My question is, I supposedly need 4 hours of antibiotics during labour to deal with Group B Strep. My previous (first) labour lasted 2hours 2 mins from time labour established and the midwives then said I had better get to the hospital quick smart next time.

I guess it's a bit of a "how long is a piece of string question" but I'm wondering if anyone has any advice about when to go to the hospital to ensure I get my 4 hours of drugs before birth - as I don't want baby having to have them after the birth, as that is the alternative.

Two midwives have told me when contractions are 5 mins apart but I really can't see me lasting 4-5 hours from then. Any advice greatly appreciated.

no advice really, except go as soon as you have the first contraction !

Check out the Group B strep site. I believe the advice is as soon as labour starts (I suppose that means contractions) and/or your waters break. www.gbss.org.uk

ditto luladoula. As soon as it starts.

Thanks everyone. Have been trying to print out the info from the v.g. gbbs website - printer not responding....

I take it that the "start" of labour is the first contraction is it? or is there another definition? Also, since I seem to have forgotten everything from last time, is a contraction always a tightening around the middle of the stomach - not down low?

Also, since the hospital midwives seem to be against the idea of coming earlier than 5 mins, is it possible and/or sensible to ring the consultant's secretary and ask to speak to the consultant (who I haven't spoken to before) to get their opinion to quote to labour ward staff?

have you discussed it with your midwife at all..? seems that if you have very quick labours you need more than the standard response of coming in at 5 mins apart...if you need 4 hours of IV antibiotics..

Well "my" midwife - or one of the midwives in my "yellow" team - told me to wait even after my waters had broken - and when I told her but with Strep B I need to go straight in, if my waters break at home, and she said oh yes, well ring the ward staff and they will tell you... And the midwife I have now seen twice on the day assessment ward told me 5 minutes apart - and when I pushed the strep B and quick labour question she said, well 5 to 7 minutes apart!!! [exasperated icon - need to contact Mumsnet]

I was told you need to have the iv done an hour before the birth.
This may not be correct but I only went in 2 hours before I had dc3 and they said it was fine.

Interesting Mrs Noah - the GBBS website says the drugs take 2 hours to cross the placenta! Glad to hear everything went well.

Message withdrawn

Is that so ? Cripes.

Was kept in a few days but they said it was routine due to dd2's poor medical history. hmmm?

Oh Podmog - everything is very clear except for those infuriating words "as soon as you feel necessary" arrgghhhhh. Are you having the drugs again this time?

i only got one lot of antibiotics with dd2 and they did not give her any drug because of this also i think if u speak to ur midwife she can give u some oral antibiotic just to help if u only get one dose or u dont get there and have baby in cr park (only joking by the way)

softmusk - no joking please - my friend was squatting in the hospital carpark when the staff rushed out and she heard "Where is she?" "Over there, behind that van."

Unfortunately, none of the midwives I have talked to have any interest at all in oral antibiotics or going outside their "5 minutes - 45 seconds long mantra" - the last one I spoke to on the labour ward said, well if you only get one lot in then we will get the paediatrician to look at the baby - which may (in worst case scenario admittedly) be a bit bloody late.

Each hospital seems to have a different policy re antibiotics.

Usually it's 1 dose, 4 hours before birth or else baby gets a small dose of antibiotics in the leg afterwards (within 2 hours.)

Why dont you phone your hospital and ask to speak to the paediatric registrar in the nursery and ask them about their policy. Then your getting it from the horses mouth!

As for going in to hospital, wait till regular contractions becoming sore and just go in -or broken waters. As a 2nd time mum, it would be pretty poor practice to send you home in case you had the baby at home - you might end up in the ward though!

Also remember GBS infection is really rare, and even more so if your waters are intact.

Good luck

Both my community midwife and the hospital were very keen for me to go in as soon as I felt labour had started. When I asked what that meant, they said when I was experiencing regular contractions, even if it meant a bit of waiting around in the delivery unit. As it turned out, my waters broke pretty much straight away, so went in then.

the baby recieving antibiotics doesnt stop the risk of a gbs infection. just lowers it. as soon as the waters break the baby is at risk.

due to personal experience with gbs i would opt for a cs before my waters break so that the lo has no contact with the bacteria. nothing can prevent an infection just lower the chances of catching it.

bubblebell, I'm no expert but have trawled the Group B Strep Support group website recently. They seem to agree ABs don't eradicate the risk, but according to them they do substantially reduce the risk. They also say CS does not eradicate the risk?

Personally i wish the medical profession were able to show more consistency on this. My local hospital is so militant your baby is likely to end up admitted for days of IV ABs if you don't get 2 doses in labour, regardless.

I'd ask to speak to the consultant. It sounds as if the midwives don't know what they're talking about.

(Neither do I, but you can tell when people are just repeating mantras, can't you).

Have been ringing the consultant non stop since Monday morning - I'm beginning to think she doesn't really exist - not sure what to do now - am just hoping it will be an induction on Friday....trying to tell myself I'm being overanxious.... - just read ds a bedtime story - extra fast as felt wet below - checked fingers and saw blood in the dim light of his bedroom omg - oh, actually it was beetroot left on my fingers from cooking tea no hospital rush quite yet then.

Message withdrawn

How bizarre - how does the 2 hours fit with the GBS advice that takes 2 hours to cross the placenta??? - agree that it would be nice for just a little bit of consistency ...

Hospital GBS policies are a real pain. They are set by the paediatric team and can change several times in a year according to latest research (or whims).

Nothing to do with the poor midwives who are just as baffled as you are sometimes.

Good luck trying to speak to the consultant, you will just get the runaround. Is there not a 'day assessment unit' in your hospital where you can speak to the staff about your concerns?

Try to be positive about the next few days, I know its worrying, but it will all turn out fine Im sure.

If you are being induced, make sure you have the IVABs within your hospitals cover time, prior to starting the syntocinon, just in case you go really fast

Thanks for that Mintpurple. I tried to discuss it at day assessment unit and the midwife there managed to stretch it to coming in when contractions are between 5 and 7 minutes.....

What does "hospitals cover time" mean?

Sorry - I meant how long your hospital wants you to have the ABs onboard before it considers the cover is adequate, some hospitals want 4 hours ABs and some 2 hours.

Thanks Mintpurple - had been planning to try to ensure that but so far have had little success at any influence on hospital . Any suggestions about what I should do if person setting up induction doesn't want to give iv before and says, don't worry, it'll be fine?