Group B strep antibiotics in labour

[JessieMcJessie]

We started NCT last night and first class was all about when to go to hospital. I have been told by my midwife that I need to go in sooner as I carry Group B Strep and they need to make sure that they have a clear 4 hours to get antibiotics in me before the baby is born.
I mentioned this to the teacher one on one at the end and I was surprised at how adamantly she objected to the whole idea of having the antibiotics at all- first she asked if I had given my consent to be tested in the first place and implied it was all scaremongering, then she said "don't get me started on what a load of rubbish it is". I didn't press her much ( though I think she meant that the antibiotics were useless rather than that the infection itself was not a risk to the baby) and not sure whether to ask at next class for her to expand on her views.

Has anyone else encountered dismissive views about GBS? I was just going by what the hospital recommended and figured that the antibiotics were no big deal.

I carried it and had the iv antibiotics. I've never heard otherwise. My friend didn't know she carried it and has a daughter deaf in one ear from it.

That's very dangerous advice from your nct teacher. Passing on GBS to your newborn baby could kill them. Sorry to sound dramatic but it's not like it's a theoretical risk, babies die from this. She should be working with you to try to ensure you get a birth that is going to keep you and your baby safe. I ended up having a c section for other reasons but everyone was very clear about getting the antibiotics early. Depending on where you give birth it doesn't necessarily preclude things like a water birth or using a midwife led unit.

Isn't it NCT who don't like to focus on epidurals and c sections too??

It depends on the teacher. Mine was fab, we talked at length about c sections (good job as 5 of 8 had one) all methods of pain relief, the only thing she couldn't discuss was bottle feeding but she did signpost where to get info from. I would actually complain about a teacher who is giving such dangerous advice.

Don't worry, I have absolutely no intention of refusing the antibiotics. I'm just interested to know if there is wider scepticism about them- I thought it was very odd that she was suggesting I should have kicked up a fuss about not consenting to the test when I was actually pleased that I'd got it on the NHS despite policy not to test for it ( they picked it up in a UTI screening).

It's a shame as her class in general was excellent and not at all biased towards natural birth, other than explaining why lying down was not a good idea.

Couldn't discuss bottle feeding?

As a mw i would advise you to listen to the hcp's more than the nct teachers who are actually giving unsafe advice here; having an iv in labour doesnt mean everything else has to be clinical, although you will have a ctg on you can still mobilise and utilise hypnobirthing and different methods of pain relief x

I was petrified over this and had a midwife reassure me that some trusts don't even check for GBS, however in those trysts there will be a minority of babies who get very sick or worse from contracting it in labour. Until there's any clue why some and not others become sick from it - the only option is to blanket give everyone antibiotics who tests positive.

Some people refuse and it's still ok... But could you live with that??

Plus this way round it's you who gets the antibiotics, if baby becomes sick or fast labour - they get them directly straight after birth

It's not always early enough for the antibiotics to work when given directly to the baby either

20 years ago nobody got antibiotics, group b strep existed and often it was fine - occasionally it wasn't. Now we know though

I expect it's because of the good bacteria and how vaginal birth seeds the baby's gut...

I ended up with a c section anyway but I had just planned on giving from birth probiotics to try and help.

Yes apparently nct policy not to discuss bottle feeding, which is a huge shame as there is lots of support for breastfeeding but no one tells you how to bottle feed safely. I planned to breastfeed but only managed a month mix feeding due to issues with a prem baby. Thank god for the NHS website that told me the up to date guidelines for formula feeding as general advice from people who did it years ago is now incorrect. It's the only complaint that any of our nct group had (3 of 8 of us FF despite all wanting to BF)

Yes the guilt of not breastfeeding can be bad in itself, let alone not having the practical knowledge of how to make bottles up safely. How judgemental.

There are some RCOG guidelines on treating group B strep that I found very useful, imho the teacher should be encouraging you to make an informed decision, whatever that may be. Fwiw having gbs in the urine, or a fever in labour, or prolonged rupture of membranes all increase the risk.

I had GBS and did quite a lot of reading about it. There's a useful website (GBS trust? Something like that.)

Basically I think the evidence base shows arguable benefit from the ABs in labour. There have been attempts to make a case that all women should be tested for GBS (as they are in some countries) and all positive women treated with IV ABs, but actually this medical strategy doesn't show a significant reduction in foetal illness so the NHS won't do it. It's argued also that GBS comes and goes, so there will be many cases where ABs are used unnecessarily.

If you are found to be a GBS carrier though it seems sensible to err on the side of caution and accept the ABs. I was found to carry in my first pregnancy and have been advised/offered ABs this time around too, which I am going to accept.

Your NCT teacher sounds like a bit of a dick on this one to be honest.

Please take this from someone who has just had first hand experience of this, antibiotics are a MUST!!!

my poor boy had strep and was very lucky as it was picked up strait away, we have just left hospital after a 14 night stay, three days of which we were separated as he was on the high dependency unit! it was a serious error on the hospitals part, on my green notes it said I tested negative and in fact it was positive ( hospital informed me of this after... big F**k up on there part) As a result I didn't have any antibiotics during labour, we were both very unwell.

all I will say is when the time comes if there is something your not happy about, speak up! insist you have the antibiotics if they don't automatically give the too you!!

the whole situation with myself could have been avoided if some one did there job properly!

There is a large cochrane review that shows the antibiotics don't actually cross the placenta to baby in labour therefore a debate over whether they are required.

As it stands, if you have GBS in your current pregnancy advise for IVABx. My trust wouldnt encourage you to come in earlier as they would still wait for you to be in established labour and don't have a time frame for getting AB in.

You should still be able to use the birth centre, water birth etc etc.. The pregnancy is still classed as low risk.

Good luck with your upcoming birth

Honestly, you should make a formal complaint to NCT head office about this - NCT teachers are not health professionals and should not be dismissing health advice as a load of rubbish.
This makes me feel really concerned about the governance and quality assurance around such courses.

I was a Group B Strep carrier with my first 2 children & lived somewhere where every woman was tested (the oldest child is now 18). I had IV antibiotics with the first & with the second child I arrived at hospital too late for ABs. Their temperature was taken every hour for the first 24 hours as a precaution. No issues arose.

I had GBS I did a lot of reading about it when deciding whether to get the antibiotics or not. The main reasoning I came across for not getting the antibiotics is there is a very small risk the baby could have an adverse affect to them which should be weighed against the risk of not having them and that there is a chance the antibiotics could affect their gut and the fact that a lot of women carry GBS and give birth without knowing and only a small percentage of babies contract GBS is it worth affecting their gut for. Personally I went for antibiotics tho as I felt that I would rather do everything I could to minimise the risk of contracting GBS and the risk factor for allergy to antibiotics was so much lower. I was also told to go into hospital as soon as labor started or my waters broke but I ended up being induced so I was there anyways.