GROUP B STREP and HOMEBIRTH?

[JARM]

Is it a viable option?

Baby number 3 not due til late nov/early dec so LOADS of time, but I was told with DD2 I had group b strep and would HAVE to go to hospital, HAVE to have IV antibiotics and HAVE to stay in for AT LEAST 24hrs (i did discharge myself early tho!)

I would love to have baby 3 at home and just chill and relax - i had DD2 with just gas nad air and she was back to back and face presentation - no tears/stitches etc

Anyone know if its an option or do I really have to endure the nightmare that is hospitals ( I hate them!)

liquidclocks - I'm aware that I was very lucky to have the care that me and my baby recieved.

I was BBS positive with my first child and didn't know it. She was born in hopital days before I got the positive result back - she was fine.

I had ds2 and 3 at home.

With Strep B you can be positive without having strep B present at the time of birth - so regular swabs right up to birth (I had them every other day) will help diagnose whether it is present just before labour.

With second babies it is often the fact that your labour would not last long enough in order for antibiotics intavneously in labour to be effective. For that reason and also the risks associated with antiBs, I think there is actually limited value in hospitalistaion for the sake of IV antibiotics.

The next precaution should be placental and baby swabs immediately after birth. The results will determine whether AntiBs are required postnatally for your baby.

As I say, I'm a carrier but I've had 2 homebirths since finding out and no problems.

I just hope one day that's what everyone gets. I was lucky - had a midwife with me the entire time, both times, our hospital's great but some of the British ones are awful.

GBS I mean not BBS!

JARM I am far from taking the piss but shocked that someone could be contemplating a home birth when GBS positive.

Yes my dd did have problems she did not get her antibiotics as I had a c section and the hospital proceedure was to not offer antibiotics with a section.

My dd's lungs collapsed and she spent 3 months in SCBU ITU fighting for her life. She contracted 3 majour illnesses and was given a 5% chance of survival. I apreciate home hospital doesnt mean a guaranteed GBS free baby but you will have all those much needed specialists at hand. My baby was so ill she couldnt be touched let alone transported. A team from Great A Street Hosp had to come to her!

My computer crashed and I couldnt post my link to photos. Dont be so quick to judge.

I thought it would never happen to me, especially after having one healthy baby already.

I have now linked a couple of photos if you wish to have a look.

(thanks lulu)

GBS is not something I take lightly and as I said would be taking the test at 37 wks before making final decisions, however I will be taking a more holistic approach at the same time to give myself the best chance of HBAC success.

So yes I would be using garlic in an effort to ensure a negative result. And any other approaches I might find to try to reduce the risks.

I did not know enough about GBS before dd's birth so blindly went to hospital for the birth and prophylactic ABs. Next time will be different, I am better informed and intend to make an informed decision at the time based on facts rather than supposition. I have all the GBS sites bookmarked and in no way would ever risk my baby. If there is genuine colonisation even after all this I will have to re-consider my options and obviously am not in a position to know what is going to happen in the future.

I don't think any one of us would knowlingly do something to risk our babies.

Garlic is good yes but I know first hand the effects of GBS in your baby. I sat there pleading with God every moment of the day watching my dd laying on a table, paralised. Listening to the monitors and being told that my precious baby girl would probably not survive. I couldnt touch her let alone hold her. I couldn't see her eyes, she just looked like a rubber doll. They kept injecting her and you could see the pain on her face but you were helpless. The agony my dd went through as although she was paralised she could still feel the agony and knew what was going on. Nobody thought I was going to bring her home, she was even baptised at 3am on day 3. Family came from miles to say their goodbyes. I dont want you to go through that pain in watching your flesh and blood. If it hadnt been for me being in hospital my dd woulnd have survived. She was in scabu on a life support machine within 20mins of being born.

To me I just wouldnt risk it for anything, not liking the aftercare is something I would put up with.

I had group step b for two births - both too fast for antibiotics so little one given antibiotics for some days after the birth (forget how many - I think two?) An intrevenous injection site was put into the hand & antibiotics were given every few hours.

More than happy to have this treatment as so important due to the risks of complications. Have read the homebirth site & find it hard to understand how they write that the risk is so small - when it's not imho.

It could be I give birth at home this time as my labours are fast - but I'd head straight to the hospital for full checks and antibiotics. If I can get to the hospital before the birth (if labour takes longer than 4hrs) then I'll have the antibiotics as well.

best wishes with your choice xxx

Hillls, I am so sorry you have had to endure this and I know you don't want anyone to go through it. I don't take it lightly and as I said will make a decision based on facts at the time, having given myself the best chance of a positive test result.

This is another reason why we need one on one care by mw's rather than being left attached to a machine... machine's don't take your pulse and check temp and note your demeanour, whether clammy, feverish etc to indicate rising infection.

Having had previous colonisation outside of pg does not place me in the high risk category in itself, which I take from all the literature, and I will obviosuly be checking out for all the other high risk indicators as my pg progressed.

A decision to transfer in to hospital would surely be made if I show any signs of fever. I do not intend to be taking any risks.

Klaw there are no symptoms of GBS in us with regards to fever etc, just the baby who usually starts by grunting, the infection is extreamly rapid.

I hope you dont think me patronising, just concerned especially when people start talking about taking photos to remember her by.

I understand you will only do the best for your baby and yes I totally agree with the midwife, we certainly need our own who sticks by us and knows our whole history.

GBS can also develop into meningitis at about 3 months of age if no symptoms have arisen at birth so keep an eye out (this is usually passed off as just meningitis not a GBS related)

Good luck with your results

No, I don't think you patronising at all, I can see that you don't want anyone to go through what you have gone through and that's fair.

HUGS!!!

I am just wary of giving prophylactic ABs as a matter of course and so had decided to plan a course of expectant management for next pg and labour having done the research.

Your experience will have taught many others whom you have come into contact with and should help to further educate the population about this. I had no idea about it for my ds, had a full labour, with various interventions including ARM and eventually emCS and fortunately we were OK.

With dd (12 years later!) I had the IVAB without having done much research but next time i want to be more in control of the decision making. But then that's something I want across the board with my next labour

I had gbs colonisation with first pregnancy so decided to deliver in hospital in case of any probs, I didn't want antibiotics however because I don't believe that they are without risk. I did a lot of personal research in to it and decided that if there were any added concerns at the time I would have the iv antibiotics (if waters broke before labour, if baby prem, if I had had a temp in labour etc) Anyway everything was fine with dd and I had a quick labour. Second time around I had a homebirth with ds and again everything was fine, incidently I was so quick that there would not have been time for four hours of abx anyway.

Things you have to consider
1 about 1 in 4 women have gbs, surely this many women do not need iv antibiotics to have a safe delivery of their babies.
2 There are risks to having them, some women have severe reactions which could endanger their or their babies lives, although this is rare it is a consideration.
3 the death rate quoted by the gbs society is up to 20% of babies who are affected, they do not make it clear in their leaflet that the majority of these babies are those born before 37 weeks when the risk is much higher anyway. I can't remember exact figures but a term baby who is affected is much less likely to die than this.

When I first found out I was gbs +ve it didn't occur to me not to have iv abx until the consultant obstetrician said to me that if everything was otherwise well it didn't increase the risk all that much. He was very against me having the abx in the mw led unit as he felt that that was very unsafe due to the risk of a reaction even though it is in the same building as the consultant unit. It was on hearing this that I did my own research in to it and made my own decision, which was not a decision made lightly. The consultant obs suggested I get a copy of the Royal college of Obs and Gynae report in to GBS which helped me to make my decision.

I can totally understand why someone who has been through the agony of almost losing a child would feel so strongly about it, it is a very personal decision. I would encourage you to find out lots about it and once you have made your final decision be confident and positive about it.

i know this is an old thread but i have just found out that i have strep b - and was planning a homebirth and really unhappy about the risks of antibiotics to me and baby and don't want to be in hospital.

i have less than a week til my due date and its my second baby.

wondered what you decided jarm,and anyone else in the same situation?

hi worrymummy,

I was found to be GBS+ve during my second labour. too late for IV ABs so they just monitored the baby for 24 hours. AOK.

I planned a homebirth for my 3rd, partly due to ridiculous hospital policies on GBS: no waterbirth, etc. I've been through the NHS hoops.

I had an independent midwife who sees this a lot, so I valued her advice.

My only options were oral ABs or risking it. The hospital wouldn't administer IV ABs in the home in case I had an allergic reaction.

You need to get the timing right on oral ABs - the course is 5 days, I needed to have had roughly 2 days worth before birth or the hospital was insisting the baby stayed in for a course of IV ABs.

You COULD go to hospital for one dose of IV ABs and then discharge yourself, but that is a pain mid-labour, and the ABs are supposed to be administered every 4 hours throughout labour. This was my Plan A, though.

If this is your 2nd or more baby, it's easier to assess the risk. If you were GBS +ve with an earlier child who did not have a problem, then subsequent babies are likely to be ok too. (those were the RCOG guidelines when I checked.)

Bottom line, you are in charge. The hospital may have very strict policies, but you can say no. I found there was a very low level of knowledge about GBS and weren't following the GBSS recommendations Or the RCOG guidelines. Chances are, if you read their websites, you'll be as well / better informed.

thank you.

because i'm due in a few days (and i had a show yesterday) i am panicking about making a decision).

i have no idea if i was gbs +ve with my first, but he was fine (born in hospital).

when i spoke to the mw today she made it sound like i had no choicebut to go to hospital.

of course my baby's health is the priority, from all that i've read this evening (not long enough to take it all in) i can't work out what the least risky strategy is.

hopefully i'll have a bit more time to think about it...

Lots of women have homebirths with strep B, but if you are reliant on an NHS m/w then I have no idea what the situation is. Can you insist? If so, I'd try to get oral ABs asap. The issue with them is that as soon as you finish the course you are likely to become re-colonised. So timing is important.

if you DO end up in hospital, they'll put the baby on 24 hour obs.

you can refuse automatic ABs for the baby, in fact RCOG guidelines were (are?) that a baby should not be given IV ABs without cause (symptoms, worrying circumstances, etc).

I can really understand people wanting home births and respect that. however, there are risks with group B strep. I knew I was a group B strep carrier, had my IV antibiotics when my waters broke and despite that I developed group B strep septicaemia 3 hours later - I was so unwell that dd became very distressed and had to be delivered by emergency section. She had an apgar of 2 and required resuscitation. Meanwhile, I developed a complication which stopped my blood clotting properly and so had a 7 litre PPH. I ended up on ICU. I know I was very unlucky, but I don't like to think about what would have happened, either to me or to my daughter, if I had been at home without antibiotics.
So, the risks are small, but for some people, the risks do come true - and if you are that person, it really won't matter to you how many other people had no problems. All worth thinking about when you're making this decision.

i had gbs, and was advised against water birth or home birth - even in pg three where there was apparently no 'active' infection - the fact that i had it in previous pgs and was a carrier meant that they gave me iv antibiotics anyway and basically treated me as if i had the infection.
I would probably go on the side of caution, if it means being safe then 24hrs in hospital isn't too much torture if it means getting the 'right' treatment and reducing the risk of problems later.