Group b strep observations..can I discharge myself?

[Becks9800]

I’m 37 weeks pregnant with my second baby. I was found to have group b strep infection in my urine earlier in my second trimester. Because of this the protocol is to give me antibiotics during labour..which need to be given at least 4 hours before birth. I had a rapid first birth so I very much doubt they will have time to give me them...if they don’t get time, I think protocol is 48 hours of observations to check the baby doesn’t come down with the infection.

Do I really need to stay in for this? Obviously if baby was in any way unwell I wouldn’t hesitate to stay in but I really don’t want to leave my 2 year old and be on post natal ward for two days because something might (and is statistically very u likely) to happen. I looked up signs of GBS infection in baby and it seems quite obvious if they’re poorly so can I not just bring baby back immediately if there are any concerns? We live 10 mins from the hospital. I’m also worried about covid etc and just generally want to get out of there asap...

I don’t meet any of the other risk factors for increased likelihood of problems..fast labours are meant to be a plus, I also had an intervention free water birth last time which is also meant to reduce the risk...and no GBS in last pregnancy.

Please please do as they ask. It’s not to be taken lightly and they are trying to save your baby.

Protocol is likely to be 24 hours rather than 48 - check this - but I absolutely would stay in especially having had it identified in your urine, indicating more extensive colonisation. I would also not describe the symptoms as obvious, quite the opposite, and being at home when they are identified if you do would delay treatment.

The ideal would be to try really really hard to get there on time for the antibiotics yourself, ring at the first twinge!

The signs of GBS infection are not always obvious and the consequences are so so serious. My baby was in NICU and SCBU for 10days with GBS sepsis and we nearly lost her. I appreciate why you don't want to stay on the postnatal ward or leave your older DC, but it really isn't worth the risk.

Can you get more information on what they'd be taking obs on and how often?

I agreed to have the antibiotics for strep b but declined the obs as protocol in our local hospital when DC was born 5 years ago was a set of obs every 6 hours which felt a bit pointless. Being at home and having someone to watch DC and checking temperatures regularly while I slept seemed more likely to spot early signs of a problem! As it happened, meconium in my waters meant they wanted me to stay in for 12 hours which we did - meconium meant observations every 2 hours which felt a lot more worth doing, it was often enough I could see they might spot early signs of a problem before we did

@CrabbyCat good point on checking protocol for observations..this was what I was thinking that it’s likely to be someone coming round with a thermometer every 4-6 hours and I’ll be up breastfeeding more frequently than that at home.

I would feel better about staying in if not for covid / nhs strain / the really bad CQC report my maternity unit has had..just want to (hopefully) get antibiotics and then get out as long as baby and me are ok...obviously with a very low tolerance for taking baby back in.

Just checked the RCOG guidance and it actually says 12 hours monitoring if no time for antibiotics and zero monitoring if I get the antibiotics in time..maybe my midwife got the 48 hours wrong!

I do understand about the concerns you have, but I have personal experience of people losing babies to this, so it’s something I always worry about. I do wish you well and hope it all goes OK and you get those antibiotics in time xxx

I understand the concerns you have but the consequences of group b strep can be devastating. It's not worth the risk.

I’ve had GBS in all my pregnancies. It wasn’t detected in my first so when my son was born it passed onto him. At first he seemed fine and I couldn’t understand why I still wasn’t being discharged but they then said I needed to stay for observations because it was possible my baby wasn’t completely well. Again he seemed fine to be but he actually went down hill very rapidly and I’m so grateful they were doing the obs (which felt so invasive and annoying) because they prob saved his life and meant that they intervened in time before it became much more serious. I definitely wouldn’t have picked up on it even knowing the signs in time.

It was horrible and I wouldn’t wish it in anyone

For pregnancies 2&3 it was picked up on and I had antibiotics both labours and the observations (it’s 24 hours in my trust) and it was fine. I knew it was going to happen so was at peace especially as ill never forget sitting in a special room with my eldest worrying he wouldn’t survive the night

Thanks everyone..this seems fair enough if the signs can be very subtle / very rapid decline. I really hope I get time to have the antibiotics but think it’s very unlikely given my first birth was super quick, I’ll be calling at first mild cramps though! I’m sorry to hear about your personal experiences with this @GuidingSpirit and @SophieHatterPendragon glad your babies were ok, I can imagine it must have been terrifying at the time.

People's babies literally die of this. Why would you not do what you're told for the sake of your baby's health? Have a read of @overatkates posts on Instagram and how quickly her son became poorly and the impact on their lives.

We were in for a week. It was pretty awful in terms of rest and recuperation but I was so pleased they picked up on it.

They picked up on it via a standard blood test in me and then checked him. As a first time mum I’d have had no clue - he seemed ok to me but it took 5 days of antibiotics.

@October2020 I appreciate that and that’s what I’ll be doing. I do think it’s good practice to challenge and question though, the nhs is a one size fits all approach, it has to be, but I like to understand all risks on both sides, e.g there are risks associated with antibiotics for newborns and risks associated just with being in hospital at the moment. I think the benefits outweigh the other risks in this case though as it sounds like it can be very serious even if for a small minority

GBS babies can go downhill so fast (I know from experience), and I’m sorry but you’re not a trained midwife so how can you be certain you’ll catch it in time if baby did have it? You’ll be absolutely exhausted from birth.
I think this is one of those areas where you have to err on the side of caution and put baby first

I know someone who's baby died from this and no it wasn't at all obvious and the decline was incredibly quick. I don't think going home to save 48 hours inconvenience is worth the risk personally, but if you do ...

I just delivered my baby at 37+5, she had GBS and went downhill quite rapidly, had to be in nicu for a week and on antibiotics. I really wish I had been tested beforehand and would have done anything to prevent passing it on to her!

She seemed absolutely fine when she was born but it wasn’t until 3-4 hours later they noticed her strained breathing and did lots of tests etc

24 hours of obs is what we had and the clock starts ticking the second the baby is born so you’re a good few hours into the 24 hours by the time you’re transferred to the ward. It isn’t just temperature they’re taking, respiration, heart rate,
Monitoring you as well. I also had a UTI with GBS which is one of the higher risk factors. I recall something like 90% of babies who will develop an infection do so within the first 12 hours but honestly with some of the time taken sleeping (or as close to sleeping as you can do on a busy ward!) it does go fast and I found it actually quite nice being able to have that time together without the sibling in tow.