GBS+ Has anyone refused antibiotics?

[Yorky]

Why? and how much pressure where you under to have them?
I am GBS+ and want to go ahead with my planned homebirth without antibiotics as I believe I was a carrier with DS and he was fine but community midwives aren't keen
Thanks

i like lists

do you have % of those risks? I'm interested, honest.

and risk fo developing thrush?

In reality the majority of strep B infected babies are pre term (i.e. before 37 weeks) and this is the most dangerous risk factor.

That said a mother could be unlucky and have no risk factors, tested negative and have a CS (they don't give antibiotics to CS babies even if mum is known to be strep B positive) and STILL the baby potentially could get strep B off a nurse or doctor who hasn't washed their hands properly.

Babies can also pick up strep B from their surroundings etc. It is not all linked to labour.

i understand what you're saying tmmj.
that being GBS+ carries different risks for different people and that the official guidance says to take the circumstances into consideration.

But what are the benefits of not having the AB's.
Possibility of developing thrush with potential difficulty feeding.
Discomfort of having IV ab's during labour?
Does it affect the decision to have a home birth?

I am really not an expert in any of this at all. However, I do remember reading an intersting article (I wish I could remember where) that suggested that having the antibiotics during labour can actually potentially make your baby immune to the antibiotics. Therefore there is a risk that you can create a kind of super strep B bug that becomes much harder to treat as it is resisitant to the antibiotics. I have no idea of the validity of the study but it was certainly interesting and can't seem to find it when I looked quickly apart from the quote below, which probably comes from the same article but I can't read the full article on the website as I'm not a member:

"Sue Read
British Journal of Midwifery, Vol. 11, Iss. 3, 06 Mar 2003, pp 160 - 163

The group B Streptococcus bacteria is now the leading cause of neonatal infection which can have devastating consequences for the newborn and their families. This article provides information for midwives and their clients on the nature of the organism and the risks it poses to the wellbeing of the infant. A universal screening programme has been shown to be ineffective in reducing mortality and morbidity rates. Antibiotic therapy in the antenatal period, prescribed on the basis of a positive vaginal culture, is inappropriate and may be putting women at unnecessary risk of anaphylaxis. Indiscriminate use of such therapy may also be instrumental in the development of antibiotic resistant strains of the organism, which has implications for the wider public health. The midwife has an important role to play in providing sound information to the women in their care, in order to allay undue anxiety and facilitate informed choice."

That quote came from this website. If you spend longer looking through google you might be able to find the full version. I only had a quick look as I am working!

That's quite interesting.

The problem is that i'm sooo biased having been one of the rare unlucky ones who should have been low risk even if i'd known i was a GBS carrier, that I can't believe anybody would choose their own personal comfort, when the risks are so great.
(unless i'm missing some major issue with repurcussions of taking antibiotics)
The long term effects of having thrush hardly compare to the long term effects of GBS Meningitis or Pneumonia. (You know the website gives % of long term damage)
Because of my experience i would absolutely say err on the side of caution. The doses of antibiotics required to be given should a baby develop GBS illness, have their own risks. Deafness being one, DS1 had to have repeated hearing tests for 2 years.

The overuse of AB's being responsible to development of antibiotic resistant strains is an interesting issue.
I think when it comes to having babies born sick or healthy however, I would be more interested in my own child that the wider public health. I know that's probably not a very wholesome attitude, but it's how i feel. And i wouldn't wish my experience on anyone.

I understand that my opinions on this are emotive and not a clinical stance on the subject. But for me, it's clear cut.

Playingthe9monthwait - I think this article is the one you're referring to.

I posted the same one on the debate about whether gbs testing should be made routine. There are a lot of viewpoints and good information on that thread here

Personally in the absence of other risk factors as outlined above, I would be vary wary of accepting prophylactic anti-bs for gbs. It has not been proven to my satisfaction that they prevent transmission when administered during labour. After all, the US routinely tests for and 'treats' GBS during labour and has seen no difference in the transmission or neonatal death rates.

The information above is good, anyone interested in the issue would be well advised to read it.

As I said in the original thread, I don't wish to upset anyone who has had experience with GBS, it's a terrible thing to have to go through with your newborn.

Don't worry about upsetting me. I find the debate interesting and understand why the guidelines are they way they are.

It's hard to read the statistics on how unlikely you are to have a baby ill with GBS while you're sat in Special care watching your baby fight for his life though.
I used to be an optimist

What does make me sad is that everytime there's a GBS thread i find myself reliving the experience in an attempt to warn people that not everyone gets away with it.
I'm not even sure it's worth it. I'm fairly sure my opinion will be disregarded by optimistic GBS carriers.
Is it helpful at all?

Dragon don't worry I'm behind you - if people were to meet women who have lost babies to this common,preventable infection then they would soon change their mind. If they met a child serverly disabled by this infection they would change their mind. If they joined the group b strep support group and met experts who knew everything about this infection they would know.

I must have met at least 20 women who have lost babies from gbs. There was even a women a few years ago who sadly posted a thread that her baby had died from it.

Whilst the links to the various studies (back to 2003) give you good background information, you must be aware that no detailed statistical information relating to ALL UK births exists. Some hospitals do record GBS birth information but the majority do not.

Likewise there is no detailed statistical information relating to the death of anaphalytic shock, although I did find one relating to 1980s and it said that every doctor will see 1 death every 20 years - so again not very useful.

Also the US neonatal death rates quoted relate to ALL deaths not just GBS. So there are other factors in the US that make this up.

Until detailed studies on all births in the UK exist, there will always be "studies" but no evidence to back it up.

Wow, this thread has taken off while I've been at Monkey music and visiting nursery!

Dragonbutter it is useful, people's experiences are much harder to ignore than statistics. I'm sorry for making you relive the scary early days of your sons life. Thank you

The supportive MW I have spoken to from our local MLU says the ABs themselves pose risks in themselves as it is a massive dose for such a tiny person.

And the homebirth issue is cloudy - I was originally told No, but after talking to the MLU who reminded me that the ABs are a choice not a have to, and that they would be happy for me to deliver there but they could not administer IV ABs. GBS does not make the labour more difficult or increase the risk of complications, and as long as I understood to watch baby (temp and breathing) closely for the first 48hrs they would support me at home.

My DH feels that if I am forced to go into hospital it will be a longer and more stressful labour than I had with DS which could add its own difficulties.
The thing to remember is that GBS lives harmlessly in your system, much as thrush or a cold sore virus do, causing no problems most of the time. Being a carrier is not the same as being ill.

And the statistics do say that having had one healthy normal delivery the chances are increased in this baby's favour. I can only assume I was a carrier then, as I was never tested. I am trying to get access to DSs notes as I know he was swabbed within about an hour of birth as my waters had gone early with him, which in itself suggests I was a carrier although he had no symptoms at all.

In the hospital I work in as a mw the policy has recently changed regarding women who had gbs in a previous pregnancy with no repercussions. They are now advised that if they really want to have iv antibiotics they can have them, but that if the previous baby was ok then the risks of antibiotics outweigh the risks of the baby getting a gbs infection. This is for women over 37 weeks of pregnancy who are otherwise well and whose waters do not break a long time before the birth.

I personally had a gbs swab with my first preg. delivered in a midwife led unit within a hospital but without antibiotics. Second time around I had a homebirth. Did not have any risk factors so did not get swabbed for gbs. Everything was ok.

You have to remember that it is a naturally occuring bacteria and a quater to a third of women have it in their vagina's, most of these women do not know it and have perfectly healthy babies. It is thought by many to be better to treat symptoms such as people who have ruptured membranes for longer than 18 hours, people in labour under 37 weeks, people who have temperatures in labour etc.

Yorky - I have GBS and it was the main reason why I was advised against a home birth. As things turned out my labour was v fast and I didn't make it to hospital, so I had an unplanned (and wonderful) homebirth.

My waters broke about 10 minutes before my baby was born. which meant the GBS risk was very small. We were advised to transfer to hospital immediately after delivery so my baby could be observed for 24 hours post natally (which is the hospital's protocol for GBS and what I was anticipating following a hospital delivery). Would this be a compromise you'd be happy with? Plan for a homebirth unless any other risk factors present themselves and go to hospital for obs for 24 hours afterwards?

Another compromise which might work, and which my consultant raised but which wasn't suitable for me given my history of fast labours, is going into hospital to have a venflon sited and have a dose of ABs, then go home. Obviously it depends on how far you are from the hospital and how quickly you labour.

I've also heard (on MN?) of someone whose community midwife administered the ABs at home so the lady was able to have a homebirth AND the ABs.

I had GBS, was diagnosed a few days before ds2 was born. I was told I was to have two bags of iv antibiotics. It never occured to me to pump my tiny newborn full of that shit instead. As it happens, I never managed to go through more than half of the first bag as my labour was extremely quick. He was out like a shot so it was very small risk. However, he developed a fever, he was dehydrated, and we were kept in for 3 days. He is fine though.

Ds was a fast labour for a first and its 30-40 mins to hospital when its not rush hour, wouldn't fancy sitting in the car for that long. I so completely agree with everyone who says they'd rather have the ABs themselves than put the baby through it but still like the sound of maxbears hospital

I have heard that garlic wrapped in muslin inserted as a pessary has good results in clearing Strep B in the vagina - this is just anecdotal though and was done by my lentil weavery friends but they went on to have homebirths. Can't harm you I suppose?

dd2 caught group b strep at 5 weeks - (from an unknown source (she was 3 months prem so in SCBU at the time)- it is a nasty nasty infection. it still makes me want to cry remebering that time - in all the time she was in SCBU, that infection was the worst, and we almost lost her. i realise this is a different situation to the one you're in - but honestly, anything to have stopped her going through that and i would have done it.