Group B Strep - How does this impact on the Home Birth I was planning?

[jen992]

In 2006 I had a home birth with my first child (planned!) and it went perfectly!
I am now 28 weeks pregnant but received a letter from the hospital today saying I have Group B strep (my urine was tested following a water infection 2 weeks ago). Within the letter it states that if i was planning on a birth at the local midwife led unit this would no longer be possible and i would have to go to the actual hospital.... Where does this leave me with regards the home birth I have my heart set on?

The more I read about this the more confused I get. I believe i have to have antibiotics intraveniously during the labour to prevent the baby becoming 'infected'. Some websites say it's possible to go to hospial for the antibiotics then return home for the birth??

Does anyone have any advise, knowledge or info on this as I really really do not want to go to hospital.

Any advice greatly appreciated!
x

hiya jen. hjave a look on the homebirth website, loads of info on there.

you should be tested again for GBS at about 36 weeks because it may have gone by then anyway. you don't HAVE to have AB's.

homebirth site

click on the "you can't have a homebirth because..." link on the left hand side.
then down to group b strep and onwards!

actually here is the single frame version

Thanks... had a quick read of this site earlier today. It doesn't really say what would happen if i was at home, without the antibiotics - what would happen if the infection was passed to the baby? oh i'm so confused.
Would i routinly be offered another test at around 36 wks or is it something I'd have to 'fight for'??

i think they are "supposed" to test you again later in pg because it can go.
I would ask your midwife next time you see her.

I guess if you give birth at home they would swab baby to see if s/he had it? and then treat if necessary?

Hi jen922 I don't know if this will help you or not but I had GBS with both of my pg's. I was told that I couldn't have a homebirth because I would need AB's, I asked if I could have the AB's when labour started and go home but was told that I couldn't do that as the AB's need to be given every 4 hrs until the baby is born.

Anyway my dd arrived very quickly and we didn't make it to the hospital so in the end she was delivered at home. All they did was keep us in hospital for one night so that they could swab her ear to see if the infection had been passed on.

Hope you get the birth that you want, Good luck. xx

thanks Dragonfly. It was only stumbled accross that i have it now! What's to say I didn't have it with my first pregnancy? oh the medical world can be so irritating sometimes!!!

Hi Jen,

if you haven't already you might want to join the homebirthUK yahoo mail group and ask this question - there are a fair few ladies that have personal experience of this issue that could tell you what they have done and why, which may help you decide.

If it were me, I would get a retest at 36 weeks (and probably pay for a private one as it is more reliable than the one usually available on the NHS), and use the result to allow me to make a more informed decision. I, personaly, would not have IV ABs if the only indicator was I was GBS +ve. Similarly, I would not automaticaly go to hospital rather than stay at home just because I was GBS +ve. If other risk factors started to show up, however, I'd probably transfer sooner rather than later.

Have you found any info on using garlic to treat GBS? There are a few ladies on here that have succesfuly cleared their infection before a 2nd test (if you search for "garlic protocol" you should find something). You might also want to contact Peter Joslin - he's involved in a product called Allicin Max, which is a stabilised garlic extract that has had some very good results treating bacterial infections. I emailed them to ask whether their product was safe for use in pregnancy and whether they'd tested it against GBS and got a very prompt reply that they had some research due to be published shortly and that first impressions were that results were very good - I don't know what the current situation is but you might want to find out (sounds more pleasant than sticking garlic cloves up the infection site!).

Good luck

i don't think there is a form of instant identification test for GBS - they would be looking for generalised signs of infection/septicaemia developing in your baby and if they saw any would whisk bub into hospital and give antibiotics. I don't know and can't find any information on whether they would provide antibiotics in tablet form as a "half way house" but it could be that never gets offered because it just doesn't work. Qorth a chat with MW/doc though.

Your UTI will put you in a statistically higher risk group for passing on GBS infection but only 1 in 2000 bubs get ill, so overall the risk is "relatively" low.

There is a lot of good information here

www.rcog.org.uk/index.asp?PageID=1400

Garlic protocol:

? Break a clove off of a bulb of garlic and peel off the paper-like cover. Cut in half. Sew a string thru it for easy retrieval.

? Put a fresh half in your vagina in the evening before you go to sleep. Most women taste garlic in their mouths as soon as it is in their vagina, so it is less pleasant to treat while awake.

? In the morning, the garlic may come out when you poop. If not, many women find it is easiest to take it out on the toilet. Circle the vagina with a finger, till you find it. It cannot enter the uterus through the cervix. It cannot get lost, but it can get pushed into the pocket between the cervix and the vaginal wall.

? Most people will taste the garlic as long as it is in there. So if you still taste it, it is probably still in there. Most women have trouble getting it out the first time.

? For easy retrieval, sew a string through the middle of the clove before you put it in. You don't want to get irritated. Be gentle. Don't scratch yourself with long nails.

If the GBS is in your urine I think it needs treating with ABs now. Check the GBS support website.

Incorrect Rolf, the UTI should be treated but not the GBS, there is no evidence to support treating GBS with abx antenatally.

Jen, your homebirth is still a possibility. I have had a client recently planning homebirth who was GBS +ve and her consultant was incredibly supportive of this. There is an option to have oral abx during labour at home but there is not an awful lot of evidence to support their efficacy.

As Tangle has already pointed out, the rates of transmission to baby are low and the rates of babies actually getting ill are even lower. The ultimate fear is transmission-illness-death but the figures for this are miniscule. It's all about weighing up the risks. Even women who receive the abx sometimes pass on infection to their babies because they don't receive the abx quickly enough. Statistically you are at greater risk of having an anephelactic reaction to the abx than you are of passing on infection to your baby.

Personally, if there were any risks of passing on an infection to my baby I'd rather be in my own environment surrounded by my own germs.

Jen if I was you I'd be thinking of a more holistic appoach to my diet to try to minimise my risk of being GBS+ at birth time.

i appreciate that a urine+ test during pg is considered a higher risk so would get a more reliable test from the London Laboratory or wherever, the NHS testing is notoriously unreliable.

Garlic, vit C, acidophilus, etc should help to minimise risks check out this site for more info

I was tested + before my first, which wasn't an issue, and then it came up for my second, 12 years later so had prophylacted ABs. I've then researched a bit more and would try the holistic approach if I ever had another baby. Just my own personal opinion.

Howdie - Rolf is correct. If GBS is the infective organism in UTI then it should be treated with ABs. It shouldn't be treated if it is found elsewhere.

Hi Jen992. I am 34 wks pregnant with DC2 and tested gbs + in a pre-pregnancy smear. I wasn't aware of this for the birth of DC1
I am also planning a homebirth. My midwife will do a test for GBS at 36/7 weeks to see if I am still positive as it comes and goes. I am going to do a private test too as the NHS ones are notoriously unreliable.
If my test comes back positive I will probably go for a hospital birth so I can have ABs. Unfortunately my midwifes are unable to administer IV Abs at home, which would be ideal. (some health authorities will do this though, so its worth checking with your MW / antenatal team)
If it is neg I will go for a home /water birth as planned and just keep a careful eye on my baby for signs of GBS.
I have read up on GBS and the effects of ABs and whether to have a homebirth or not... and there is so much conflicting information and differing opinions. I think it comes down to personal choice and weighing up the pros and cons for you.
I came to the conclusion that I want to minimise any risk to my baby's health, so if that means ABs in hospital then that's what I will do... not my ideal way of giving birth though.
There are quite a few threads on MN if you search 'GBS homebirth'.
Good luck!

Just to put another spin on it for you It is confusing.

Look at here and here on MN and there are quite a few other threads too..but not so recent

Just to say my daughter had a GBS infection (meningitis) at birth and was on IV antibiotics in special care for two weeks. She was fine after that.
I think hkz has a sensible attitude to it - the chances of passing on infection are small but it does happen and the consequences are often devastating.
Also personally I would not relish watching my newborn for signs of a GBS infection. It really is awful. The treatment if they even suspect the baby has an infection is pretty awful too; 12-hourly IV antibiotics through a canula in their tiny hand, which is painful for the baby, daily heel prick tests and a long stay in SCBU.
I think IV antibiotics are a small price to pay for peace of mind.
But as other people have said, the chances of passing on the infection are small. I just felt I should say something having been through it.
I hope it goes well whatever you decide