Looking for anyone who tested positive for Group B Strep and went on to have a homebirth

[Picante]

There must be someone... I have a dilemma!

Picante, true for the stage you're at now. Ds was prem because of GBS.

Zuzi, yes PROM because of GBS.

Obviously had no personal experience of GBS before I had ds and it was a steep learning curve. I did know someone (not well) who lost their baby to GBS 2 hours after being born perfectly healthy. Not widely spoken about but fortunately when I found out that I was a GBS carrier I was able to have a look at the website and understand what GBS was. Never ever thought that anything would happen to ds as a result of me being a GBS carrier. Didn't even think much about having ds early. Only when I saw him in SCBU (they whisked him away immediately he was born) and was told how poorly he was and then when he was 6 days old being told he was likely to die, made me understand how deadly GBS could be.

Racmac, that is interesting that the hospital policies differ so much across the country. This is something I honestly fail to understand.

MollieO, again, when I was diagnosed with it, the doctor who called me with the result was really laid back and said: Oh, it's nothing, you only need atb in labour... And the midwife's reaction was quite similar until I explained that this completely changes my plans for birth, and was extremely upset about the whole thing. Maybe the professionals themselves don't have a united approach and sometimes even deeper understanding of it? I don't know.

Picante,

I tested positive for GBS after a routine swab for thrush at 24 weeks. I am still planning a homebirth with the following provisos:-

If I go into labour before 38 weeks I will have IV ABs

If my waters break and no baby for 12+ hours I will have IV ABs

If I have a fever in labour I will have IV ABs

If baby shows any signs of GBS infection post birth I will take baby to have IV ABs (or what ever is recommended)

I am currently 30 weeks with my 3rd pg and I will be retesting privately at 37 weeks. Prior to the test I will be doing the raw garlic up hoo-ha thing and also using Hibi-Scrub as an external wash. Hibi-Scrub is an antimicrobial preparation for pre-operative surgical hand disinfection, antiseptic handwashing on the ward and pre-operative skin antisepsis for patients undergoing elective surgery. You can put it on any part of your body except meninges (membrane of nerves), brain, middle ear, body cavities and eyes. You can buy a huge bottle of it in Boots for about £7.

My midwife is happy with the plan and is still fine with hb going ahead (even though I am epileptic and had to fight tooth and nail to get a hb with my 2nd DD!).

I, too, am wary about the side effects of the IV ABs - so far I have seen stats of 1 in 100,000 chance of death due to anaphlaxysis, 1 in 5000 chance of permanent kidney damage, risk of baby being attacked by opportunistic infections as ABs have knocked out natural resistance and no exposure to natural vaginal flora which populates the gut of the baby.

As this is my 3rd baby I wouldn't want to place myself at risk for a maybe as I have DD1, DD2 and DH to think about not just baby. If it was my first baby I'm sure I would be a bit more cautious and just go in anyway but as I have had one very interventionist hospital birth I am keen to avoid being put in the sausage machine again .

I had two children with no knowledge of GBS, then got a positive test on my third at 33 weeks and was immediately told I could nolonger have the planned homebirth.

My second birth was only 2.5 hours so I was worried about not getting enough time for antibiotics (requires 4 hours before birth to be effective) So I decided that with the third birth, I would go to hospital (which is an hours drive away) but would not take the IV AB's unless it looked like a slow labour and I had rupture of membranes.

My third child however had his own ideas though and came too quickly. So ended up being an unplanned homebirth. Following the birth, the midwife who attended rang the hospital for advice and was told I could stay at home as long as any signs of infection were watched for closely and baby brought into hospital if any doubt.

I watched the baby like a hawk for 48 hours, barely risking sleeping. But at the back of my mind I knew my waters had gone just half an hour before delivery, so that the risk of infection was low-ish.

I am pregnant again and I go with verity's thoughts on :
"If I go into labour before 38 weeks I will have IV ABs

If my waters break and no baby for 12+ hours I will have IV ABs

If I have a fever in labour I will have IV ABs

If baby shows any signs of GBS infection post birth I will take baby to have IV ABs (or what ever is recommended)"

However, with two very quick labours for the last two, I don't suppose that I will have a long enough labour again for AB's in labour, and that a quick labour in itself reduces the risk. So this time, I also will PLAN for a homebirth this time no matter what, as I don't want to be caught out like I was before!

Whoops I just realised that this is an old thread - please forgive me for posting here.

My experience was similar to Verity79, I was allowed a homebirth with similar provisos.

I had the private test for GBS at 37 weeks and was devastated with a positive result. Midwives were categorically not allowed to adminster ABs at home (in case of reaction). I asked if I could go to the hospital for a dose then go home, but they reckoned there would likely not be enough time (2nd birth). By the same token they said even giving ABs in hospital might be difficult, because they need at least one dose 4 hours before delivery. Finally they agreed I could deliver at home as long as I did not fall into one of the risk categories - premature delivery, prolonged ROM, internal exams, fever. Also the very understanding head midwife told me that her theory was that home deliveries in the case of GBS may be safer - you are relaxed, have quicker labour and are only exposed to your own germs at home, I think she quoted risk of 1:6000 of fatal consequences, so a lot lower than risk of some other possible problems (I have no factual evidence to back this up). The highest risk seems to come from prematurity. Also as others have pointed out ABs are not a magic bullet and carry their own risks - and babies can suffer with GBS even after ABs being administered.

I did LOT of research following my diagnosis and implemented a routine of supplements - extra strength vit C, alicillin (garlic), propolis & echinacea (sparingly) and the piece de resistance of nightly garlic cloves up the foof . Anything that would give my baby a fighting chance.

In the end I had a very quick labour 3.5 hours established, so absolutely would not have had time to have ABs in hospital. Also we had absolutely NO interventions during labour apart from external monitoring of baby, midwives were only there for last hour anyway. They gave us very specific instructions for doing 2 hourly obs on DS for the first 48 hours (would have been immediate admission and ABs for him if any problems). For us it was all about risk management, at least knowing I had it meant we could manage the risks.

Oh dear rainbowdays, you sucked me in too, now I feel

Glad you two got sucked in! This is something I've been wondering about - had GBS and IV ABs in hospital with DC1. Am preg now and am wondering whether to test privately for GBS again, or if I should just try the hippy remedies (garlic up the noo-nah, manuka honey by mouth every day, etc) and hope for a good homebirth. Or try the remedies and then get tested.

It's terribly sad to read the stories of GBS infections in babies on this thread. At the same time it's important to keep a sense of perspective - as someone said earlier, most babies will not be affected this way. We don't usually decide not to do things (drive, fly, eat chicken) because we've heard of a few stories where things have gone wrong. So perspective is very important.

I only heard about GBS from a waiting-room chat magazine and when I asked my midwife about it at the 28 week checkup they said that the NHS does not consider it enough of a risk to do routine testing, but we could consider going private if we really wanted the test.
When I spoke to our local private hospital, they said they only do the test after referral from a GP and that it is not commonly requested.
The midwife also threw in the comment that if we came back positive after a private test they would refuse to support our home birth.
So, I decided not to worry about it.
It is, however, definitely worth knowing about and the advice to keep a close eye on your newborn for at least the first two days has to be a generally very good plan...

That's interesting Ames about the private test - I did a private test but it was a mail order thing where they posted out the swabs and you posted them back. Didn't need to go near a hospital to do it.

I agree - not worth the risk.

I know this is an old thread but it's still important to discuss GB. I know of someone who lost her baby at 29 weeks recently.

Interestingly, when I went to hosp for the swab that I'd requested, I was asked to consent to it. This is because if I test positive, my booking will be changed from MLU to consultant-led. To my mind, tht means additional cost to the NHS for what ultimately is highly risky but rare. I don't care how unlikely it is that my baby will suffer ill effects from GBS, I'm not taking any chances.

I agree kitcat.

When I discussed GBS with my a/n group none of them had ever heard of it and I got a big sigh and rolled yes and "you do too much research" from one of them for saying I'd had the test.

rolled eyes

Ok, this is only personal experience and statistically insignificant - but I was group B strep positive (paid for private swab), decided on hospital birth, had IV antibiotics, labour going fine then developed high temp 2 hrs after waters breaking - basically full blown group B strep septicaemia. Baby delivered by emergency section 15 minutes after I spiked a temp, poorly on arrival but subsequent lumbar puncture and blood cultures showed she was absolutely fine and was just poorly when she came out because of how ill I was. I had a 7 litre PPH because of clotting problems caused by group B strep, 20 + units of blood / blood products and an HDU admission. However, after 4 nights in hospital we both came home with no long term ill effects thanks to the fantastic, highly medicalised, hospital based obstetric and paediatric care we both received. Had I opted for a home birth (which was offered when I first got pregnant) I genuinely think we would both have died.
This is an extreme example and I don't want to scare anyone - I'm well aware that hospital births also carry risks - but it's worth thinking about.

I had a home birth first time around, and am planning one this time. I'm currently struggling with whether or not i should be tested for group B strep. I met a friend of a friend who lost her baby because of it.

My midwife advised if I tested positive I would have to go in to hospital.

I feel the same as you about hospital Zuzi...

It would be interesting to hear if there is any possibility of having the antib's at home if positive?

I Totaly agree kitcat and GhoulsAreLoud .I come from abroad and was supriced to find out this test is not obligatory here as in Europe and States is standard.NHS costs I believe but I am not willing to put my baby in any risk I can knowingly avoid.There are so many things out there I cant control during birth that eliminating even some through the means of medicine we thank God are enjoying is great.
after all its only an IV in my hand.I sumpathize with those hating hospitals and needles etc because I am one of them(and sincerely had enough of them for 7 years) but if I am going to manage labor,stiches and many more terrifying words I think this will be the least of my problems

Hi everyone. I will have my penny's worth.

For DS I was planning a home birth and tested positive for GBS at 28 weeks (NHS test). I did all the natural alternatives Lionstar suggested: garlic, echinacea, visualisations to see if that would fend the GBS off. Apparenlty the GBS works in 3 weeks cycles which is why the private test is done at 37 weeks.

I decided to take the private test at 37 weeks and had decided that if it were positive I wouldn't risk a HB (although you can go to hospital and have a first dose of AB there then go back home). I had discussed the options (and there are a lot) with my IMs but decided that because I am too much of a worrier, if I was positive I would go to hospital. I had negotitated with the lovely consultant at the hospital and she had agreed to me having a water birth regardless.

At the end of the day, seems that the garlic did the trick as I tested negative at 37 weeks and gave birth at 38.

I am pregnant again with number 3 and will definitely look into the options and take the private test again nearer the date

One of my best friends had a homebirth with her first - great birth, lovely baby, no problems - until baby was rushed to hospital 12 hours later with pneumonia caused by gbs. Was really ill, touch and go for a few days, and although he is now fine, she went into hospital for the second one. Obviously each to their own etc but I can't see why anyone would want to take the risk of a homebirth if they know they have gbs. How could you live with yourself if the worst happened - that's what you've got to ask yourself.

my 38 week pregnant brain is now totally scrambled! First baby, I have just found out have tested positive for group b strep, on top of this have breech baby, so our planned home waterbirth looks unlikely..pool is here now, using it to relax in as much as possible seeing as we have paid up might as well!

I am booked in for C section, have had no real explanation of what the proceedure is with the anti b or anything, only that if I have c section (still hopefull baby will turn before) that is isn't a problem...although now it seems other have had a problem, even with c section? the first midwife who saw my result said 'oh no..' and then said they generally just give you anti b if your waters go early, or baby is early. they then swab baby, and monitor - and that hb was still an option?

If baby does turn, and I have the anti b, then what are the chances of those causing harm, due to wiping out the natural immunity to other things? plus thrush, and all the other stuff that can come with them. however, if I dont get them, do they have to give them to the baby? wuld definitely rather I had them.

I have already had so many choices to make in the last week, such as finding out about breech, it just all too much to take in!

thinking is it worth giving the capsules of garlic, echinacea, and vit c a go - guess it cant do any harm?

dh is a microbiologist, and very against using anti b 'just in case', he would be worried about losing immunity, and how effective they actually are, and the effects on the baby.

I have a history of epilepsy, and have argued to be at home, this all kicked off at the homebirth talk, less than a week ago, so maybe I just need to give up on it, and try to make the best of being in hospital?

its so difficult - although my friend, with a toddler, says it all just the beginning of weighing up all the pros and cons of everything constantly - and being a parent!

smileyhappymummy wrote:
"Had I opted for a home birth (which was offered when I first got pregnant) I genuinely think we would both have died. "

But Smiley, if you'd been at home and had a temperature rise, your midwife would have transferred you urgently to hospital anyway, and the team would have been phoned to be aware that you were coming in, GBS positive and with a fever. Depending on how long it takes to transfer to hospital, clearly there may be a delay - but the point of homebirth isn't to stay at home no matter what, it's to start off at home, keep vigilant and see how things go.

MollieO wrote:
"Zuzi would you refuse your newborn having antibiotics? Why?"

This was about a case where the baby appeared well, but IV antibiotics hadn't been given in labour, despite mum being GBS positive, I think.

The UK guidelines from the Royal College of Obstetricians and Gynaecologists are that there's no clear evidence on this one. Giving the baby 'just in case' antibiotics, even though he appears well, will reduce the chances of him developing GBS disease, but a large review found that it resulted in an increase in the overall death rate. It looks like maybe other antibiotic-resistant organisms filled the gap, so to speak, but it seems so far nobody's explored exactly why this happened. The research abstract is here:

Benitz WE, Gould JB, Druzin ML."Antimicrobial prevention of early-onset group B streptococcal sepsis: estimates of risk reduction based on a critical literature review.
Pediatrics. 1999 Jun;103(6):e78. Review. PubMed PMID:
10353975.

Mollie, what happened to your baby must have been truly terrifying, but you were in two very high-risk categories - PROM and prem baby below 35 weeks. I understand that the GBS itself probably caused all that, but I doubt any mother in that situation would think twice about accepting any intervention which was offered her. Even if you've not had a GBS test, my understanding is that UK guidelines are to strongly recommend IV antibiotics in prem labour anyway. The risks of a baby developing GBS when the only factor is the mother having a positive GBS test, is way, way smaller - around 1 in 500 chance of the baby developing GBS disease and 1 in 5,000 risk of death. The numbers may not mean anything if it happens to your baby, of course, but we all have to make decisions about risk all the time. Homebirth reduces the risk of some other problems, eg roughly halves the risk of baby needing to be born by assisted delivery or caesarean, roughly halves the risk of baby being born in poor condition compared to mothers of the same risk level planning a hospital birth (because fewer interventions are usually needed), so there are benefits to balance against the risks. Refs for these are on my website, www.homebirth.org.uk and are based on large-scale UK studies in the 1990s.

Tinasan wrote:
"One of my best friends had a homebirth with her first - great birth, lovely baby, no problems - until baby was rushed to hospital 12 hours later with pneumonia caused by gbs.... I can't see why anyone would want to take the risk of a homebirth if they know they have gbs. "

But Tina, would this have been any different if she'd been in hospital? If she had not had a GBS test and didn't know she was positive, she wouldn't have had antibiotics in labour, and would normally have been on course for early discharge from hospital. If the birth was straightforward, there wouldn't have been any reason to keep her in and she might well have been at home anyway. And after a homebirth, you still observe the baby closely - the midwives are usually there for a couple of hours after the birth but if there are any worries at all about the baby's health, you don't mess around, you call an ambulance and go to hospital and get checked out.

One of my friends from antenatal classes also nearly lost her baby to GBS. She'd had a hospital birth which ended in a caesarean for slow progress, was discharged a few days afterwards and shortly after she got home, she was worried about her baby. She contacted a health professional - I can't remember now whether it was her GP or a midwife - who, IIRC, said she was just worrying. Later her baby turned blue and stopped breathing, was rushed to hospital and spent the next week or so in SCBU on IV antibiotics - fortunately he made a full recovery. Most cases of GBS disease show up within 12 hours, but 10% occur between a week and three months after the birth (and of the 90% which occur in the first week, 10% of those are after 12 hours). So we all need to be vigilant about the health of our newborns, regardless of where we give birth.

Anyway... there are quite a few birth stories about GBS and homebirth on my website, at www.homebirth.org.uk/gbs.htm. Some women have had IV antibiotics at home, others have not, or have gone to hospital to have the antibiotics and then gone home. The GBS Support Society suggests an alternative of intramuscular injections of antibiotics in late pregnancy, for women who have been refused antibiotics at home. Incidentally, they also say there is no reason why waterbirth should not be supported for women with GBS, and reprint an article about it which you can give to your midwives - see their FAQ section on www.gbss.org.uk