FFS! Tested + for Strep! How long will baby have to stay in hospital?

[CheeseFondueRocks]

There was optimistic me imagining the calm water birth of DC2 and our return home after the usual 6 hours.

Got a call from the midwife just now, informing me that my pee sample came back positive for a Strep infection and that I need to take an oral course of ABs now and have IV ABs during labour. She said I could still have the water birth but I bet they're going to change their mind.

Never mind that I hate drips and this is going to cause me massive discomfort during labour, but it also means that baby and I will have to stay in hospital for observation, doesn't it? On one of those horrible wards with other people!

I know the most important thing is a healthy baby but honestly, I'm so upset about already knowing I'll have to stay in hospital with stupid visiting hours when I should be at home with DH and DD, bonding with the new baby.

And yes, I'm having a rather ranty day today. I'm in a mood.

Does anyone have experience with this? How long did you have to stay in hospital? And how much did a canula in labour limit you?

I tested positive for Strep B during my last pregnancy. I too was upset when I found out that it would limit my labour choices but to be honest, when the time came I didn't care anymore, I just wanted the baby out!

I ended up being 7 days overdue and my waters broke. They recommended I be induced immediately to prevent the infection risk so I had the antibiotics and induction drip started at the same time. It was easy enough to walk around with the drip, although I didn't leave the room. The room was quite big so I just walked around in there, bounced on the birthing ball, etc.

Labour wasn't quick, it took 22 hours for DD to be born. I got an epidural about 8 hours into the induction so that stopped me moving from the bed. DD was born at 10am the following morning and we were allowed to stay in the room until about 9pm that night when I was then moved to the post-natal ward. Doctors gave us both the all-clear at 9am the next morning to go home, although it then took till 6pm to get all the paperwork, etc done as the midwives were so busy.

So all in all I think I had quite a good experience despite being induced and having the IV AB. Even if I hadn't been Step B + or been induced, I think I probably would have spent that night after the birth in the hospital anyway as it was my hospital's policy to encourage you to stay while you establish breastfeeding, etc. Any delay in me going home was because of midwife shortages and it just being a busy day, rather than the Strep B.

I know its upsetting at the time to be told that your labour choices are limited but I promise you by the time you are full term (or even overdue!) you'll just be so keen to hold your baby in your arms you'll do whatever they recommend to get there!

My DS got GBS, I didn't know I had it beforehand and we had to stay in hospital for a week while he was pumped with strong antibiotics after having 2 lumbar punctures, chest x-rays and blood tests.

So if you have to stay in overnight for monitoring, just remember the alternative is possibly not being at home with your DD and DH bonding, but far worse.

Thanks for the replies.

I'm frantically doing my research and it seems like as long as I can avoid induction, hassle should be minimal.

I went into labour with DD at 38+6 and all the females in my family tend to give birth at around 39 weeks, so I'm hopeful. DD as a 18 hour labour so also hoping for this to be shorter with a second birth.

If I'm not induced, a water birth should still be possible and I'm considering having the cannula removed after every round of ABs. Apparently some women ask for this.

And guidelines seem to suggest that you can be home within 24 hours if baby doesn't show sings of infection.

Am a little re-assured now.

I tested + for GBS in both my previous pregnancies. I ended up being induced with my first, as the waters went then no contractions, and they used the same cannula for the antibiotics and syntocinon, so that wasn't a problem. I was completely mobile throughout and gave birth kneeling up, despite being hooked up to a drip the whole way through, and was passed DS straight away. It was a really positive experience. DS2 was not induced, though I had to go to hospital as soon as my waters went for the IV antibiotics. This was better as they only hook you up to the drip for a short time every couple of hours for the antibiotics, though the cannula stays in. I had most of my labour in the pool and just got out to push him out (my choice). Again all very positive. I had also told the MW I didn't like the cannula & could it be taken out ASAP after the birth, which she did, whereas first time round I didn't know this and it stayed in overnight. They like to monitor the baby for 48 hours after the birth, but with DS2 I discharged myself after 12, all was fine, but not everyone would want to take the risk.

Another thing to watch that the antibiotics can affect the baby's gut flora, so check their bottom at nappy changes, and if its red or sore, ask MW to check for thrush, DS1 had this but it cleared up quickly with cream.

Good luck, it will be fine, you can still have a really mobile & positive birth.

comfy Did the cannula bother you during labour? And were you allowed to get it wet in the pool? I imagine it to be quite awkward having to stick your hand out of the pool the whole time.

From what I've read, waters breaking before labour isn't a problem as long as you go in and get the ABs but my hopital's guidelines say they will induce you if that happens.

How quickly I wonder? With DD regular strong contractions started at 3am and my waters broke about 6am. I assume that would be fine?

My gut feeling is that if my waters were to break before labour starts, I'd go into hospital, have the ABs but refuse induction for a few hours.

I will make notes and discuss it all with the midwife in a few weeks. See what compromises can be made.

I just want to avoid the bloody ward afterwards. And induction of course.

Would second the poster above - DS caught an infection from me (probably GBS, tests inconclusive) and we spent a hellish week in hospital - dusky episodes (basically stopped breathing several times) NICU, 2 lumbar punctures, 12 hourly IV antibiotics, regular blood tests. That first night was the worst period in my entire life.

I guess my point is to do your research and take expert advice. Hope it all goes well for you both.

Worst bit about the cannula is going in, then tbh it didn't bother me as labour got going. You do have to hang your hand out of the pool, but it's not that bad. I'd rather not have had a cannula in, but it wasn't a big deal, especially if you warn MW you want it out quickly! If you've already had a baby then you are ahead of the game....with DS1 I was induced because I just clammed up as soon as I got to the hospital as I was scared. With DS2 I knew what was what & that I was having mild contractions so went out for a walk for an hour to really get things moving! By the time my waters went & I had to go in I was confident things were progressing already! I'm pregnant with DC3 now, and I would do the same as you this time - if waters go, get to hospital for antibiotics but refuse induction & keep mobile. You get them every few hours until you deliver, so once you've started on them I think the risk is very small. You'll be fine, it's just a bit when you find out! Do your research so you know the risks, but it's your baby and your labour. They wanted to put a fetal scalp monitor on DS1 but I refused, so clearly I knew more about the risks that them! Any other questions, feel free to ask.

Being a GBS carrier isn't the problem, it's not knowing about it that can be. My heart goes out to the posters above who's babies were affected, must be a very upsetting & worrying experience & I'm glad it turned out ok for you both. I kept this in mind & it helped me keep it all in perspective.

Comfy how do you find out though? I didn't miss any MW appointments and urine was tested the day I went into labour.

Will I always be a carrier?

Sorry to hijack OP!

Bill yes, once you had a baby with GBS, you always, always need the IV abs in labour. The infection comes and goes but once you're a carrier, you're a carrier.

It's also not routinely checked for in the UK and doesn't always show up in urine, so there is no way you could have known, Bill.

It was only found in my urine because I have HG and my pee sample was super concentrated and had a trace of protein. And because I only have 1 kidney, the MW decided to send the sample off for a culture. I would have never known otherwise either.

If you are pregnant again, you need to make sure you're previous history is highlighted so you get the ABs.

Here is some great information.

www.gbss.org.uk/content.php?sub_id=15&section_id=3

My first DC spent the first three weeks of his life in the SCBU due to a group B strep infection.

The second time around, I wasn't upset about not being able to have a water birth or going into hospital as soon as my waters broke for monitoring or having IV anti-biotics etc.

Staying in hospital for observation was a doddle compared to the joys of intensive care.

I tested positive with DS2, had to have the ABs in labour (didn't bother me), but didn't with DS3 and didn't have to have them (and believe me, I checked, double checked and then checked again). I haven't heard anything this time, so assume I'm fine. Apparently it comes and goes. Had them both at Kings in London, so pretty confident with the care I was - and am being - given.

Thanks, really useful

If you have had a previous baby infected with GBS you are considered high risk at subsequent births and have to have antibiotics. As soon as I told the midwife DS had had it, she got massive stickers saying 'give IV antibiotics' and plastered my notes with them to make sure it wasn't missed.

As it was, I had an ELCS (first was an EMCS, how DS got GBS is a bit of a mystery as my waters broke early, but not early enough to be considered a risk factor and usually babies get it while going through the birth canal!), in order to avoid the worry of getting it again.

Well, it's up to each hospital how strictly they stick to the recommendations.

But at my hospital, once you've had a baby with BGS, you always get the IV abs.

That's why I'm keen to still achieve a good birth for myself without compromising on the safety of my child. Because what happens is different in different hospitals and also countries.

Some hospitals will let you have a water birth, others won't. Some will induce once waters go, some won't.

www.nhsforthvalley.com/__documents/qi/CE_Guideline_WCDLabourWard/PreventionofEarlyOnsetGBS.pdf

Giving away my location, this is what happens at my hospital.

It actually looks like I can be out within 24 hours if baby is symptom free.

At my hospital I had a load of red stickers over my notes as well. To be honest, after the experience of one infection, there was no chance in hell I would have let them forget .

I was tested positive about a week before I gave birth so had just finished my ABs when I was induced (due to prolonged rupture of membranes - I thought it was just my slack bladder!). Ab drip, plus a load of other stuff, throughout labour.

We were in for 5 days post birth but that was because DD was on ABs because she swallowed meconium on the way out. Otherwise, I think we would have left as usual.

Yes It's not routinely tested for, God knows why. Mine was picked up as I thought I had a weird discharge and insisted the MW do a swab. You are always a carrier once you've tested positive but it does come and go and new guidelines say if you don't test positive in subsequent pregnancies you don't get the antibiotics. IMO they should test routinely throughout all pregnancies, as babies can and do die from GBS related infections, and even if the outcome is ok, the stress while you wait to see if the baby is alright must be terrible. I feel a Mumsnet campaign coming on....