Group B strep: How did it affect your birth?

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I've just been told I've probably got group B strep - they need to do retests but I've heard a false positive test is very rare, so the likelihood is that I do.

So from what I understand, this means I will have to be on intravenous antibiotics throughout birth to avoid transmitting it to the baby.

Obviously if this is what needs to happen to keep the baby safe then so be it. But I'm really worried that it means I'll end up confined to a bed, unable to move around, use water, my ball or any of the things I know are likely to make a big difference to my physical and mental capacity to get through it.

If you have group B strep and have given birth before, can you tell me what that meant for what you could and couldn't do in labour?

I had antibiotics in labour as well as being on a drip to be induced. Unfortunately yes, I was unable to move much or use my birthing ball, yoga etc I'd been rehearsing! I don't know about a water birth, I was in a birthing room with no pool so it never came up. If you are attached to a heart beat monitor it seems unlikely however.

It is a shame when the birth is not what you planned. Group B strep is very serious though, it's great it had been picked up and you will have treatment, so try to focus on that during the labour. It's one day of your child's life, don't worry about it being perfect.

It didn't affect my labour at all - and it was so long that I think I had about 4 lots of the IV drip!

It's not like you're on the drip throughout (at least not in the MLU I was in),you just have to let it do its thing for 20 mins or so every four hours.

I used the water pool for about 8 hours (had to hop out for a bit for the drip), went on the birthing ball, was on all fours over the bed - wasn't on my back at all until much later on, when it all went wrong (but that was a different story and nothing to do with GBS).

Ask your midwife what the arrangements are where you are, but here GBS has very little impact on labour choices.

That sounds much more manageable, running. Hope your experience is more like that OP.

My results only came back after I'd given birth so didn't affect birth at all (although that was already difficult enough for other reasons so a drip would have made no difference), they monitored DD after birth before we were released from hospital so it was one of the reasons for us staying in hospital for longer than normal, but we were given a private room so I didn't mind that.

Thanks, both of you. Sorry, Owl, that you were so limited. My midwife is being quite blasé about the whole thing and just saying "Let's wait until we know for sure" - but I don't have all that long to go, and for the sake of my mental health I want to be as prepared as possible.

Running, that sounds much more manageable. I will advocate strongly for that kind of scenario.

Did either of your babies ever show signs of any ill-effects from the GBS?

Hi op. I didn't have group B strep in the end but there was a point during pregnancy when everyone thought I would. I got quite het up about it because I got so many different answers on what would happen, if I would be able to have a low risk birth etc.

Best thing I did was speak to a supervisory midwife at the hospital I was booked into. She pointed me in the direction of the publicly available group B strep guidelines on the hospital website. They clearly stated that particular hospital's procedure. I printed it out and highlighted the salient points and stapled it to the front of my notes to make sure I wasn't immediately rushed to labour ward!

Maybe try finding your hospital policy online? Will give you clarity on what they will do/recommend if you do come back positive.

I had it, had no effect on any of my labours at all. Never got antibiotics. Dc1 was jaundiced and we were kept in 5 days but can't remember any swabs. Dc2 was swabbed and we had to stay in two days for the cultures to come back. Dc3, no swabs and sent home after one night.

I don't recall that it had that much impact on my labour, but then I'm not a great believer in having everything planned out - my mindset was that I would do whatever I was told would be best for my babies (twins - so it was high risk anyway) and that the medical staff would know best. I didn't move an awful lot anyway so the IV drip didn't affect the labour.

2nd pregnancy - because I'd previously been Group B strep, they didn't even test me, just assumed I would need antibiotics. Labour was so quick they didn't have time to get the IV drip in though, we had to stay in for 24 hours to monitor baby, but everything was fine.

If you are able to prepare yourself mentally, then tell yourself that it is the right thing for you and your baby. That having the IV is the absolute best thing if you have it. My twins were in NICU as they were premature and there was a baby on the unit, born at term, who was quite poorly from having contracted GBS during labour (his mum wasn't aware she had it).

OP - no, my DS showed no signs of being affected by the GBS at all. He was, and is, fine.

In my second pregnancy they didn't test me for GBS. I did ask if they wanted to test me as I'd been positive last time round, but apparently they don't do that. So I didn't have any antibiotics (not that there would have been time anyway!) and DD was absolutely fine.

It didn't, they didn't tell me id tested positive for it at around 24 weeks pregnant until after I'd had DS! Had to stay in for 24 hr obs but that was ok, just wish I'd have known. Didn't have any antibiotics in labour, was induced and baby born in 40 mins so maybe they intended to but didn't get round to it.

I mean 34 weeks pg!

Slightly different perspective. Dsis's labour happened quickly when she got to hospital and so by mistake they didn't administer antibiotics to her. Both dsis and niece had to stay in hospital longer (2-3 days) to give niece IV antibiotics as a precaution. Obviously your movement will be restricted during labour but the alternative is your baby having to receive IV antibiotics and a longer stay in hospital.

Well...

I was a GBS carrier in my last pregnancy. At that time you had to have IV ABX on the delivery suite, not allowed in the MLU, so that was the plan,...

As it happens, i was the special extremely rare snowflake that went from being carrier to septic.. Which actually meant that i was very ill and attached to several drips, ABX, fluids, paracetamol etc followed by the hormone drip as things weren't processing and baby in distress...and therefore pretty much bed bound.

DS2 have IV ABX and monitoring in SCBU. I had to stay in hospital for 7 days on IV ABX until i was well enough to go home, with several weeks worth of oral ABX.

I am super unusual apparently.

This time, hospital policy has changed so, all being well, I can go to MLU and be given the IV ABX over the course of 20 min or so and then have it topped up every 4 hours as needed, and therefore still be mobile/able to use the pool in the meantime. If i don't get the full 4 hours+, then poor baby has to go to SCBU to have IV ABX for 24/48 hours (can't remember which). I will do my utmost to avoid that.

I was diagnosed with Strep B for my second pregnancy and was worried like you OP that I would have limited movement in labour because walking around was what got me through the first one. But actually I was more active the second time round and gave birth standing up where the first time I had to be on a bed in the end (after all the walking) because of complications.

So what happened was, I was told to get to hospital as soon as contractions started, which I actually liked as I didn't have to play the guessing game of "am I ready yet?". I was put on a drip but could still move about (pushing it!) and didn't have to stay on it the whole time, just while the antibiotics were being delivered. I wasn't attached to a drip when I delivered. I believe that I would have had to have another dose four hours later but DS2 came before that time.

We had to stay overnight to be monitored, but I had to stay two nights with DS1 for various reasons, so it seemed better!

Thank you, everyone, for sharing your experiences. I was stunned to learn how common GBS is given that neither I nor most of the mothers I've spoken to have ever heard of it.

It had a big impact on my labour.

If you have Strep B, you have to go in as soon as your waters break, it's unsafe for the baby not to.

My first symptom of labour was my waters going, so I was called in and they induced me on a syntocin drip. (Or I think it's called "augmented" if you've already started labour, but the same process).

I found labour tough. It was long, and the midwife made it much more difficult by wanting me to be on my back - she refused to engage with me if I was not on my back, which was against everything I'd learnt from ante-natal classes.

If I had to do to the same again, I would ask beforehand

• under what circumstances I would be induced / augmented?
• what method(s) of induction are they likely to use?
• what pain relief is available for induction (if you are on the syntocin drip, you will almost certainly want an epidural, no matter how against you may be now! I can't speak for any other induction methods, they may be less painful).

My labour could have been made much easier by having a cooperative, supportive midwife. You do have the right to ask for another midwife if you want to, and the single thing I'd do differently if I had that time again would be to insist on another midwife - or to get my partner to. I had a lovely midwife for an hour while the sullen one had a break, really nice and encouraging of me being not on my back. If my labour had been with her I'm sure it would have progressed quicker.

Your waters may not go early (with my second labour, my waters didn't go till I was on the ward, pushing, and I didn't have Strep anymore in any case), in which case you may not need to worry about induction.

But my advice to you is to learn about induction just in case, and - in the unlikely event you get a MW who is unsupportive of you being not on your back at all times, and assuming you do want an active labour - have a plan with your DP (assuming you will have a DP there) for how you will tackle that - would you ask for a new MW? Is this something you'd want your DP to do?

If you can afford it, maybe consider a doula.

Nice to hear the positive stories about birth here. I hope I haven't worried you, but I think I would have coped better if only I'd known more beforehand.

The "I didn't have antibiotics and my baby was fine" stories are not very useful though. The whole point of Strep B is that it's low-risk/high-impact. Or in other words, few babies will have poor outcomes if no treatment is given. But for those who are affected, it can be absolutely catastrophic. So if other people had no ill effects, that's great and to be expected for most people. Doesn't the risk of infection being something you really, really want to avoid.

The should say .... Doesn't change the risk of infection ...

Hi- can someone explain how this is first tested for? Do I need to ask for the test and are there any risk factors that indicate someone likely to have it?

That's the thing Jessie - testing isn't done routinely. I was only tested because I ended up in hospital with bleeding at 39 weeks.

The reason they don't test is because GBS is extremely common (around a quarter of women have it), and it comes and goes. For example, if they did the test at 37 weeks, lots of women who tested positive then would no longer be carrying GBS at 40 weeks. And vice versa. The NHS test is also reported to be quite inaccurate.

So millions of women who are carrying GBS don't know about it and will give birth without antibiotics - and some who have tested positive will give birth with the antibiotics, even though they're no longer carriers by the point they go into labour.

You could pay for a test privately, but that only provides a snapshot of whether you're positive for GBS at that given time,not whether you'll be positive in labour or not.
gbss.org.uk/who-we-are/about-gbs/what-is-gbs/for-pregnant-women/

I have it too, well I had it but like yourself I need a test closer to the time again because it can come and go. My last labour was really really fast so I am worried I won't have time for the antibiotics at all! The group b strep website are very helpful, there is loads of information there and they emailed me with advice last week. Have a look and arm yourself with as much info as possible, here is the website: gbss.org.uk/
Best of luck.

Thanks both, that's a helpful website. I may ask my consultant about it at next appointment. Sounds like maybe a private test at near full term is the best option.

I just want to add in my bit about Group B Strep. Dd is a teenager now, and since her birth I have moved to another country, so not quite sure of how things work now. I am very hopeful that there is now a standard test during pregnancy for it (and I am hopeful there is as this is how you know OP).

As dd was affected, when she was younger I was part of the group that put together a proposal to government for it to become standard testing during pregnancy. As I mentioned, its now some years later and I am no longer in the UK, I don't actually know what ever became of the proposal.

Had I known that I was GBS + whilst pregnant, I would, without a doubt have taken the antibiotics during labour. However, we didn't know and so didn't get them, and yes, it was passed on to dd.

Had an extremely quick labour, but once she was born, I just had an inkling that something wasn't quite right. My ds is older, so it wasn't my first birth, I know you cant compare really, but she wasn't alert etc. She couldn't feed, couldn't suck, eventually she was fed formula by midwife from a sippy cup. I am going to be completely honest and tell you that my experience of this, unfortunately put the NHS in a whole new light for me. They did some basic tests on her, sugar levels etc, of which was low... but not too low for major concern. She and I were discharged later that day and off we went home.

She wasn't well for the first few weeks, I battled to feed her, eventually we settled on a fast flow teat and I expressed, tried so hard to breast feed her, but although she latched, she could not master the sucking motion. Not one doctor or midwife thought this was of concern. I should add in here, that I was on a high dose of antibiotics myself, as I developed a serious womb infection after the birth.

When she was 5 weeks old, she really didn't seem well. I took her to see 4 different doctors during that week. Each one told me something different. She had a rash, I was told it was from the heat. Next one said a cold. Every doctor turned me away with something trivial. Not one dr took bloods or did anything other than give Calpol. On the day she turned 6 weeks old (it was a Thursday), she was floppy, had a rash and had a 42 degree temperature. Only a locum dr was available at the surgery for appointments. Dare I post here what he said to me. After checking her over, looking at notes from previous visits... he basically in a round about way, suggested that it was all of the things that I had been told it was in the past week, and I should go home and give her the calpol. He also added in that some new mothers do tend to think the worst some times, but it wasn't abnormal to see an anxious new mother!.

Fast forward a few hours, I had a lifeless baby. We rushed her into A&E, where they actually listened to me and took me seriously. They performed the LP right there in front of me, and without even getting the results, started her on high dose av antibiotics...for meningitis. Within a few hours, she had already started responding.

Although I am now cutting the story short, the diagnosis was partially treated, late onset meningitis from GBS. Partially treated, in that I was giving her breast milk and I was being treated for infection with ab's myself, which passed on to her. She was in hospital for 10 days. We were told to expect some side affects, some of which she has, but hardly compare to what could have been...basically if we got to the hospital an hour later, I would be telling you a very different story today.

So my very beautiful daughter is 13 years old now. She has had a difficult start to her life, as she did experience hearing loss on one side, she has difficulty in processing some things (background/foreground for eg), she had a tumour removed from behind her ear, plus surgery on her eyes.. all of which we think are linked. Strangely enough, just last year she was diagnosed with mild spina bifida (the opening of base of her spine is not completely closed) - imagine us only finding this out now after everything she has been though, which surely must be linked..... Although things have been difficult, you wouldn't know if you met her. She is so strong, rarely cries (even as a baby), and she is a top scholar, the most beautiful dancer and does so many sports I wont even begin to list them.

Sorry, I see this is very long, but this is a very emotive topic for me.

So, what I really wanted to say to you OP.... please have those antibiotics during labour. Even if its just suspected, please just do not take the chance. Yes, it may change your birth plan, as not sure if you did, but you wont be able to have water birth, home birth etc...

I am glad to read that others who were positive and have given birth fine with no complications. But with my experience now, I just wouldn't take the chance.

And I know I put it at the beginning of the thread (but then my heart just starting pouring out words) is this a standard test now in UK?

Murphys, I don't believe it is a standard test - I was diagnosed when I had a test for something else that I can't remember now. That was six years ago now but I don't think there is a standard test still from what others have said.

Cross posted, I see that its not standard testing....

It's not a standard test. They only found it because they were testing my urine for other things.

To all those who've been hinting I shouldn't put my baby at risk: I have never suggested I wouldn't take the antibiotics. I just wanted to know how this was likely to affect labour. It's good to hear that for at least some of you it didn't affect things too much.

I have also never suggested I had a super-fixed idea about how I wanted things to go, but I slightly resent the implication I think I see in some posts here that if I don't just want to roll over and be attached to a drip immobile the whole time then I'm somehow being selfish. My hopes about active labour are absolutely based on my conviction that this would be the best thing for the baby - leading to the least stressful labour all round - as well as for me.

I know this has slightly gone off the topic of GBS.