If you have tested positive for GBS, how did it affect your labour?

[Jooni]

I'm 36 weeks and have ordered a home test for Group B Strep after reading about it online and freaking myself out slightly. The NHS doesn't routinely screen for it and I realise I'm being a bit neurotic (was never this bad with DC1) but I've decided for the sake of £35 I'd rather be safe than sorry.

Anyway, obviously if it comes back negative that's all great. However, I'm a bit concerned about the impact a positive result would have on my labour. I have no idea if I was GBS+ or - when I had my first but I had a fairly straightforward natural labour with minimal intervention required during or after. I know if you're GBS+ it means you have to have IV antibiotics during labour, but I'm not really sure what that means in terms of labour options/positions etc? For example, would I still be able to get up and walk around during labour, maybe even use the pool if I wanted to? Anyone have any experience of this?

Hi Jooni,

You only have to lie down whilst the IV is in so you can request that it's out in between with just the cannula in so you can walk about. Think it's every few hours you have to have it for about 20 mins (all a bit fuzzy I'm afraid)

It is a very grey area and my positive result has caused me a lot of phone calls!

However consultant midwife at hospital said I can still have a water birth which is what I want. I typed a letter with our verbal convo up and put with my birth plan. Community midwife was happy with this too.

It will depend on your hospital.

I'm also a bit neurotic and would rather know! Hope u get a negative

Sorry should add I will have an IV with antibiotics in labour, but can still use a pool.

Baby will be observed for 12 hours after birth too just to check

Thank you so much both for your replies! Salted I'm sorry to hear you got a positive result, but it sounds like you and your midwives are on it. Good luck with the impending arrival!

Hello Jooni, I was GBS positive in my last pregnancy. Also tested privately and was a bit shocked to get a positive result, which opened a whole can of worms!
The only difference for me was that I had IV antibiotics during labour. At my hospital all other options were open to me. My baby is now 5 weeks old and is healthy, he didn't need any antibiotics but we were admitted for observation 24 hours post delivery so they could monitor his temperature, which is standard practice.
Good luck with your impending arrival, the GBS shouldn't cause you any problems.

I had my first and had never heard of it and my second I got a positive result. My labours were very similar other than the IV every few hours. Fingers crossed for you!

It depends on your hospital. I had a long conversation with the consultant midwife about options either for being on hospital, or having the home birth I wanted.

My hospital I would have been given IV antibiotics and allowed on the midwife led unit. They then want to keep you in for observations for the baby for 24 hours after birth (temp, heart rate, oxygen saturation from memory), but they only did them every 6 hours so actually mainly relied on you spotting concerning behaviour changes.

On the home birth forums I was on policy seemed to really vary by trust - it's quite common for them to insist you are on the consultant led bit which means no water birth.

The IV itself takes about 30 min to run through and unless you are penicillin allergic you need it every 4 hours. While you are on the drip you can move around but my hospital wouldn't let you in the water. I hate cannulas so insisted they took it out after the first dose but then they'd obviously need to put one in again if you didn't deliver within 3.5 hours (DD was my 2nd and apparently 2nd time mums rarely need a 2nd dose).

Thank you for the other replies!

I am allergic to penicillin and reading up on this more it seems that's quite problematic, as the GBS bacteria is quite likely to be resistant to non-penicillin antibiotics so the alternatives which would be offered to me may not even be effective. I really don't know whether I'm better off not taking the test when it arrives! Like you Cric I'd never heard of GBS when I had DC1 and maybe ignorance was bliss

I've actually got my antenatal HV appointment tomorrow so will discuss with her and maybe also contact my midwife to see what her recommendation would be. I just need to have this baby now - I'm finding more things to worry about by the day!

They didn't tell me I had tested positive for GBS in late pregnancy until after DS was born I was told I could still walk around, no sign of IV antibiotics in labour or anything. I was induced and allowed to go out and walk around the park next door.

I went from 2cm-delivery in 40 mins, so maybe they would have mentioned it and given me antibiotics at some point later if it had been slower. Once DS was born and all was calm they mentioned he'd have to stay in for 24 hours for observations. He never had any antibiotics or anything. He's a strapping boy, rarely ill, 2 on Thursday

I found out I was GBS positive when I went into hospital after my waters broke. I dont even know when they tested me for it. I am also allergic to penicillin, I had to be hooked up to the IV the whole time before I eventually had a c section.

My hospital wouldn't allow me to have a water birth and DD had to have a Canula fitted so she could be given antibiotics for 48 hours while they waited for her results to come back, just in case, even though I had a section.

It was a massive faff and horrible to see my tiny baby with a canula in, but I really think you should test now you have ordered it. Ignorance isn't bliss if something goes wrong. It can be so dangerous, I had literally never heard of it til I found out I had it! Since I had DD my friend has had a baby, it was her third and all had been finewith her other 2 but baby no 3 had to be hospitalised for 5 weeks with sepsis as a result of undiagnosed GBS. It does happen.

Lots of luck with your delivery, a healthy happy baby is the priority, even if us mums have to have a bit of a rough time!

Thank you both. Bendy I'm glad you didn't have any problems and Build I'm glad your DD was fine and I hope your friend's DC3 is doing well now?

Out of interest Build, do you know if you had to be hooked up to the IV the whole time due to the type of antibiotics they were using instead of penicillin, or was that just your hospital's policy on all IV antibiotics during labour?

To be honest, I'm not sure. It's all a bit of a blur, after the first 27 hours I was on the IV because I was being induced too. Sorry. I remember wanting to move more and not being able too because of the drip but I do t remember much more.

Ok, thanks anyway. Sorry you had such a rough time of it

I had the penicillin alternative, which in my hospital was clindamycin. You only need it every 8 hours, so it actually gives you more time off the IV than benzylpenicillin does. To answer your resistence point, I remember it's something like 10% resistence against clindamycin.

(I had it rather than benzyl penicillin because I then went home again for a planned homebirth and it gave more time).

In case it is helpful, this is the section on benefits and risks of IV antibiotics in labour from the hospital's strep b policy. I had DD 6.5 months ago so it's recent.

'BENEFITS AND RISKS OF INTRAPARTUM ANTIBIOTIC PROPHYLAXIS
3.1 IAP for colonised mothers has been shown to significantly reduce the risk of culture- positive early onset GBS but not late-onset disease (occurring 7 or more days after birth).
However, a Cochrane review concluded that, it has not been shown to reduce all causes of mortality or GBS-related mortality.9

3.2 IAP has potential risks which include severe anaphylaxis (estimated at 1/10,000
women treated) and the development of resistant organisms.
The ORACLE trial showed antibiotic prophylaxis (albeit different antibiotics) was associated with a higher risk of Cerebral Palsy.

Exposure to antibiotics in utero may also affect neonatal faecal flora with a subsequent impact on immune development and later allergy.'

I found out I was strep b positive from a UTI, and decided in the end I couldn't live with the risk of not having the antibiotics. However, my daughter now has food allergies, and there is no way of knowing if it's linked....

I had strep B but they didn't get the ABs in me in time (as they didn't believe I was in labour).

DS had to have ABs himself and we stayed in for days so he could have them.

Thank you both, especially MrsPanda for the detailed info.

I have read a bit about the gut flora/allergies/risk of other infections arguments in relation to early antibiotic treatment and they are definitely concerning even though there doesn't seem to be total certainty around any of it yet. More studies needed etc. I think I'm leaning towards not testing at the moment to be quite honest. I wish I'd never heard of it tbh!