Experiences/advice please - GBS Group B Strep

[MandaHugNKiss]

So, following my stay in hospital last week I received a letter through the post today to tell me the swab they'd taken has shown positive for Group B Strep (GBS). I now have a fancy 'Alert!' sticker for my notes and the letter tells me they advise I receive IV antibiotics during labour (ideally 4 hours prior to birth but at least 2).

Am I being silly for being upset about this? I know from reading the literature that this isn't something I've 'caught' - we all have gbs in our intestines but for about 25% of women it migrates and colonises the vagina, so in that sense I'm not ashamed or anything... but my hopes for a midwife led birth in the 'home-like' atmosphere of the birthing centre are vanishing before my very eyes (as it is, the stay in hospital was for a bleed because of placenta previa - so was already having to 'hope' the placenta plays nice and moves up and away from my cervix).

I know the important thing is that forewarned is forearmed - the baby would be potentially at risk and now I KNOW I'm a carrier we can take steps to prevent that but... but...

In addition to this, I have very rapid labours (1st was 5hrs 15mins start to finish, 2nd 1 hr 40mins) which is making me think the whole labour will have to be even more managed - going to the hospital, starting the IV and then being induced in order to give the anti b's enough time to do their thing (and as it is, I'm allergic to the anti b of choice - d'oh!).

Eh. I dunno, kinda just ranting I think. But also asking any of you who have experience of GBS in pregnancy/labour to share your stories, please.

The first time i'd ever heard of GBS was 24 hours after DS1 was born with respiratory distress. He took 5 minutes to be rescusitated at birth, then was taken from me a few minutes later when he was grunting. He was taken away for a spinal tap and swabs and looked after in ITU.

I saw him the next day, he was breathing very fast and very hot, sweaty and swollen looking. When they'd identified GBS on his skin but not in his spinal fluid they diagnosed GBS pneumonia. They said he may need to be put onto a ventilator as he could become fatigued with the fast breathing. They then started him on meningitis doses of IV antibiotics. Statistically he had a high risk of death or lasting damage.

Every few hours they injected his hand through a venflon with painful anti-biotics which made him scream with pain.

Because of his respiratory distress i was told not to hold him as this made it worse.

It was days before i got to hold my baby and the IV antibiotics continued for a week i think.

He made a slow recovery. He had a feeding tube initially which i put expressed milk in to begin with. Because he wasn't allowed to latch on early he didn't know how to do it and also got very tired when we tried to breastfeed as he was still breathless.

I also developed an infection post c-section and had septicaemia with abdominal cellulitis. I also had IV antibiotics for 2 weeks until they finally couldn't find any more veins to put them in. They had to resort to continuing my antibiotics orally, so we then went home when he was 2 weeks old.

He finally latched on at 8 weeks old but had lost a lot of weight in that time and had to make it up over the next few months.

The dosage of anti-biotics they had to give him, we were told, could cause deafness but that was a side-effect we were willing to deal with, if it meant he would live.

For the first year, he had lots of chest infections, bronchiolitis and needed inhalers. His immune system was dreadful, he had lots of conjunctivitis too.

I inevitably developed PND as a result of guilt of it being 'my infection' to nearly kill him, the disappointment of the birth not being anything like i had hoped for, the feeding problems, the health problems, the exhaustion, the worry of whether he would continue to develop normally, whether he was deaf, whether his lungs would recover etc.

Every night until he was about 3, DH and I would check on him to see if he was still breathing.

I finally got closure when DS2 was born by elective c-section, healthy and feeding immediately.

So, there's my experience of GBS.

I hope it is helpful. I don't intend to terrify you honestly. You are lucky, you know what you can do to prevent the same happening to you.

Yes the statistics are in your favour and problems are rare, but as another mumsnetter who lost her child said to me recently, the statistics mean nothing to those who have been affected.

Yikes, my longest post ever.

the GBSS website is brilliant and worth a look for a more unbiased opinion.

I tested positive for Group B strep and had the medication during labour - sorry i can't remember how often, but though an IV, but I also had a natural labour (24 hr) until the very last minute when baby got stuck. I guess my point is it doesn't interfere with a natural birth apart from having to be at the hospital, i don't remember noticing it much and did pool, wandering around, ball, everything. I'd be glad that they had detected it, it doesn't cause much probs and poor ngdb seems to have had a nightmare>

good luck xx

THank you, both, for your responses.

NGDB, sorry to elicit your longest post by bringing up what must have been a very traumtic time for you... but thank you so much for taking the time to share. It's clear you're not intending to terrify me - merely giving your experience of what could happen. And, you're right, of course; I am lucky to know now rather than jollying along in an 'ignorance is bliss' fashion.

I guess I just need to adjust my thinking/come to terms with what this all 'means' (and I did only open the letter at midday so it's all kinda 'new' at the moment).

Thanks again.

londonlexi Thank you, also. I was under the impression that the antibiotics would be administered via a drip (and so I'd be reletively restricted movement wise) but perhaps they are just put into the cannula at intervals... you even still used a pool?! 'Good news' that cheers me up .

Hi I am the mumsnetter who nevergoogle referred to. My baby passes away 22 hours after her birth from pneumonia and septacaemia caused by infection.

I had no idea I had strep b as I had no symptoms, was not swabbed before induction. I was also very ignorant of GBS. Well, I learned about it in the most devasatating way. My daughter just stopped breathing when I held her. She was crying because she must have been in pain, calmed down in my arms, then her breathing went silent. I just received the report from the doctor who looked after her and it was the saddest thing I ever read as it gave very fine detail about how they revived her, what happened to her heart beat, how many times it stopped beating, her blood turning acid, etc, etc.

Please plan your birth so that you have time for the anti b's and have a paediatrician there after the nirth to check your baby.

You have read two cases which detail how bad it can be BUT with a well managed labour, the risks to your baby are low and so don't worry too much.

nevergoogle - my gosh I hadn't realised from your previous posts that things were so bad. I really am in tears reading your story and thinking about what your tiny little baby endured. I am so very very happy that he is ok despite the rough ride in his first year. Also, even galling is what you went through yourself at the same time.

You know, reading your story makes me believe even more that if my daughter was meant to live, then God, fate, whatever would have created the circusmtances whereby everything would have come together for her to live. Instaed, she had her last breath in her mother's arms and there was no better place for her. Right, I am going to stop because I am going to cry even more. Thanks you for sharing nevergoogle.xx

gbss.org.uk for organisation that nevergoogle referred to.

All the very best.

You'll be fine MandaHug, it needn't be a problem for you. You sound like a sensibly sort.

btw, he's 5 now and absolutely fine.

oh dear sh77, you're starting me off too.

did you lose your daughter recently?

April - so not long ago. I think that even after years have gone by, it will always seem very recent. I learned a lot through your post as I never read about anyone's experience in such detail.

me neither, i haven't met anybody in RL who has real experience of GBS. i'm not sure i've met anyone on here either until now.

april was not that long ago. i hope you are allowing yourself lots of time to deal with it all.

occasionally i post on GBS threads, but like i said before find the 'just put garlic up your fanny and you dont need to worry' sort of advice too upsetting. but after talking to you the other day, i've been thinking about it. i felt the need to get it all out when i saw this thread.

i think it's healthy to write it all out or talk about it once in a while.

Im sorry MandaHugNkiss but i need to hyjack your post! Computer playing up and wont let me start a new thread but of course, it is Group B related.
I had a thread recently where I too was upset at the prospect of IV antibiotics but people like ss77 >waves hello> put it in perspective for me and I was happy to take them.
Today (32 weeks) I had an appointment at the High Risk clinic and it went sooooo well.
Im treated as high risk because of the many complications of my last PG and birth. They also noted group B step in my waters days after DS was born but he luckily wasn't effected.
My midwife told me at booking in that they would just treat me as GBS infected and Id get IV Anti b's.
The consultant I had today is brilliant, really knows her stuff. She has said that after many scans and tests they are happy that this PG is very different, the growth is good, the placenta is behaving, not low and Im fit and healthy and no longer deemed High Risk - whoo hoooo!!
I then asked "so how soon should I arrive at hospital given the GBS status". She said, "no no, we would only be presumming you were a GBS carrier if your DS was infected, he wasn't so you wont be tested"????????
I pointed out that although my waters broke hours before, he was delivered by C section so maybe that stopped infection to him.
She just shook her head and dismissed it.
Said they would only look at IV if my waters broke 18 hours before, I had a temp, baby was early, otherwise, no need.
She is always very knowledgeble, always reads my notes and knows her stuff.
Should I trust her opinion or get a private test?
If so where do I get them?

Yes, I think so too. I don't ever talk about what happened that night with anyone apart from my hubby and so coming on here does help. I thought it would help me (and I hoped like I have never hoped) that getting pregnant again would help me to move on but I am in the midst of a missed MC so the shite continued to rain down on me (hence all my time on MN). It has destroyed any progress I made in feeling better. I am sure I will be ok but I am giving TTC at least a 4 month break.

I was going to try anything and everything this time, even the garlic and parsley stuffing. Next time maybe.

hiya whensmydayoff - yes, get a private test as the NHS ones are known to be unreliable. The private ones use a more accurate method.

Go to gbss.org.uk and they list private companies. The test costs about 35 quid and you get your result within 48 hours.

I have read that if you tested positive for GBS in previous preg, then they automatically give you anti bs in future pregnancies. Not so sure what to advise given your consultant doesn't think you need them. I would say deffo have a test very close to delivery day though.

Also, very happy that your pregnancy is progressing well. x

oh sh77, you are having a shitty time.

i suffered badly with ante-natal depression second time around. purely fear of what might go wrong this time that make me feel miserable and anxious.

you will get your 'closure' or feeling of coming to terms with it all. i would doubt very much it would be this year. really it is still so soon. i hope other mumsnetters who've lost their babies can offer you lots of support too. i wish i'd known about mumsnet back then when i wanted to speak to somebody who really knew about it.

whensmydayoff, see the gbss website for the latest advice. different hospitals will have their own policies. i had no temp and my prolonged rupture of membranes was undetected.

Manda, I tested positive with DS (again, had gone in for completely unrelated reason but just happened to find out) and had planned a homebirth - was told I could still have it but we'd have to transfer to hospital afterwards for the antibiotics so didn't seem any point and I decided to go to the hospital instead.

I too was told I needed to be there 4hrs before the birth so to go in straight away but as I was only in labour 2hrs it didn't happen. DS was given anti-biotics after the birth so it wasn't a problem. The only downside was that he was taken away shortly after the birth to have them and I felt very guilty about that. But they did allow some skin-to-skin contact first. And as I was having stiches for a 3rd degree tear, I wouldn't have been with him anyway!

Even if the antibiotics are given during labour, it's a single dose so you won't be immobile.

sh77 and dragon - so sorry for what you have both been through

I would second looking at the GBSS website.

Ds was born 7 weeks prem and with all the symptoms of early onset GBS infection - grunting, low blood sugar, high temperature, fast/slow heart beat and he frequently stopped breathing. When he was 7 days old I was told he was unlikely to survive the night. Fortunately he did and he is now a strapping 5 yr old. However he was very very poorly the first few months of his life and was on practically permanent antibiotics for the first 4 years of his life - repeated infections, we used to get a month off in the summer.

I'm pleased you are planning to do everything you need to to ensure the healthy delivery of your baby. I get very fed up with a number of posters on MN who write that they have tested positive for GBS but want a home birth etc. Like sh77 says all the statistics in the world won't change the reality if it happens to you.

sh77 I think you are incredibly brave for sharing what happened to you.

Thank you all very, very much for taking the time to answer and share some experiences that I suspect many, many of us are unaware of as outcomes for this condition. Certainly, before I opened my letter today I had no idea about GBS, and I suspect that's the case for most of us before it happens so firstly if threads like these raises awareness then I'm thankful. Secondly, that I can come here for straight-talking anecdotal evidence has proven invalable to how I'm beginning to feel now (as opposed to how I felt after opening my letter). You ladies are fantastic.

sh77 I can only begin to imagine your pain; I'm so sorry for your losses. Not that I imagine it's any consolation but your (and DGDB's) story has been fundemental in helping my feeling shift to a more positive place. It's a special person who will reach out to help others in a time of pain & grief; I hope one day you'll find the peace you truly deserve.

Dayoff no worries on the highjack! As you say, it's very much related I've been taking a look at the website suggested and , if I were in your position, I think I would invest in the test to, if nothing else, put my mind at rest. Apparently, colonisation can come and go... but, if it is there when your dc xomes along? Well, knowing what we know now, would you just blithely think 'Oh, well, it won't happen to me.'?

Thanks for sharing your experience Fleecy. Your story actually makes me feel more comfortable about suggesting I start the iv anti biotic followed by induction as I know I have very fast labours, plus it can take over an hour to get to the hospital in rush hour traffic. The way things stand, I feel I'd prefer to recieve the iv over my newborn having anti-biotics (although, of course, if that's the way it goes, that's the way it goes and I'll deal).Glad you had a good outcome and can I ask did you breast feed? I ebf both my previous two dc's and fully intend to do so again - not sure how the baby needing anti biotics might affect that.

MollieO as with the others, thanks so much for sharing. Again, another experience that is making it clear to me that whilst nobody would 'choose' iv anti biotics as part of their birthplan in an ideal world, the alternatives, in the face of a known risk that can be prevented, are far worse than a slightly different birth than we anticipated. So glad ds is fit and well now

Once again, ladies, I'm very grateful.

Thank you for this thread! I have been looking for one on GBS and was too shy to post about my experience.

I was tested positive for GBS while in the middle of labour. B/c they caught it right b/f I gave birth, after I had my daughter, they gave both of us antibiotics straight away. I didn't know much about it and they didn't really explain to me what it meant at the time so afterwards I forgot all about it. That was June 2008.

Now I'm pregnant with my DS2 ( due in Jan) and while I had my dating scan at the hospital, the midwife started sticking big red stickers that said GBS all over my folder. It made me feel like I had a deadly disease or something. So I started asking questions and all she told me was basically b/c they found it in my last pregnancy, when I feel like I'm going into labour with my pregnancy now, call the hospital straight away so they can have me come right in and be put on antibiotics. She left me with a pamphlet and told me all I needed to know was in there, then left.

Well that scared the crap out of me!! I had no idea what was going on or what it meant. I felt like I had a terrible disease that I would pass on to my child. I do remember slightly about them explaining GBS in my last pregnancy but it wasn't anything that stuck b/c I was so exhausted and out of it from having a rough pregnancy ( baby was back to back). So I waited to ask my midwife on my next appointment. She was so good and explained to me everything about it. She said not to worry b/c its very common and just think of it as being lucky that the doctors had found it so that we can prevent the baby from any complications. So I left the midwife feeling a lot better about the whole thing even though it still scares me that I've got something that could harm my baby lurking in my body.

I just wanted to say to NGDB and sh77, I am so sorry to hear your stories. I can't imagine what you both have been through. Thank you for sharing on this thread!! I'm sure your stories will help others out there be aware of this and want to get informed. I only wish that the NHS would start testing all women for GBS. I think they should at least give us pamphlets when we start out pregnant so that we can all be informed of what it is and have the choice to get tested.

you or the baby needing antibiotics shouldn't affect breastfeeding at all.

although we had lots of feeding problems initially i went on to feed DS1 until he self weaned at around 1 year.

Mandahug- you said in your opening post that you are allergic to the antibiotics of choice (penicillin), just want to state the obvious and hope you don't mind, but it is important if you are allergic to penicillin, to make sure that the people looking after the baby once he/she is born know about this. Especially if there is a chance that he/she might need antibiotics after birth. Penicillin would be the first drug choosen for the baby, and you would not know at that early stage if the baby is allergic as you are, so ensure the paediatricians know of your allergy.

The other thing to remember is that as it says on the GBSS website "Implementing these recommendations could reduce GBS infection in newborn babies by 60% and deaths from GBS in babies by 70%." Having antibiotics in labour does not eliminate the risk of GBS infection, it just reduces the risk. If you have had a positive GBS test during pregnancy then it is important to watch out for any potential GBS symptoms in the baby after birth, regardless of the antibiotics taken during labour.

As an alternative story, I had a positive GBS test during my 3rd pregnancy, and was told that homebirth was out of the question. But my 2nd birth was only 2.5 hours and I was anxious about how I was going to get even 2 hours of antibiotics during labour. My 3rd baby had other ideas and came so quickly I had no chance to even transfer to hospital, and ended up being born at home. But when the midwife rang to ask if the hospital wanted to administer antibiotics to the baby, they said that since the baby was born well, we were to stay at home unless the baby showed any signs of infection within 48 hours. It was an anxious 48 hours but we were one of the fortunate ones that had no transferrance of the strep b to the baby during birth. So without taking anything away from those who have suffered from the effects of GBS, I just wanted to put the other side of the many women like myself who are so much more fortunate.

Should add that I had oral antibiotics following PROM and iv antibiotics in labour and ds had antibiotics immediately following delivery. Didn't stop him being so ill but they might be the reason why he survived.

I tested positive for GBS at 20 weeks following a fall and admission to hospital.

I agree with willit - important to bear in mind that the majority of GBS+ women will not have an unfortunate outcome. I was unfortunate as I wasn't swabbed and my baby's deteriortaion was so rapid with no obvious symptoms apart from low tem and not feeding (we were told this was normal) - worst possible scenario. The NHS won't introduce mandatory testing as the economic cost outweighs the magnitude of the risk. This doesn't explain why many countries (Canada, US, Italy) do have mandatory testing.

Thank you all for such lovely comments. I have received much support on MN.

OH my goodness, im so glad i read this thread now. I was a carrier of GBS with DC1 but thankfully he was fine, and when the midwife told me id automatically be given IV abs 4 hourly when i go into labour with this DC, im ashamed now to say i was going to decline ab,s, after reading experiences on here ive changed my mind.

Thank you all for sharing your experiences on here.
sh77-i am so sorry to read about the loss of your DD, how devestating for you, and the loss of your most recent pregnancy. I hope you find the strength to carry on. Im sitting here with tears streaming down my face after reading your post.

NGDB-What a time you had, im so glad your DS made a full recovery but what an awful year or so you had.

My waters broke early with my first child from having Strep B. Both her and me stayed in hospital for a week and luckily after loads of tests etc, she was clear and healthy.

With my second pregnancy I use the 'garlic protocol' to clear myself of strep B and paid for a private test at 36 weeks pregnant to confirm that I was negative and therefore attempted to have a home birth. (which I failed at for other reasons non related to Strep B)

There are different strains of Strep B and not all can be treated by giving the mother antibiotics. Even if you get the antibiotics your baby could still develop Strep B, so as a PP said, we all need to watch our babies closely, just in case.

nevergoogledragonbutter, glad to hear your son overcame his Strep B infection.

sh77, I am so sorry for your loss

Should add my daughter was negative for Strep B.

My first baby was a planned HB but my waters broke before established labour and I still wasn't labouring about 50 hrs later so I went to hospital for monitoring/assessment.

I had a swab done, then I was due to be induced/augmented with synto but the babys heartrate plemmeted and I ended up with a crash CS under GA, the most horrific thing I have ever experienced. Turned out DD was brow presentation. We were both well and went home after a few days.

A year later I got my notes and saw there was a results slip stating Group B Strep positive, paeds review ASAP.

I had not been told.

Granted, the result had not been available until she was 12 days old but illness can arise in the neonatal period and not just immediately after the birth.

I still don't know who should have told me and why no one did.

For next pregnancy I knew that as DD wasn't affected, I wouldn't be treated as high risk unless other risk factors, eg temp, PROM again, etc. I chose not to test.

Had another EMCS for failure to progress but both well again and no routine antibiotics- having the knowledge of GBS status raises lots of questions doesn't it.

So no advice from me, but that was my experience.

sh77 so sorry to hear about your loss

I just wanted to say, I was tested positive for GBS, but was told this after DD was born. I had never heard of it all the while when I was pregnant, and the day my DD was born, my waters had broken but I hadn't realised (I was very tiny, you couldn't tell I was pregnant so there was very little water, and I was also 3.5 weeks from due date so in denial!) So when I realised something was not right, they asked me to go in, they checked, did a swab and sent me home saying they may see me later. 2 hours later I was back, and DD was born. She wasn't breathing when she was born, and it was the most terrifying few minutes of my life which seemed to last hours. It wasn't til the next morning they said "btw you are postive for GBS, here are a list of things you need to look out for on DD". I was so worried that DD was going to get ill, and so angry that noone had told me about it. So I always tell people I know to go get tested. Luckily DD had never caught anything, and I'm very thankful.