Natural Birth
Group B strep +
I was + for group B strep with my last pregnancy and delivered before I got the full dose of abx so my son had to have blood cultures drawn-it left a nasty bruise on his little hand. Of course the hospital thought the cultures were necessary, but really, were they? I'm pregnant again and I'm wondering if you are + once, will you always be, and if so, can't you get oral abx (or some natural herbal preparation or something) to take at home for a week or two before your due date? Just wondering what midwives do for home births/birthcenter births for group B strep + moms-not blood cultures and IV abx I bet! Is group B strep that much of a danger, anyway? I've never heard of anyone having a problem. My insurance doesn't cover midwives or birth centers, so I'm stuck with an OB in the hospital and 'conventional' treatment.
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Re: Group B strep +
Your status can change at any time so it may be a non-issue for you this time. I'm delivering at a birth center and they still do the test and antibiotics if you test positive. It can have serious consequences for baby - although the chances are slim even if you are +.
There are alternative treatments - I never looked into them last time but will this time if I'm positive again. Hopefully, someone will chime in with those!
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From what I've researched, Group B strep can be a very serious problem (as in death of infant), but even normal births where nothing is done where the mom is GBS positive don't always pass along group B strep to the baby. There were deaths at some point and around that time the regulations were changed to giving any GBS+ woman the antibiotics. Many NB books say it's overkill, but at the same time, I guess for me it is worth it, personally.
You won't necessarily have Group B strep again this pg - it is something that kind of comes and goes. The current ACG guidelines say that if you are diagnosed w/ Group B Strep at anytime in your current pg, you should get the antibiotics. The problem with doing oral a few weeks before (if you do have it) is that it is something that can come back in between then and the birth. I don't know what all Midwives do, but there are home remedies, and a doula suggested Hybiclens (sp?) before to get rid of the infection. I didn't research it much, and I guess I'm ok with the antibiotics, as I will be able to get a hepblock. Some people have opted to do some of the natural remedies before getting tested. Personally my issue with that for my pg is what if it did come back, etc.
Good luck!
The 'heel prick' is the standard PKU & genetic disorder testing.
https://www.justmommies.com/articles/heel-stick-screening.shtmlMy midwives were planning to give me IV antibiotics, but DS was born too fast. They didn't do any additional blood testing for him that I know about -- just the heel prick a few days later at home.
Personally, I wouldn't skip the antibiotics on purpose though. I'm not a fan of antibiotics, but I trusted my midwives to not put me and the baby through anything they felt was unnecessary.
1) My midwives don't do a hep lock, but they do push antibiotics with a butterfly needle. I think it's one time, unless labor is very long. I believe they are ok with oral antibiotics, but recommend the first option.
2) I was GBS+ last time, but they will swab again this time because the status can change. I may opt for the antibiotics anyway if there is sufficient time.
Stupid side note: Last time I didn't get the antibiotics because I went straight to the hospital after the midwife exam determined DS was breech. The OB and nurses gave me grief about it even though he was born by c-section. Really, what are the odds that a few hours of broken water are going to give DS a massive GBS infection when he didn't even exit through the vagina?
As a pp mentioned, Hibiclens is an alternative treatment. It's used as a douche prior to and during labor. The study that I'd read (I'll do my best to find it and post when I get a second) decided that it was as effective as IV antibiotics during labor. This option was given to me, in addition to the option of antibiotics or also declining all treatment. I chose to do the Hibiclens.
It is a decision that only you can make, as the consequences (of all the treatments) are yours to deal with.