Group B Strep

austenreader85

I've had UTIs caused by this and am interested in doing a med free VBAC with a birth center. I am meeting with the midwife on Tuesday and will talk to her of course. But I was wondering if anyone else delivered at a birth center while colonized with GBS and what options you had. Most things I've read say you need IV antibiotics during labor, I'm not sure my CNM could even get that since she's not an RN.

edit: she's a CPM, not a CNM sorry for the confusion.

Mrs.AmyDylan

Wow, great scoop from PP!

I was GBS+ and successfully delivered at a birthing center, in water, with a MW.  I was treated for a UTI at 35w with macrobid and tested for GBS at 36w. When I got the results at 37w, my MW and I created a strategy to retest in a week. I took grapefruit extract, a raw prenatal vitamin, tons of vitamin c, and a probiotic with acidophilus. I also inserted garlic wrapped in gauze vaginally each night. 

My water broke and I went into labor at 38w, on the day I was supposed to retest. I have no idea if it worked. I did get antibiotics every 8 hrs (different stuff than the hospital). They did the IV with a butterfly needle and didn't leave it in between doses. My MWs partner is an OB, so there is a chance that the OB is the one who acquires the meds. Either the MW or OB could have delivered me, the MW was just the one oncall.

Good luck! At the time it seemed like the end of the world. However, my daughter is perfect and I had no trouble from the GBS.  

austenreader85

secondaryPULSE:

austenreader85:

Most things I've read say you need IV antibiotics during labor, I'm not sure my CNM could even get that since she's not an RN.

I'm confused by this statement. CNM means Certified Nurse Midwife. You're required to be an RN before becoming a CNM. If she's a CPM, that's different, and it really depends on the state you live in regarding her scope of practice.

 

Anyways, to answer your question,  you'll hear different responses to the best course of action in regards to treating GBS. The research shows that IV ABX vs. Hibiclens (evidence somewhat inconclusive) vs. not treating the GBS does not change the incidence of neonatal sepsis r/t GBS disease. There have been correlations, however, with antibiotic-resistant e. Coli in babies whose mothers were treated with IV ABX along with maternal yeast/thrush infections. 

references:

https://summaries.cochrane.org/CD007467/intrapartum-antibiotics-for-known-maternal-group-b-streptococcal-colonization 

https://summaries.cochrane.org/CD003520/vaginal-chlorhexidine-during-labour-to-prevent-early-onset-neonatal-group-b-streptococcal-infection 

There is, however, promising research regarding waterbirth and the reduced transmission of GBS:

 https://www.ncbi.nlm.nih.gov/pubmed/21322437

 If you're colonized with GBS, I would do everything in your power to restore the correct pH/flora of the vagina. A great place to start would be consuming as whole a diet as possible (reduce white flour/sugar, HFCS, sodas) and include lots of fermented and live-culture foods (kimchi, kefir, yogurt/probiotics) and dark leafy greens (kale, collards, romaine, spinach, etc).

Good luck! GBS is a particularly interesting topic to me, and I hope that you're able to test negative! 

Yes, sorry, she's a CPM. My midwives in my former state were CNM. And thanks for the info!

austenreader85

And

secondaryPULSE:

austenreader85:

Most things I've read say you need IV antibiotics during labor, I'm not sure my CNM could even get that since she's not an RN.

I'm confused by this statement. CNM means Certified Nurse Midwife. You're required to be an RN before becoming a CNM. If she's a CPM, that's different, and it really depends on the state you live in regarding her scope of practice.

 

Anyways, to answer your question,  you'll hear different responses to the best course of action in regards to treating GBS. The research shows that IV ABX vs. Hibiclens (evidence somewhat inconclusive) vs. not treating the GBS does not change the incidence of neonatal sepsis r/t GBS disease. There have been correlations, however, with antibiotic-resistant e. Coli in babies whose mothers were treated with IV ABX along with maternal yeast/thrush infections. 

references:

https://summaries.cochrane.org/CD007467/intrapartum-antibiotics-for-known-maternal-group-b-streptococcal-colonization 

https://summaries.cochrane.org/CD003520/vaginal-chlorhexidine-during-labour-to-prevent-early-onset-neonatal-group-b-streptococcal-infection 

There is, however, promising research regarding waterbirth and the reduced transmission of GBS:

 https://www.ncbi.nlm.nih.gov/pubmed/21322437

 If you're colonized with GBS, I would do everything in your power to restore the correct pH/flora of the vagina. A great place to start would be consuming as whole a diet as possible (reduce white flour/sugar, HFCS, sodas) and include lots of fermented and live-culture foods (kimchi, kefir, yogurt/probiotics) and dark leafy greens (kale, collards, romaine, spinach, etc).

Good luck! GBS is a particularly interesting topic to me, and I hope that you're able to test negative! 

Duplicate post.

MangomamaFL

I am currently planning on birthing at a birthing center. I tested positive for GBS.

The midwives are fine with me not having antibiotics while in labor, as long as my membranes haven't broken for hours. I am also refusing all internal checks. 

 

Mumma Meg

A baby who catches gbs can die, it's a massive infection. Rare for this to occur yes, but simple preventative antibiotics can prevent this from occurring, they won't cause you any problems or your baby. So my question is if you were gbs pos why wouldn't you have the antibiotics

wifeofadam

I haven't even had the GBS test for my last two pregnancies, so I'm another one that is in the no antibiotics camp.  My CPMs are actually very anti-testing and routine use of antibiotics for treatment.  I'm planning a waterbirth and feel confident that it will decrease the chances of passing anything to my baby.

austenreader85

Mumma Meg:

A baby who catches gbs can die, it's a massive infection. Rare for this to occur yes, but simple preventative antibiotics can prevent this from occurring, they won't cause you any problems or your baby. So my question is if you were gbs pos why wouldn't you have the antibiotics

If she can offer them to me, then yes I will take them.  But I'm not sure the slim chance of early onset GBS (every thing I've read says nothing can prevent late onset)  is worth not having a med-free birth with a midwife and instead having to stay with my OB group that I am not a fan of and is forcing me to have a RCS, when my research is showing that it's safer for both of us to have a vaginal delivery.  It is something I'm doing research on and will discuss with my MW and what she thinks.  I don't think she even tests for it actually, so I would be surprised if she will be convinced it's even necessary.