More questions about being GBS positive!
Annaeliz84
member
I know Racie just posted a bunch of questions the other day (and had a great birth experience despite GSB, yay!) but I have a few more additional questions after meeting with m OB today.
So first of all, my OB delivers the news that I am GBS positive like she is preparing for battle. Not exactly sure why, since she is only one of 6 OBs in the group practice and I've only seen her a few uneventful times. She was really vague answering my questions, so I am coming here to get more information from anyone else who has been in this position.
Her first comment was that if my water broke I would have to come to the hospital right away for antibiotics. Whatever, I'm fine with that. Give me the antibiotics and after 30 minutes dragging a poll around I can get a break until the next dose. But then she stressed that if my cervix is long and thick (like it is now, but I am 1cm dilated) that they will need to induce me. If they need to induce me I have to be continuously monitored. More on that later.
She said the GBS diagnosis wont change when I should come into the hospital if my water doesn't break (following the old 5-1-1 rule). Prior to this diagnosis I was planning on waiting longer than 5-1-1 but again I don't think this will be a big issue.
Then I asked her a bunch of questions that got confusing answers Her answers often annoyed me because they either weren't well explained or weren't backed up by facts. For example she implied that 50% or more of women's labors begin by the bag of waters breaking. Everything I've ever read has said 10% or less! But again, I digress. Here are my questions:
- Why do I have to be continuously monitored if they must induce me with Pitocin or Cervidil?
- Has anyone successfully had a natural birth despite being induced? If so, how did you avoid the monitors? I can't imagine trying to go natural and being strapped to a machine the whole time!
- Are there any additional precautions I should take now that I know I am GBS positive?
- I've heard that doctors often tell women who are GBS positive to come to the hospital early but my OB still wants me to follow the 5-1-1 rule (assuming my water doesn't break). Of course that still sounds pretty "early" to me but I'm wondering what other women's experiences have been.
- Is my water more likely to break b/c I am GBS positive?
- From what I've read it sounds like they need to do 3 courses of IV antibiotics to be considered effective. What if there isn't time to get all of them?
Thanks so much for helping me out with this! I know I will feel so much better when I hear a little more from other natural birth bumpies and know more about what to expect!
Edit/Update: I just realized the main reason I'm so nervous is that the OB I spoke with today seemed so evasive. Hopefully she was just having an off day...
Re: More questions about being GBS positive!
- Why do I have to be continuously monitored if they must induce me with Pitocin or Cervidil? They need to monitor you continuously because pitocin induced contractions are stronger/longer and often have adverse effects on the baby. They will adjust levels according to you contractions, progress, and how the baby is handling it.
- Has anyone successfully had a natural birth despite being induced? If so, how did you avoid the monitors? I can't imagine trying to go natural and being strapped to a machine the whole time! One of my good friends had an induction in a hospital with MW and OB supervision (her induction was at 36 weeks and medically necessary). She was continuously monitored and was still able to have a pain med free birth although it sounded way more intense that what I experienced.
- Are there any additional precautions I should take now that I know I am GBS positive? not that I know of?
- I've heard that doctors often tell women who are GBS positive to come to the hospital early but my OB still wants me to follow the 5-1-1 rule (assuming my water doesn't break). Of course that still sounds pretty "early" to me but I'm wondering what other women's experiences have been. My water broke and I had meconium the fluid as well. My MW had me come in within 2 hours of my water breaking. She basically said " don't rush. Finish dinner, pack you stuff and head on in, I'll meet you there in an hour or two"
- Is my water more likely to break b/c I am GBS positive? Again, not that I know of?
- From what I've read it sounds like they need to do 3 courses of IV antibiotics to be considered effective. What if there isn't time to get all of them? I was only in labor for 5.5 hours from first contraction to DS's birth. I had one round of anitbiotics that took an hour to administer (I was in the shower on a labor ball with the IV). Ben was born 3 hours and change after I finished the antibiotics. NICU was outside the door when he was born, but as far as I know that was becuase of the meconium, not the GBS/antibiotic time frame. The pedi at the hospital wanted to keep an close eye on him because it wasn't a full 4 hours after but that's the only precaution that was taken. DS still roomed in with us. We stayed one night longer than we probably would have otherwise, but we also didn't question that suggestion or ask why, etc.
That sounds like an odd Dr visit, especially the completely untrue statement that half of labors begin with water breaking. Are there other OBs in the practice you're in? Maybe you can see a different one for your next visit to get better information.
Other than that, I can share some of my experience being GBS+. It applies to your last two questions specifically. My water did not break naturally. My midwife performed AROM 20 minutes before DD was born because the intact bag was making pushing less effective for me.
And because my water never broke naturally I labored at home pretty much the whole time. I showed up to the hospital fully dilated and pushing. Since it was clear DD was arriving very soon administering antibiotics was pointless and I ended up not getting them at all. (Part of this was compounded because I am allergic to penicillin and the alternative drug requires 2 infusions 8 hours apart to be effective in preventing GBS infection during childbirth.)
Being GBS+ had pretty much no impact at all on my med-free birth. The pediatricians at the hospital knew I was GBS+ but also that DD was fully enclosed in the bag of waters until the very end. She was monitored for any signs of infection, but ended up being completely fine.
To address your last two questions:
No, I do not believe GBS has anything to do with when your water will break. My water broke as the first sign of labor with my first child and I was GBS Negative, but with my second when I was GBS positive, the midwife broke my water right before I started pushing to check for meconium. Speaking of which...
My second labor was fast. I showed up at the hospital ready to push, there was no time for antibiotics. But the fact that my water didn't break until right before I started pushing, and then the fact that I only pushed five or six times (thank you, baby jesus!) meant that my son's time of exposure was very brief. Still, because I was GBS positive they recommended a full 48 hour hospital stay to monitor my son and watch for any signs of infection. They also did a blood test. He was fine, no problems. So they will just keep you longer to monitor the baby.
Ok, about the monitoring, if you need to be induced they monitor you to measure your contractions. I don't know exactly why I was monitored (I think because of my GD, but I don't really know - the nurse wanted me on them, but my Midwives would remove them every time they came in) but it was my least favorite part of labor. Period. I hated them! BUT I was still able to move around and labor in whatever position I needed to. They weren't limiting, but they were uncomfortable. I think I hated them so much because they added more pressure onto my lower abdomen, which was already so full. Between having a full bladder, an unbroken bag of waters and a baby's head in my birth canal, I could hardly stand the pressure as it was and the tight monitors added insult to injury. That being said, they were the worst part of my labor and they weren't that bad.
I don't believe you are at a higher risk of having your water break because you are GBS +, and I think you should follow your doctor's advice and wait until you know you are in labor to come in. They recommend you getting two or three doses of Penicillin (I think?), but if your labor is faster than that, it's OK. I was only in the hospital for 4 hours before I delivered, thus giving me only one dose of antibiotics. They made me stay for a full 48 hours after delivery for monitoring, but other than that, no special precautions were made after I had my daughter.
I freaked when I found out I was positive, but in all reality, it was a non issue and not worth the stress. Try to relax as much as possible - you'll be ok!
My experience was that I only got one IV dose before delivery, due to a fast labor. My water did break very early (or so I thought) in my labor, so I went to the hospital earlier than we would have otherwise. The only "complication" we had was that the in-hospital pedi was concerned about LO only having gotten the one dose while I was in labor. We addressed that by agreeing to see our pedi one day earlier than we would have otherwise.
My providers (OBs and MWs) all seemed pretty vague to me when I asked questions like these after learning my GBS+ but before labor. In retrospect, I think it is because this is something they work with every day, it's just not a big deal to them.
I was induced and was GBS+.
- Why do I have to be continuously monitored if they must induce me with Pitocin or Cervidil? As others have said, to make sure you and the baby are tolerating labor. I second the suggestion to look into telemetry monitoring if it's available. I was able to use it when I got in the jacuzzi tub. The nurses were pretty accommodating in helping me try the birthing ball while still hooked up to the monitors and IV (and I hated it anyway, so whatever).
- Has anyone successfully had a natural birth despite being induced? If so, how did you avoid the monitors? I can't imagine trying to go natural and being strapped to a machine the whole time! I am sure a fair number of women do. I planned on an epidural and got one, though.
- Are there any additional precautions I should take now that I know I am GBS positive? Nope.
- I've heard that doctors often tell women who are GBS positive to come to the hospital early but my OB still wants me to follow the 5-1-1 rule (assuming my water doesn't break). Of course that still sounds pretty "early" to me but I'm wondering what other women's experiences have been. This was exactly what my OB recommended - go to hospital immediately if water breaks, otherwise, 5-1-1. Not that it mattered since I was induced.
- Is my water more likely to break b/c I am GBS positive? No.
- From what I've read it sounds like they need to do 3 courses of IV antibiotics to be considered effective. What if there isn't time to get all of them? My OB said the greatest risk is if there is a long period after rupture - more than few hours, as I recall. If you have a really fast labor - too fast to get all the doses, the risk is low because the baby hasn't had significant exposure. I never inquired further because I was induced and I got my first dose of antibiotics when they inserted the Cytotec the night before starting the pitocin.
Other thoughts: Neither baby nor I had any side effect from the antibiotics (like thrush). It was honestly kind of a non-issue. If I hadn't been getting pitocin, the administration of the antibiotics would have been 20 minutes every four hours or so, and so if I had been planning on a natural birth I would not have needed to spend the whole time lying in bed.
Married Bio * BFP Charts
I was GBS+ and my water did not break on it's own. I went to the hospital after 22 hours of labor when I thought things were getting serious and I was only at 4 cm (bummer!). I ended up getting 3 rounds of antibiotics before DS was born 14 hours later. I was told prior than 2 rounds were necessary to really be considered effective.
I went back and forth about whether to get antibiotics at all. I was told that there would have to be all extra monitoring on DS if I didn't get the antibiotics, like them keeping him 48 hours after birth, so I decided to get them. And guess what - they kept him that long just because I was GBS+ even though I'd had all of the antibiotics.
Honestly, I would just go to the hospital when you feel like it's time to go - be that at 5,1,1 or 3,1,1 or whenever else you think you're ready, regardless of GBS status. Water breaking would not change that for me, though if it was broken for many hours, I would go even if I wasn't having strong contractions.
Above all else, I would not let them scare you into an induction based only on GBS status. I would have accepted an induction if my water was broken for an extended period of time, but because of the risks associated with ruptured membranes not GBS. Since cervical checks can introduce bacteria, I would have really pushed those off as well if my water was broken.
DS, May 2011
- to monitor the baby. The meds used to induce may have an effect on the baby, they want to make sure the baby is okay.
- I had a natural birth after being induced (and was GBS pos) with my first. My water broke, but I wasn't dilating on my own. I was put on pitocin about 12 hrs after my water broke. You can walk around with the monitors (mine was just a belt). However, I don't believe you are allowed to go in the tub if you are on pitocin. I could have if I was just on the antibiotics for GBS.
- I wouldn't wait too long before going to the hospital. You need those antibiotics before the baby is born. You never know if your labor will be fast or slow.
I don't know the answers to your other questions. But a natural birth is still possible if you are GBS+ and have to be induced. I will not lie, pitocin is awful, but if this is your first you don't know any other way. I was lucky enough with my second that I didn't need pitocin (but still was GBS+).
You can do it!!