Group B Strep Info

Just trying to organize my own thoughts.

GBS is a bacterium that normally lives in the intestinal tracts of many healthy people. In truth, you should never be termed “GBS infected” but rather “GBS colonized”. Remember that the intestinal tract is composed of normal healthy bacteria, including GBS. It is usually a transient condition that will come and go through your pregnancy. You may swab positive at 36 weeks, only to be negative again at 38 weeks.

GBS can cause problems only when it is present in the genital area during birthing and delivery. When this happens, there is a very small risk that the bacteria will be passed on to the baby and become sick.

Two in 10,000 babies may be saved by antibiotics during birth, but this comes at the cost of giving 1/3 of all pregnant women antibiotics. The risks of developing a superbug are greater than the chances of saving your baby with antibiotics. This also doesn’t take into account how many other infections babies given antibiotics may develop other than Group B Streptococcus.

GBS Risks to Newborn
•sepsis
• fever
• respiratory distress
• pneumonia
• and/or meningitis

GBS Treatment Options
Antibiotics-
• Oral: 3 a day starting at week 37w and then one a day until birthing begins. When birthing begins, take one every 4-6 hours until the baby is born.
• Intramuscular: This method will cover you for 30 days after the injections (4 injections total to give the full dose).
• IV (hep-lock): CDC recommended treatment
Vaginal Flushing-
• Hibiclens (chlorhexidine): comparable to the efficacy of antibiotics
Natural-
• Goldenseal
• Garlic
• Probiotics
• Tea Tree Oil

Two in 10,000 babies may be saved by antibiotics during birth, but this comes at the cost of giving 1/3 of all pregnant women antibiotics.

Reasons Against Using Abx.
• Yeast infection and/or thrush: possible interference with breastfeeding.
• Increasing occurrence of antibiotic-resistant infections (“superbugs” - think MRSA)
• Use of antibiotics has increased risk of developing other infections (sepsis & E. Coli included)
• Colonization of GBS is a poor indicator of which babies will become ill
• Antibiotics fail to prevent infection in 30% of cases

Prevention
• Breastfeed immediately and frequently. Colostrum is full of antibodies that •strengthen the baby's immune system.
• Refuse vaginal exams
• Avoid internal fetal monitoring
• Refuse membrane stripping or sweepingAvoid induction of labor or application of cervical ripeners
• Do not permit artificial rupture of membranes.

GBS Symptoms in Baby
Early Onset (within 7 days of birth)-
• 6 percent of babies will die from complications of the infection
• Full-term babies are less likely to die
• 2-8% suffer fatal complications
• Premature babies have mortality rates of 25-30%

Symptoms:
• fever or abnormally low body temperature
• jaundice
• poor feeding
• vomiting
• seizures
• difficulty in breathing
• swelling of the abdomen
• bloody stools

Since these symptoms can occur in so many circumstances not related to GBS, a C-Reactive protein test can be given to a symptomatic baby to reveal the presence of an active infection.

Late Onset (7 days to 3 months)-
infection is more complicated and may not have anything to do with whether you had GBS during birthing.

I personally would do anything it took to reduce the risk.

And I personally want to choose the best for myself and baby.. hence the extensive research I've been doing.

I was GBS+ twice. First one I had one round of antibiotics, there wasn't time for the second round, I stayed at the hospital for 24 hours as recommended.

The second time, by the time I got to the hospital and my midwife was ready with the antibiotics, she didn't think there was time to get a single dose into me (they said that it has to be at least an hour before the birth, though I've read 2 hours as well). My son was born just over an hour after that, only because the pushing phase was around an hour or so. My water was broken for less then 30 minutes before he was born and I did not have a fever. We checked out of the hospital a couple hours later, against medical advice (had to sign a paper, but we could contact the midwives any time).

Quoting oh zombie baby *37*:" And I personally want to choose the best for myself and baby.. hence the extensive research I've been doing."

Understandable. I just don't understand why some people make such a huge deal about the antibiotics being given. None of the side effects are any different than those with the antibiotics regularly given for any infection.

Quoting Roe23:" I was GBS+ twice. First one I had one round of antibiotics, there wasn't time for the second round, I ... [snip!] ... of the hospital a couple hours later, against medical advice (had to sign a paper, but we could contact the midwives any time)."

Oops, I meant to say that there was no infection in either of them.

I really didn't like the antibiotics and wanted to avoid them. I did research too but when it came down to it, I couldn't bring myself to go against the recommendations  . It also affected my daughter (first born), her bowel movements smelled horrible, not like how they should have for a breastfed baby.

Quoting Queen leaky tits:" Understandable. I just don't understand why some people make such a huge deal about the antibiotics being ... [snip!] ... being given. None of the side effects are any different than those with the antibiotics regularly given for any infection."

They are very large doses of antibiotics and there are questions as to how much they help vs how much they hurt (possibly creating resistant strains of things).

Quoting Roe23:" I was GBS+ twice. First one I had one round of antibiotics, there wasn't time for the second round, I ... [snip!] ... of the hospital a couple hours later, against medical advice (had to sign a paper, but we could contact the midwives any time)."

Ty for sharing your experience   I plan on labouring at home, birthing in the hospital and my midwife will discharge us 3 hours after birth and then provide home visits days 1, 3 and 5.

I was not GBS positive with my first, but I am this time around (tested at 35w). I personally do not want to change my birth plan, which was to labour at home until as close to transition as I felt comfortable before transferring to the hospital. However, in choosing this a full course of antibiotics is probably not likely to happen. The more research I do, the more it looks like antibiotics really aren't that effective any how and potentially pose more of a risk than prevention. I plan on bringing this all up with my midwife on Tuesday and hashing out a plan of action with her  

Quoting Queen leaky tits:" Understandable. I just don't understand why some people make such a huge deal about the antibiotics being ... [snip!] ... being given. None of the side effects are any different than those with the antibiotics regularly given for any infection."

But if only 2 babies in 10,000 are saved by antibiotics, that means that 9,998 babies were subjected to antibiotics needlessly and exposed to abx. side effects for no purpose at all.

Quoting oh zombie baby *37*:" But if only 2 babies in 10,000 are saved by antibiotics, that means that 9,998 babies were subjected to antibiotics needlessly and exposed to abx. side effects for no purpose at all."

Not doubting what you are saying but the American Pregnancy Associations numbers are extremely different then those you have.
http://www.americanpregnancy.org/pregnancycomplications/groupbstrepinfection.html

Quoting Queen leaky tits:" Not doubting what you are saying but the American Pregnancy Associations numbers are extremely different ... [snip!] ... are extremely different then those you have. http://www.americanpregnancy.org/pregnancycomplications/groupbstrepinfection.html"

CDC estimates that 0.5% of babies born to GBS-positive mothers with no treatment will develop a GBS infection, and that 6% of those who develop a GBS infection will die. Six percent of 0.5% means that three out of every 10,000 babies born to GBS-positive mothers given no antibiotics during labor will die from GBS infection. If the mother develops anaphylaxis during labor (one in 10,000 will), and it is untreated, it is likely that the infant, too, will die. So, by CDC estimates, we save the lives of two in 10,000 babies-0.02%-by administering antibiotics during labor to one third of all laboring women.

Quoting oh zombie baby *37*:" Ty for sharing your experience   I plan on labouring at home, birthing in the hospital and my midwife ... [snip!] ... a risk than prevention. I plan on bringing this all up with my midwife on Tuesday and hashing out a plan of action with her  "

I didn't notice that you're in Ontario too, so we have the same system  .

I had IV antibiotics to have at home too (I'm not sure if I mentioned that I had planned to give birth at home). If you are comfortable with that, you might have the option of getting the first round at antibiotics at home. When I was pregnant with my children, the midwives were not able to prescribe the antibiotics, but got the licensing shortly after my son was born.

I had also looked into a vaginal wash that could have helped, but I didn't like the idea of that either. My midwives were comfortable doing whatever I wanted though. At one point, I was planning to only get the antibiotics if my water broke early in labour (or before labour) with my second or if I developed a fever.

Quoting Roe23:" I didn't notice that you're in Ontario too, so we have the same system  . I had IV antibiotics to ... [snip!] ... to only get the antibiotics if my water broke early in labour (or before labour) with my second or if I developed a fever."

That is actually my plan of action currently.

I've been leaning towards the vaginal flush because it would be easiest to do at home. I've also been taking probiotics to help balance things out (and prevent yeast/thrush if I do receive antibiotics).

Did you have a hep-lock with your abx. or were you tied to an IV your whole labour?

you know... think about all the mothers who test negative for it at 36/37 weeks. they dont get any type of antibiotic or probably dont even think about it again. i'm sure a lot of them could have turned positive the day they delivered.

i know its bothering you, it did me too when i researched it, but i say as long as you dont have any warning signs... i wouldnt worry about it. if you have a fever or prolonged labor after your water, then maybe consider it, but i'm sure you will be fine   like i said, USA and Canada are the only countries who routine test... its just a silly test esp because it can change daily.

Quoting /b/i/r/d:" you know... think about all the mothers who test negative for it at 36/37 weeks. they dont get any type ... [snip!] ... like i said, USA and Canada are the only countries who routine test... its just a silly test esp because it can change daily."

TY! I got together with my doula today and went over my concerns with her and she really helped put my mind at ease. I'll go over everything on Tuesday with my midwife and I'm fairly certain I'm going to be declining antibiotics unless I develop a fever or have a prolonged rupture of membranes during labour.