GBS, Home Birth, etc.

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GBS, Home Birth, etc.

If you are having a home birth are you taking or skipping the GBS test?

I was positive with DS1 and negative with DS2. I did have SROM with DS1 and my positive GBS status greatly impacted that particular birth.

I have the option. She would test at my home visit at 36 weeks.

If I am going to take the test I am going to do my darndest to test negative ~ I don't remember my regime from last time (probiotics? Vit C? Garlic? Hibiclens?) anyone care to share their thoughts around testing and/or what you did to try to ensure a negative test result if you DID decide to test?

TIA!

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I'll ask Emily to pop in, because she had an interesting experience with this. I'll also share mine.

I did the test even though I was planning a homebirth, because midwives here can administer IVs at home.

I don't remember my exact regime, but for a week or two before the test I did take a supplement regime. I also only swabbed my vagina and skipped swabbing my rectum (my midwives let me do the swab myself).

I ended up being negative so it wasn't an issue in the end.

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I did test both pregnancies for GBS (second time was yesterday actually!). If I didn't, and wound up a transfer, they would automatically treat me as positive, so I'd rather know. I have been taking garlic capsules for the past week. And before I swabbed yesterday I used a homemade witch hazel wipe. I also avoided my backend. Will your midwife give you the swab to do yourself? Does she do IV AB's at home?

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I have done the testing for GBS with each of my pregnancies. My reasoning is the same as Jordan's: to avoid the complication of the assumption of being positive in case of a hospital transfer. I also only swab the vagina and not the rectum...I don't birth out my @ss. LOL. I know how to get pregnant, I can certainly handle doing a swab myself. Smile

With my last pregnancy I tested positive at 36 weeks. My labour started with my waters breaking about 12 hours before labour kicked in. THe original plan was to NOT have the antibiotics, because I do have a history of fairly fast labours. But with waters breaking early we opted for the ABX. My midwives do offer this at home. I had to get my regular doctor to write a prescription for the abx and then brought them to my midwives, who are fully qualified to administer them. Are your midwives able to do that for a homebirth?

This time around, I'm still going to test for it, but if I test positive I'm going to request the test be readministered at 39 weeks.

I'm going to do an internal remedy of taking, twice a day:
*15 drops grapefruit seed extract
*500mg vitamin C
*350mg echinacea
*1000mg garlic capsules

This should, hopefully, reduce or completely obliterate any GBS bacteria floating around where it shouldn't be. Smile

HTH!!

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~

Thanks guys. If I choose to test and then test positive she will give me three options:

ABX in labor (routine)
ABX in labor only is I present with risk factors
or
Watch baby for fever/breathing issues and treat baby with abx if infection signs are shown.

She also listed (Duh, it just hit me to look in my information from mymidwife, LOL)

Acidophilus 4 billion cells/dose
Echinacea
350 mg 2x's/day
Garlic 58- MG capsules 2/day and/or inserted clove vaginally
Vit C 500 mg w 200 mg bioflavenoids
Grapefruit sed extract 15 drops under tongue
Hibiclens

with an option to retest closer to date.

With my Moms history of all three births SROM well before labors onset and me having one birth that went that way I guess I will test.

Jordan/Arty/Em how far in advance of your test did you start the regime?

She will have me self swab and yeah ~ I'm so with you on not messing with the exit door on that one, LOL

Thank you guys

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I'm pretty sure I started 1-2 weeks before the test. So if you are testing at 36 weeks it wouldn't hurt to start now. And if it were me testing positive, I would go with option C of observing the baby. I'm really not a fan of prophylactic antibiotics.

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I would start now with your prophylactic treatments. Can't hurt!

I would also be wary of inserting a garlic clove vaginally as raw garlic can burn the tissues down there. Owie.

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I did the test both times and both times was negative, so no issue. I choose to do it for the same reason I do all other routine tests, just that I do not think more information is a bad thing. I would rather know personally. I did not do a regime, but if I had tested positive I was planning on doing the regime and being retested. My mw also can administer abx at home.

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Do you girls mind if I jump in and ask some questions?

I've tested - for both my kids so I've never given it a 2nd thought, but now I do have some ?'s. I really don't know much about GBS as you will see from my questions below Smile

If you treat before you test, couldn't that give you a false answer? Would it come back?

Outside of hb, have you ever requested your dr to retest closer to your due date due to a + result?

I read in "Ina May's Guide to Childbirth" that she recommends a few things during labor to essentially get rid of it before the baby comes through, has anyone done anything like that?

Can you refuse abx at a hospital if you test +? If so, will that result in baby being kept longer?

It think that's all I have for now. I'm extremely curious about this!

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My choice is to get tested (in case of transfer), but to opt for no antibiotics (if I test positive which I haven’t) and watch for signs of infection. Chances are very low.

Reasoning: Studies that I read a while ago (can’t remember it was a couple years ago I researched it) show that children exposed to antibiotics in their first year (and particularly first 6 months) have a much higher incidence of allergies and illness. I guess it somehow seems to mess with the immune system.

If there’s new research on this that anyone has that contradicts this, I would gladly read it.

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"sarahsunshine" wrote:

My choice is to get tested (in case of transfer), but to opt for no antibiotics (if I test positive which I haven’t) and watch for signs of infection. Chances are very low.

Reasoning: Studies that I read a while ago (can’t remember it was a couple years ago I researched it) show that children exposed to antibiotics in their first year (and particularly first 6 months) have a much higher incidence of allergies and illness. I guess it somehow seems to mess with the immune system.

If there’s new research on this that anyone has that contradicts this, I would gladly read it.

I don't have research to refute it, I have research to back it up. There's a whole chapter in Gentle Birth, Gentle Mothering on this, and the upshot is that now testing positive is my biggest fear. I REALLY DO NOT WANT to get the antibiotics unless it is ACTUALLY medically necessary--basically it messes with the baby's delicate digestive systems and can cause all kinds of subtle long term issues, like you mentioned with allergies and illness, pluc colic and nursing issues and all kinds of stuff. And I think the statistic was something along the lines of 500 GBS+ moms have to be treated for no good reason to save 1 baby from dying from GBS infection. Not a big enough percentage to justify prophylactic antibiotics KNOWN to wreak havoc on the baby's system, in my opinion.

momW--from my reading on preventing a positive on the test, what I'm seeing is that these remedies in no way "trick" the test--they clean out the GBS. Even if you do nothing, you could easily test negative at 36 weeks and still become infected by the time you give birth--it's that transient. (Begging the question of why they even test at 36 weeks, honestly, but that's a whole other issue.) If you are truly concerned about infecting the baby, you can just keep up the regimen for the rest of the pregnancy--if it worked to clean it out, it should work to maintain your negative status. I think the policy I'm adopting is to try the regime, hoping for a negative test so I'm not forced into anything, and then just quietly keep an eye out for symptoms in the baby...which, frankly, wouldn't you do anyway? Who isn't going to call their doctor over a sick newborn?

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My m/w and acupuncturist both suggested starting the prophylactic regime at least 4 weeks before the swab JIK. The m/w also told me to just double my normal dose of probiotics since I take them everyday. If you take probiotics everyday you should switch brands every 1-2 months.

I am also going to increase my intake of foods like yogurt, kefir and kombucha and try to include some naturally fermented sauerkraut because they all contain probiotics.

I really don't want to test positive because I have so many allergies to abx and have a familial history of penicillin allergies (I have never taken it though).

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Thanks Leigh!

You girls are definitely answering my questions just as the thread progresses. It's is quite an interesting thread btw!

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I'm going to do the test, with DD it was negative so I'm not too worried. I'm eating better with this pregnancy than I did with hers so I'm not too worried.

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So, I'm getting tested this Tuesday. I'm not particularly worried because I tested neg last time. I'm pretty sure my m/w will want to give the the antibiotics if I am GBS+ but I haven't discussed it.

I think it's too late in the game to bother with supplements at this point--do you all recommend swabbing with witch hazel before I go in for my appt? (or even in the bathroom when I get there?) How "internal" should I swab?

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"momW" wrote:

Can you refuse abx at a hospital if you test +? If so, will that result in baby being kept longer?

I didn't really worry about GBS since I tested neg. during my first pregnancy. My OB (who is a really great OB) forgot to tell me the results of my test, and I kept forgetting to ask her, and I figured she would have told me if it was positive. Well, I arrive at the hosptial in very active labor (contrax were 2 min apart, and I was found to be 8 cm) and find out that I had, in fact, tested positive. I went ahead and got the antibiotics since I hadn't done any natural remedies, but there was only time for one dose since he was born just under 4 hours after we arrived. The hospital kept DS for 48 hours after birth for the sole reason of watching him to make sure he wasn't infected since I hadn't gotten 2 doses of antibiotics, so I'm sure if I had refused (and technically, you can always refuse anything), they would have done the same.

Next time, I am going to make an effort to make sure I am negative--the 5 attempts to start an IV in active labor were not fun, and if I have another hospital birth (really hoping to be do home next time, provided I find a midwife I like), I really don't *want* to be at the hospital long enough to get 2 doses of antibiotics, nor do I want to stay there that long after the birth again.

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Thanks for all of this information! I had a small amount of GBS in my urine at about 9 weeks of pregnancy. They put me on antibiotics for me and told me they will assume that I am GBS positive at delivery and give me antiobiotics, which makes no sense at all to me, and I do not want it. DD has food allergies, and I am not going to do anything to increase this LO's chances of allergies or immune problems. I would much rather clean away any GBS naturally than with antiobiotics.

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"CaBlondie918" wrote:

I'm going to do the test, with DD it was negative so I'm not too worried. I'm eating better with this pregnancy than I did with hers so I'm not too worried.

Just for the record, GBS has nothing to do with how well you do or don't eat.

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"BuckeyeK" wrote:

Thanks for all of this information! I had a small amount of GBS in my urine at about 9 weeks of pregnancy. They put me on antibiotics for me and told me they will assume that I am GBS positive at delivery and give me antiobiotics, which makes no sense at all to me, and I do not want it. DD has food allergies, and I am not going to do anything to increase this LO's chances of allergies or immune problems. I would much rather clean away any GBS naturally than with antiobiotics.

Ugh. How ridiculous. Based on a positive GBS test at 9 weeks, they will assume you are positive at 40(ish) weeks?? That's crap. I'd refuse it too.

I did the Vit C/echinacea/garlic/probiotics regime starting at (I think?) 32ish weeks. I believe I was on the supplements for a month or so and then had my GBS swab at 36-37 ish weeks. Negative. I was also neg in my first pregnancy. I chose to do the test because my MW will administer the IV ABX at home if I wanted it (She says very, very few moms choose to have it). Not sure what I would have done if it were positive, but at least I could have considered it. Moot point anyway, since my water didn't break until I was pushing.

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"Panonim" wrote:

Ugh. How ridiculous. Based on a positive GBS test at 9 weeks, they will assume you are positive at 40(ish) weeks?? That's crap. I'd refuse it too.

I did the Vit C/echinacea/garlic/probiotics regime starting at (I think?) 32ish weeks. I believe I was on the supplements for a month or so and then had my GBS swab at 36-37 ish weeks. Negative. I was also neg in my first pregnancy. I chose to do the test because my MW will administer the IV ABX at home if I wanted it (She says very, very few moms choose to have it). Not sure what I would have done if it were positive, but at least I could have considered it. Moot point anyway, since my water didn't break until I was pushing.

I think that it has less to do with her positive at 9 weeks and more to do with the fact that if ANY untested Mom comes in to a hospital they will assume a positive result to cover liability. Ditto any pre term Mom who came in before she was tested.

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When I was planning the homebirth of my DD 3 years ago - the MW's in VA could not administer antibiotics during labor - so I made the decision to decline the test, because whether or not I tested negative, they recommend a transfer to the hospital if you show signs of GBS or risks of infection - which according to them were: fever, ROM for longer than 18 hours etc.

So I was never tested for that pregnancy. My water did break early w/ no contractions, and 18 hours later, I was still dilated only to 5, so I did deliver her at the hospital after 1 dose of antibiotics - and another 9 hours of labor.

This time however, I'm in IL and homebirths are "illegal" so I have to go to the hospital to feel safest, and they require an IV - unless you can prove negative GBS status and sign a waiver - so I did get tested and did use hibiclens daily for a week prior to the test. I tested negative.

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just because i feel like joining your party....

i tested negative and had a hospital birth. but aparantly the OB on call cannot read a chart properly, and gave me antibiotics anyway... the blew a vein and had to try again, and i'm not entirely sure, but i think the damn IV is why they got me into the bed in the first place and i never got to leave the damn thing. not sure if they would have let me up if i asked or not. they also did it during transition when i had a hard time arguing with them. and then he gave me an IV of pit AFTER which took nearly 24 hrs because either my veins really didnt want it or the hose got kinked too many times.... so i really dont think that dose over that timeframe did a damn thing, and they started it AS SOON AS ellie was born, without waiting even 5 minutes to see if i needed it for excess bleeding ... before they even stitched me up!

that turned into a random vent... sorry...

this is why i want a homebirth next time. or at least a doula.

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"Potter75" wrote:

Just for the record, GBS has nothing to do with how well you do or don't eat.

I was totally having pregnancy brain when I first responded, lol. It was registering in my brain as gestational diabetes (no clue how I came to that assumption), haha.

kvo
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What Sarah mentioned about antibiotics makes total sense based on what we now know about over-use of them in adults. Our family doctor almost never prescribes them since you can easily develop an immunity to them, therefore leaving you vulnerable if you were to contract a serious illness that only antibiotics could cure.

I never even considered that when I took them after developing severe mastitis (102 fever and rock hard bbs). Zoe was colicky, but fortunately she has no serious illnesses nor does she have allergies (except for seasonal ones).

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Discussed this with my HB midwife the other day actually. I plan on testing as I was pos. with DS. We did antibiotics with him, since my water broke before labor really got going. They did it in my hand and left it in. I didn't like this at all!

If I am pos. this time she said she can administer antibiotics if I want and remove it completely, so I can have a more comfortable birthing experience.

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"Potter75" wrote:

I think that it has less to do with her positive at 9 weeks and more to do with the fact that if ANY untested Mom comes in to a hospital they will assume a positive result to cover liability. Ditto any pre term Mom who came in before she was tested.

Actually, they said they will do the standard swab at 36ish weeks gestation, but regardless of the result they will still do the antibiotics during delivery. They told me that if you test positive for GBS at any point during the preganancy, you get abx. If my swab is neg at 36 weeks, I am refusing the abx. If it's positive...I'll think about, and make a decision based on the circumstances of the birth.

I also found out at my appointment following the one where they detected the GBS, that the amount they found was very minimal.