Strep B and homebirths

[missyelliott]

Hello

I have just found out I have strep B. I was hoping for a homebirth but that now seems unlikely. Is there anyone else that has had strep B and managed to homebirth safetly? It seems a lot of people may actually have it as they don't routinely test people and 1 in 4 woman have it

Any info/ advice welcome

Thanks

Catherine

[Princess]

I had it in both my pregnancies. Baby number 1 was always planned to be born in hospital. He came very quickly and we only just made it to hospital in time. As a result there was no time for me to have the antibiotics myself so we stayed in Kings for 5 days so the poor little mite could have them twice a day. This subsequently led to a nasty case of thrush for us both.

As a result, we did consider homebirth for baby number 2. The midwives said I could deliver at home (seemed sensible if it was as fast as first time) and then we could both go to Kings for the antibiotics after delivery. Unfortunately, I had further complications at the end of my pregnancy so had a complete re run of first labour with the addition of an ambulance ride and again stayed for 5 days, got thrush but caught it very early on.

Personally, knowing I had Group B, if i were to do it again (unlikely) I would still try and get the antibiotics inside me 2hrs before delivery at hospital rather than risk my baby's health. Even though the chances of them being affected are quite small I wouldn't take the chance. It really is a very personal choice though.

[oimissus]

I think the problem is that midwives in this country can't provide an antibiotic drip (I believe they can in for example Holland, where of course home birth is much more common). I had strep and had antibiotics both when it was discovered (about 10 days before I went into labour) and during labour and birth. Personally, once I knew I had it, I would have wanted to ensure everything was as safe as possible for the baby - the fact that many women have it but don't know was irrelevant - I did know, and I found out that if it gets into your baby's eyes it can cause sight problems, so antibiotics all the way for me (I was wired up to so many things anyway, one more didn't make any difference!).

Have you spoken to your midwife team about it? My info could be a couple of years out of date. Obviously the best thing would be for midwives to be able to administer antibiotics.

[missyelliott]

Thanks both. Yes I have spoke to my midwife and they do recomend hospital births. They can administer the antibiotics at home but they don't like too. I think we are probably going to have a hospital birth to be safe. It's something you can't risk but I just wanted to to try to avoid a hospital birth as I hear such horror stories that normally start with a person being induced - or people saying, I probably wouldn't have had x y or z if they hadn't rushed to induce me. We have also hoped to have a hypno birth. I know you still can create a calm environment in the hospital room but it is harder.

Thanks again for your advice x

[jennyh]

Hi Missyelliot, just to pick up on your last post - please don't be concerned or scared about the hospital. I know that there have been recent threads about hospital births etc but people are more likely to look for support after a bad experience than they are to share their good experiences!

I had my daughter at Kings and whilst it wasn't quite as I had hoped for (what labour is!), it was fine and she was delivered healthy and I was healthy and that is the end result you most hope for. For all the bad stories there are loads of good ones - start a thread asking for positive birth stories and you will get loads! Kings provide fantastic care and in that moment when you are delivering your child you are the only person that matters to them at that moment. My hospital room was very calm, it was just me providing the entertainment throughout, my midwife was calm and even when it got a bit stressful at the end they were great at sweeping in to sort it out and in retrospect I wasn't aware of any panic so that is testament to their experience.

I have also known people with positive and negative induction stories so that isn't always as bad as the general picture can be, plus your baby could come at any time so nothing to say you will def be late. My daughter arrived the day before my booked induction after loads of sweeps, acupuncture and lots of marching around the park like a nutter!

Perhaps go for some hypnotherapy or something to help and def do hypnobirthing preparations as the breathing is def something you can do in the hospital to help.

[oimissus]

hi missy, I agree with jennyh, although my birth was quite full on the team at Kings were fantastic and I would have no qualms about having another child there. I did yoga classes all the way through pregnancy and certainly used, to my advantage, some of the techniques I learned there. Maybe look into having a doula there if you feel that would make you more comfortable.

[Princess]

Ditto both posts above. I can't fault Kings.

Neither of my labours, despite being fast were completely straightforward. My community midwives didn't have time to make it to Kings first time and on the second occasion they worked alongside the team at Kings to ensure both my son and I were as comfortable and safe as we could possibly be.

If it puts your mind at ease you can tour the labour ward and ask all sorts of questions. It helped me get it in perspective and have a vague idea what to expect.

[BellendenBear]

I thought that you only needed to have antibiotics if there is a delay between waters breaking and onset of labour? Otherwise everyone would be screened and more people would need antibiotics.

I had group B strep in 1st pregnancy which was only detected because my waters broke at 37 weeks and contractions didn't follow. I ended up being induced in KCH, having loads of iv anti-biotics and having to stay in for 48 hours for baby to be 'observed'.

2nd pregnancy I opted not to be tested again after discussion with my midwife (Brierley). They would have given iv antibiotics at home if I'd wanted. I had a very uncomplicated home birth.

Like you say lots of people carry group B strep without knowing about it which is why I decided not to be tested.

[Kes]

BellendenBear - the UK is pretty unusual in not routinely testing everyone for it, in most other western countries they do and offer antibiotics to anyone who tests positive.

Currently in the UK the offical line is only to test high risk women - ie. those who've previously had a baby affected by GBS or those who's waters break early. They don't test everyone as it's thought that the risk of harm to a baby even if the mother is positive is pretty low and outwieghed by the risk of a severe reaction to antibiotics and of spreading antibiotic resistance. There are also concerns from some natural birth advocates that giving IV antibiotics early on in an otherwise normal labour could be the start of a slipperly slope of medicalisation.

However there are planty of obstetricians who disagree with this and would prefer the UK to test everyone as they do in France, Germany, USA, Australia, Canada etc etc. as for the few babies that do contract GBS the consequences can be very severe, including lifelong disabilities and even some fatalities.

I suspect the OP was tested by Brierly as they have to be extra careful about everything since they are dealing with home births, and have to cover their own backs if nothing else.

I should add that I'm not an expert in this but I was researching it recently for a blog post I never actually wrote, sorry for not linking to the relevent evidence but I don't have my note on me at the moment.

I think if you google the NHS screening authority and GBS support group they have info.

Also if anyone isn't tested and is worried you can get kits online for about ?35 - again google GBS support group and you'll find a link.

K

[oimissus]

that's interesting, Bellenden, as I was told once you have strep, you have it, it doesn't go away, ie I would need to have antibiotics at any subsequent birth I had. Also, do you not think your baby should have been observed? We had to stay in a long while as baby was on antibiotics (she swallowed meconium on the way out) and then they wanted to observe her for one more day once she finished those, although the postnatal ward would not be my top choice of place to hang out, for my baby's health I was more than happy.

People do see to have a lot bad to say about hospital births which I think is very unfair as they can be absolute, and literal, life savers, a good team is a good team wherever you are.

[Lacey]

I had Group B Strep detected in my urine at about 35 weeks (I'd complained about needing to go to the loo alot and so my midwife had sent it off for testing) with my first child and went on to have the antibiotics during labour. I then stayed in one extra night for the baby to be observed.

In my second pregnancy (2010/2011), I was advised that Kings policy is not to assume that you have it still and not to give antiobiotics on the basis that you might have it. This seemed like a recent change of practice as my midwife called Kings to check the position.

I decided to get the private test from the GBS website and my practice nurse did it and sent if off to the lab - all very straightforward except it was over Christmas/New Year and my waters broke before the results were ready. Following various discussions with the consultant and midwives, I went on to have the antibiotics again after being induced (my decision to be induced; the consultant would have allowed me to wait longer). The results came a couple of hours after the birth! They turned out to be negative, but again we stayed in one night for the baby to be observed.

The GBS website is a very helpful resource.

Also, to add and to echo what others have said, I was exremely happy with my care at Kings.

[oimissus]

that would explain it, Lacey, my info was from 2009.

[Mrs TP]

I had my 3 all at Kings. After emergency C-Section with no1 (2001) nurse was reviewing my records and noticed a positive strep B test that had been ignored in labour, she slightly panicked and baby had anti-b for 48hrs after delivery and all good.

I was shouting about it during birth of next baby (2004) and I had the anti-b drip but all too late and baby born 30mins later. Baby and me kept in hosp, baby observed for 3 days and all well no signs of illness and no anti-b.

No 3 (2009) again rapid labour and too late for effective anti-b drip during labour. Baby given anti-b for initial 48hrs, bit poorly and so extended for 5 days, heavily monitored, chest x-rays etc and responded well to anti-b and discharged after a week.

There are still many hosps that do not routinely test for this. Kings are tip top and I feel priviledged to have had mine there.

[BellendenBear]

I didn't mean to give the impression that I was knocking the care I received at Kings. I totally agree that the care that they provide is excellent on the whole. I put 'observed' not because I didn't feel that she should have been observed but because she wasn't. The paediatricians wanted us to stay for 48 hours so she could have 4 hourly observations recorded. Her obs were checked twice during that time after lots of reminding. I know the postnatal care is supposed to have improved a lot since then.

Also I wasn't saying that group B strep can't be a serious thing or that the decision to induce and give ABs in my first labour was wrong. Just that the circumstances of the 2nd labour were completely different and uncomplicated so I didn't see the point in screening for something that many people have and that isn't screened for in everyone. Had my waters broken early again or there have been any other risks then of course I would have had anti-biotics.

[sarahnickharry]

Hi Missyelliot

I had Strep B with my younger boys and had home birth as the consultant at Kings told me the midwives (Brierly) could give me the anti b's at home and they did. They also stayed with us for a while afterwards and spoke to consultant after birth to check baby observations etc, and visited us more than usual the next 48 hours. Consultant persuaded me that home birth was a safe decision with Strep B - but, you have to just do whatever you feel comfortable with. I'm sure whatever you decide it will all go well for you.

[Lakey]

Hia,

I was Streb B positive after testing due to friends experiences, and was devastated as I hate hospitals and was desperate for a home or BC birth. However, gave birth at Kings and it was the exact birth I wanted despite my initial fears. I gave birth in water (you can still do this with antibiotics - one thing I was very relieved to do). Te team were amazing.

Whilst we are on the subject - slightly off topic - My baby had bad colic and we think it was down to the antibiotics in labour killing her good bacteria in her gut (I am not a doctor so please forgive me if anything I said has no medical grounds!), and found that a probiotic called biogaia helped us (after months of trying everything). Just thought I'd mention it given you will be having antibiotics, and hope to save you the trouble with had.

Best of luck with your birth. It's a great thing to know your Streb B status and it doesn't need to affect your plans I promise.

X

[Ole]

During the birth of my son I developed a high temp and was put on an antibiotic drip for the whole of it and for 2-3 days after, and when I was sent home I had to take carry on taking antibiotics for 2 weeks. I don't know if this was because of strep b or not, but a few days after we went home my son developed a really bad rash all over his body and had to have an emergency lumbar puncture thingy and he was on a drip for a whole week. He was fine and I don't know what caused his rash (the lumbar fluid came back clear so it was not meningitis).

[sillywoman]

I don't know about your particular case Ole, but new babies often develop a rash sometime in the first week or so. It can look like heat rash, or - more alarmingly - german measles, and is usually due to their skin reacting to the impurities in our horrible London air.

It's wise to always get a newborn with a rash checked, but I wouldn't be worrying until a doctor or Midwife was showing signs of concern about it.

Very sorry that he had to have a lumbar puncture though, I bet it was horrible for you? :(

[Ole]

I know that now sillywoman, but at the time as a new mum and with a fuzzy brain high on meds I thought it would be best to get it checked out (I think it was the weekend and could not get a doc appointment and my postnatal midwife was still to make an appearance). Apparently though they were worried about some tiny black spots that were also appearing on his skin rather than the rash itself - I can't remember what they thought the black spots would be but he was also covered in them and apparently that was what they were more concerned about.

We were not allowed to be in the same room as him during the lumbar puncture because we were told it would be too stressful for us (I guess it is more important that they get him to be completely still so that the needle goes in the right place). It was a hassle dressing and undressing him with the catheter in situ, but it was such a relief when we were told that he was fine, I had to control my urge to kiss the paediatrician. I have to say that in terms of clinical care I would not want to be anywhere else apart from Kings, within a couple of hours of arriving there he had had the thing done and was hooked on a drip.