# I don't want an IV of antibiotics



## illinoismommy (Apr 14, 2006)

Yup, its about group b strep. I really need help. They found it in my urine at 8 weeks and I was trying to be nice with the midwife (at the hospital) but I was really frustrated about it, she said because they found it in my urine its a strong concentration, strong enough that they don't care to test again, and they WILL NOT test again (can you tell I asked several times?), and that they absolutely want to put the antibiotics in me. She said unless I am crowning when I come in they are going to try to get that IV in me (so laboring at home won't help), she talked about the CDC's recommendation.... blah.... and I said just because the CDC recommends it doesn't mean I have to do it, but it sounds like if I want to refuse it its going to be a MAJOR hassle. I asked her if there wasn't another route, with pills or even an IV before I go into labor (on another day) and no.... the only thing they offer is the IV during labor. I know its supposed to burn and I don't think I can handle something additional going on during labor or I'm going to want an epidural and just forget the whole thing, if all I have is to concentrate on the contractions then I think i can do it. So anyway after all that conversation I don't think they're going to be in favor of any alternative treatments. She probably wrote "crunchy" on my sheet by the way I was behaving, and at the end she asked if I wanted to find out the sex of the baby at the ultrasound and I said yes and she said "Oh.... I didn't think you would be that kind of person..... "







:

What is the risk to the baby if the mom has group b strep? If they do get it from mom, what are their chances of coming out a-ok? The way I see it, urine or not, the chances of me testing negative in 30 additional weeks are just as good as anyones... maybe I'm wrong about that... but I'm still annoyed. I just wanted an intervention free birth. I can't have a home birth in my opinion because I live 45 minutes from the hospital and had a serious tear last time, and because its cheaper for me to go to the hospital.... and we're poor. I just thought I'd mention that before everyone cited that as the answer... and anyway its not the answer because I still want to know about the risks to my baby and how to keep him/her safe.

Please help!!!


----------



## dynamicdoula (Jun 11, 2004)

Let me address your items...

* the antibiotics burning - as a doula, i have NEVER seen a mom notice the abx having any sensation other than the same as the saline- cold.







If someone experienced burning I would be concerned about possible allergy - I've just simply never seen it. not saying it can't happen, just saying it's probably very unlikely.

* You have a right to be tested again if you wish it. Go to your family doc if you have to, call the insurance company and let them know what is going on - heck, maybe you can find a home midwife who is willing to do it for you (if you're able to pay out of pocket)? Your GBS status will change throughout your pregnancy - there's no real benefit to testing until 35 or so weeks because your status is unlikely to change from that point until birth. It doesn't mean it can't, it's just less likely than if you're tested at 8 weeks. Ask your midwife about the *routine* test done at 35 weeks and if she is denying you that, and on what medical grounds? You have a right to have everything explained to you until you at least understand the reasons- itd oesnt' mean you'll agree with it all but you should at least be clear on what is happening and why, from the medical perspective.

Why are you sticking with this midwife, who by appearances, doesn't seem interested in you as an individual? What is the difference between her and most OBs? Something to think about.


----------



## illinoismommy (Apr 14, 2006)

Quote:


Originally Posted by *dynamicdoula*
Let me address your items...

* the antibiotics burning - as a doula, i have NEVER seen a mom notice the abx having any sensation other than the same as the saline- cold.







If someone experienced burning I would be concerned about possible allergy - I've just simply never seen it. not saying it can't happen, just saying it's probably very unlikely.

Yeah my friend who had the antibiotic in her first delivery said it burned, and the midwife actually mentioned it today too.







:

Quote:

* You have a right to be tested again if you wish it. Go to your family doc if you have to, call the insurance company and let them know what is going on - heck, maybe you can find a home midwife who is willing to do it for you (if you're able to pay out of pocket)? Your GBS status will change throughout your pregnancy - there's no real benefit to testing until 35 or so weeks because your status is unlikely to change from that point until birth. It doesn't mean it can't, it's just less likely than if you're tested at 8 weeks. Ask your midwife about the *routine* test done at 35 weeks and if she is denying you that, and on what medical grounds? You have a right to have everything explained to you until you at least understand the reasons- itd oesnt' mean you'll agree with it all but you should at least be clear on what is happening and why, from the medical perspective.
She said because it was in my urine, they won't test again.... because its a strong enough colonization... so that gives me the impression that even if I did force a test and was negative at 35 weeks, they're not going to care, they're going to want to give me the antibiotics... on the other hand, it WOULD make a difference to me and then I would refuse the antibiotics because I would feel safer.

I was pretty forward about it though and she absolutely refused me. I don't have a family doctor. What else could I do?

Quote:

Why are you sticking with this midwife, who by appearances, doesn't seem interested in you as an individual? What is the difference between her and most OBs? Something to think about.
The way the midwives work at the insurance-covered hospital is that you see all of them and whoever is on call at delivery delivers you. So I didn't pick her, she's just one of them. Although I have to say she's a lot nicer than the first one I talked to.







:


----------



## phoebemommy (Mar 30, 2006)

I'm pretty shocked by your midwife's attitude. The pp put things quite well, but I'd also like to add -- has your mw explained to you the risks of GBS versus the risk of the antibiotics themselves? I know that hospitals are really gung ho on the IV antibiotics, but it's pretty uncool to railroad you into that route without the information, without another test, and without giving you the chance (or help) to work on cleaning out the GBS naturally. I agree, go somewhere else for another GBS test. It's your right.

I'm having a dopey pregnant day and don't have the strength to dig up sources about homeopathic treatment and the antibiotic risks, but maybe someone else can.


----------



## illinoismommy (Apr 14, 2006)

Quote:


Originally Posted by *phoebemommy*
I'm pretty shocked by your midwife's attitude. The pp put things quite well, but I'd also like to add -- has your mw explained to you the risks of GBS versus the risk of the antibiotics themselves? I know that hospitals are really gung ho on the IV antibiotics, but it's pretty uncool to railroad you into that route without the information,

I think so too. Does anyone have any information? I don't want to refuse antibiotics and put my baby at risk obviously....







:

Another thing.... you said there is a way for homebirth midwives to test at home? And if you are positive, and you have a homebirth, is there any way to test your baby at home to see if they didn't get it?


----------



## shellbell (Jun 18, 2006)

I will look for more exact information, but I have read that you can use garlic as a vaginal suppository (makiing sure it is not knicked or it will burn) and that can help (not sure how long you use that for either). Also, I read that you can soak a tampon in sugar free yogurt and put that in your vagina over night for three days to cure a foul odor. I don't know if it would work, but I might try that for GBS also, as eating yogurt is as good thing for GBS. Although, I would probably use kefir instead of yogurt. I will look around and post again if I find any exact info.


----------



## illinoismommy (Apr 14, 2006)

I have a list of things to help it... but what good is getting it helped if I don't get tested again.... sigh....


----------



## phoebemommy (Mar 30, 2006)

Do you have a Planned Parenthood or anything like that around? I'd think those places could help you out for cheap or free... or they could point you in the direction of somewhere else that could. But the poster who suggested you call your insurance had a good point. Once my DH went to a crackpot dentist who refused to do xrays or a cleaning and just insisted he needed a very expensive gum treatment that wasn't covered by insurance. He called insurance and they told him how to go about getting a second opinion covered (and it turned out the gum treatment was bs).


----------



## shellbell (Jun 18, 2006)

Quote:

What is the risk to the baby if the mom has group b strep? If they do get it from mom, what are their chances of coming out a-ok?

okay... here's an answer to your question, quoted from Ina May's Guide to Chidlbirth: "... In the fifteen to twenty percent of women who have group B strep in their vaginas during labor, about half of of the babies wil be colonized at birth. But this does not mean that all of these babies become ill. In fact, ninety-eight percent or more doe not become infected. When the infection does occur, however, it is serious, as it is fatal in ten percent of cases. Still, it is important to remember that only two babies out of a thousand in the population at large get infected. The problem is that there is no really accurate way to know which two babies out of a thoseand those will be. Risks associated with higher than usual risk of infection of the baby:

low birth weight or premature babies
membranes ruptured for more than eighteen hours before birth
long babors, with multiple vag exams
interventions such as induction, IFM's, vacuum extractors, and forceps
babies whose heart reates are unusually fast during labor
mothers who develop a fever during labor
mothers whose vag cultures show expecially heavy beta strep colonization
babies who need resusitation at birth

Also... You can slightly decrease the risk of your baby becoming infected by declining as many intervetions as possible (including vaginal exams) and by having everyone wash their hands frequently before toching the baby during the newborn period. (Some group B infections develpf during the first 3 noths of the life of the newborn)."


----------



## MamaTaraX (Oct 5, 2004)

You know, they can't put an IV in your arm if you don't hold it out for them







Just a thought (because everything else I wsanted to say has pretty much been said)

Namaste, Tara


----------



## illinoismommy (Apr 14, 2006)

"However, a pregnant woman who is a group B strep carrier (tested positive) at full-term delivery who gets antibiotics can feel confident knowing that she has only a 1 in 4000 chance of delivering a baby with group B strep disease. If a pregnant woman who is a group B strep carrier does not get antibiotics at the time of delivery, her baby has a 1 in 200 chance of developing group B strep disease. "

I guess I'll just get the darn thing..... sigh.... has anyone had the group b strep and can tell me it does *not* burn?


----------



## rootzdawta (May 22, 2005)

Quote:


Originally Posted by *illinoismommy*
"However, a pregnant woman who is a group B strep carrier (tested positive) at full-term delivery who gets antibiotics can feel confident knowing that she has only a 1 in 4000 chance of delivering a baby with group B strep disease. If a pregnant woman who is a group B strep carrier does not get antibiotics at the time of delivery, her baby has a 1 in 200 chance of developing group B strep disease. "

I guess I'll just get the darn thing..... sigh.... has anyone had the group b strep and can tell me it does *not* burn?









I got it and it didn't burn. It was just uncomfortable and when I was laboring in the pool, fell out which was a god thing because I didn't know it was routine to give mother's pitocin after they give birth (to make sure everything comes out). More than anything, the IV was a PITA and I am really afraid of needles so it was a bit nerve wracking. I would suggest eating lots of probiotic foods if you will have the ABX because ther's a chance that thrush could become an issue in baby and you and also you want to promote the recolonization of the good bacteria thr ABX destroyed.


----------



## illinoismommy (Apr 14, 2006)

would acidophilus work?


----------



## mezzaluna (Jun 8, 2004)

i would... try natural remedies until such time as you retest at 35+ weeks - i really don't see why they won't retest that much later! if you test negative, consider declining the IV antibiotics. if you test positive... if i were you i would go ahead and do it. it wasn't a big deal in my labor - i was so distracted by the pain of contractions i hardly noticed the needle going in. once i got the dose, they locked off the IV, covered it in plastic, taped it down and i went in the tub. it was a very minor inconvenience compared to many other things i had to endure in my "natural" hospital birth, like the EFM, the 14 page questionnaire (!?!&#$*&) and the quite incompetent management of my delivery by the OB. anyway, i didn't get the dose in time, even though i'd only labored at home for 2 hours. DS was born 3 hours after i got the dose. we were supposed to stay in the hospital for 48 hours because of this, but at 36 when everything looked good we were ok'ed to go home. as soon as i got home i started taking probiotics every day for 2 weeks to counter at least some of the damage of the antibiotics. and we didn't have any problems with thrush and breastfeeding, btw.

Quote:


low birth weight or premature babies
membranes ruptured for more than eighteen hours before birth
long babors, with multiple vag exams
interventions such as induction, IFM's, vacuum extractors, and forceps
babies whose heart reates are unusually fast during labor
mothers who develop a fever during labor
mothers whose vag cultures show expecially heavy beta strep colonization
babies who need resusitation at birth
oh, and i would also consider consenting to IV abx for these conditions if you know about them in advance (obviously last one cannot be known in time) even if you test negative on the retest.

we talked a fair amount about GBS in my Bradley class, and of all the interventions that we discussed, this was the one that we were most favorable towards.... the risk of your baby getting it is small, but if they do, the risk to them is large. and the risk to having the IV during labor isn't huge.... especially, IMO if you take measures to counter the bad effects of antibiotics.


----------



## rootzdawta (May 22, 2005)

Quote:


Originally Posted by *illinoismommy*
would acidophilus work?

I think it would be best to eat freshly made yogurt, kefir, and cultured vegetables as you can be sure the cultures are alive and kicking. The acidophilus you buy in the store may or may not be alive--you just don't know.

I agree with pp . . . it is so early. I would try some more natural remedies first and then like at week 38, re-test . . . it is entirely possible that the GBS will not be present then.


----------



## Emilie (Dec 23, 2003)

I would work very hard at finding a different ob/mw/caregiver.

What are your options?

Is there another practice in town? where do you live? Im in illinios to.

I would be more than happy to get you in touch with my mw- she can help you to naturally deal with this now.( you can still birth at a hospital- just a phone consult with her!)

This is ludacris that they are regusing to retest you!
It is your body- your baby- your birth.

please list your other birthing options( other providers, doulas to help inforce etc)

good luck.

oh and pleae go get another practice- ask on here for who is good in your area-.

If you decide to stay with these medwives- please speak to someone about the way you were treated. you do not want to be treated this way during the birth of your child.


----------



## Robin926 (Jun 25, 2005)

Everyone has given some great advice here. I just wanted to respond to the "has anyone had the group b strep and can tell me it does *not* burn?"

I gave birth at a FSBC and had a hep lock put in when I was admitted in "active labor." Every 4 hours, they hooked up an IV bag just long enough for the little bag of abx to be adminstered and then unhooked it. I even got it while I was laboring in the tub, I just laid my right hand (which had the catheter in it) on the side of the tub while they had the bag hooked up. I never felt any sort of sensation at all while they were administering the abx. Obviously I had the sensation of having the IV in my hand, but it was never uncomfortable, never burned, wasn't cold or anything like that. It really wasn't a bother for me personally.

I definitely think your MW isn't really listening and working with you though. She sounds very condescending. Whether you decide to go with the IV and abx or not, you definitely need a care provider with whom you have a respectful relationship


----------



## savithny (Oct 23, 2005)

Quote:


Originally Posted by *Robin926*
Everyone has given some great advice here. I just wanted to respond to the "has anyone had the group b strep and can tell me it does *not* burn?"

I gave birth at a FSBC and had a hep lock put in when I was admitted in "active labor." Every 4 hours, they hooked up an IV bag just long enough for the little bag of abx to be adminstered and then unhooked it. I even got it while I was laboring in the tub, I just laid my right hand (which had the catheter in it) on the side of the tub while they had the bag hooked up. I never felt any sort of sensation at all while they were administering the abx. Obviously I had the sensation of having the IV in my hand, but it was never uncomfortable, never burned, wasn't cold or anything like that. It really wasn't a bother for me personally.

I definitely think your MW isn't really listening and working with you though. She sounds very condescending. Whether you decide to go with the IV and abx or not, you definitely need a care provider with whom you have a respectful relationship









Same thing here. Heplock, two bags 4 hours apart, nothing hooked up to me inbetween, didn't feel much of anything. Able to use the tub, they didn't use the IV to push Pit... the IV would have been out before baby if baby hadn't decided to come VERY fast (5cms to birth in an hour).


----------



## doctorjen (May 29, 2003)

For what it's worth, I don't think your midwife is crazy.







:

The reason for not retesting is that group B strep in the urine is different from colonization in the vagina or rectum. Group B strep is normally a pretty innocuous organism that hangs out as a colonizer in the GI tract. Like e. coli, it normally stays there and doesn't cause any trouble. We know that such colonization tends to be transient, too, so that if you test people repeatedly you get a now-you-see-it-now-you-don't kind of effect.

Group B strep in the urine is a different situation. Bacteria that can manage to infect the normally sterile urinary tract are believed to be more potentially pathogenic. This bacteria has already managed to cause one infection, so it's likleyhood of causing another is higher. Even strategies for group B strep that only consider treating women with risk factors (instead of treating all women who are colonized) consider urinary group B strep to be a risk factor (along with preterm labor, preterm rupture of membranes, or a previous infant born to the same mother who had invasive strep disease.) It is not considered standard to retest when mom has group B strep in the urine, because you are no longer looking for a fairly harmless, intermittent colonizer in the GI tract.

You of course should still be able to refuse or decline anything you want, but if you are going to decline you need to check what the pediatric provider's policy will be for the baby. Some will consider just watching the baby closely, some will want baby to have blood cultures and a blood count, and some would start antibiotics automatically until cultures returned negative.

If you choose to have IV antibiotics (the only strategy that has been large-scale tested to reduce group B strep transmission - which doesn't mean that other methods may not work, just that they aren't likely to be accepted by allopathic medical providers) be advised that penicillin is the drug of choice, and it does tend to burn. Ask to have just a heplock, not a continuous IV, and try to have it put in the largest vein they can find. If the penicillin burns, have the rate turned down, and/or have some saline run with it. It takes about 30 minutes to run a dose in, but this should not in any other way interfere with your ability to move around. We often run antibiotics while moms walk, soak in the tub, or move anyway they want. You might just have to drag an IV pole for a little while, though.


----------



## MamaTaraX (Oct 5, 2004)

doctorjen, I always love your posts







I knew that stuff about group b strep in urine, but you said it so...well. (sorry, don't mean to sound like some nerdy groupie or anything)

Namaste, Tara


----------



## TwiceBlessed (Mar 6, 2006)

I tested positive for gbs , and I did get the antibiotics during delivery, And yes it did burn so I agree it is best to have them deliver it as slow as possible. I arrived with plenty of time for this because I knew it would be an issue after I got all my antibiotics I was at a 5 we decided to break my water and the bay arrived about 30 mins later. Although I would have prefered to not get antibiotics I certainly felt much better knowing I did. we did have a problem with thrush ( which I didnt treat with nystatin , and it went away on its own in a few months) because of it though so I would talk to your babies dr about acidophilus right away Im not sure how soon you can give it but with antibiotics it always helps since they tend to cause some yeast problems. go with your insticts and youll do great, good luck I wish you a healthy pregnancy and a healthy baby


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *doctorjen*
For what it's worth, I don't think your midwife is crazy.







:

You of course should still be able to refuse or decline anything you want, but if you are going to decline you need to check what the pediatric provide
Ask to have just a heplock, not a continuous IV, and try to have it put in the largest vein they can find. If the penicillin burns, have the rate turned down, and/or have some saline run with it. It takes about 30 minutes to run a dose in, but this should not in any other way interfere with your ability to move around. We often run antibiotics while moms walk, soak in the tub, or move anyway they want. You might just have to drag an IV pole for a little while, though.

Antibiotics should ALWAYS be piggybacked onto a main line, never run in by themselves. They tend to be quite caustic and often do burn. If penicillin is used, it should be mixed with lidocaine and run in over 30-40 minutes instead of the standard 20. Also, if it's brought to room temp before running it in it tends to hurt less. If you cannot tolerate penicillin, then clindamycin is the CDC's choice for pen-allergic women, and it seems to be better-tolerated. Also, it's only every 8 hours instead of every 4.

I'm a big believer in GBS prophylaxis because I have seen an infant with GBS sepsis, and I've also seen a lot of healthy infants treated as septic because their moms were untreated. GBS is usually not a problem, but when the babies are septic they go bad very, very quickly, and personally I'd take the antibiotics over having blood cultures and a 48-hour stay for a newborn.


----------



## hopefulfaith (Mar 28, 2005)

Quote:


Originally Posted by *maxmama*
Antibiotics should ALWAYS be piggybacked onto a main line, never run in by themselves. They tend to be quite caustic and often do burn. If penicillin is used, it should be mixed with lidocaine and run in over 30-40 minutes instead of the standard 20. Also, if it's brought to room temp before running it in it tends to hurt less. If you cannot tolerate penicillin, then clindamycin is the CDC's choice for pen-allergic women, and it seems to be better-tolerated. Also, it's only every 8 hours instead of every 4.

I'm a big believer in GBS prophylaxis because I have seen an infant with GBS sepsis, and I've also seen a lot of healthy infants treated as septic because their moms were untreated. GBS is usually not a problem, but when the babies are septic they go bad very, very quickly, and personally I'd take the antibiotics over having blood cultures and a 48-hour stay for a newborn.

As usual, rock on, maxmama.


----------



## dove (Jun 13, 2005)

just skimmed and I saw the mention of "they can't hit a moving target" type post, referring to actually getting the IV in. It is your right to refuse anything you want to, but it would be best to work it out ahead of time. If your mw is really unbending on this, you may end up with a baby that gets railroaded into having a full septic workup (not pretty) because you were not treated. I think this sucks, and it should be your choice, but some practitioners are really into sticking it to people who decide on their own. I've seen court orders come down to have babies kept in the hospital and worked up in this manner (but this was a hostile toward out-of-hospital birth environment in the 90's in a particular geographic locale).


----------



## doctorjen (May 29, 2003)

Clindamycin is no longer the automatic choice for pen allergic women due to increasing resistance. The recommendation now is that the Group B strep strain be tested for clindamycin sensitivity if possible, and if not possible or if it is resistant, the following strategy is used.
If the penicillin allergy was mild and the risk of cephalosporin allergy unlikely, Ancef (cefazolin) is the next choice. If the penicillin allergy was severe, vancomycin is used.
Cefazolin would be an option for someone who just couldn't tolerate the penicillin in their IV.
Also, there is debate over whether it is safe to give lidocaine IV to pregnant women, even though it does work well to decrease the pain of IV penicillin.


----------



## lorijds (Jun 6, 2002)

I don't see how if the abx is piggybacked or not makes any difference; the main line stops while the abx solution is running.

I work part time at a birth center and full time on the medical floor of the local hospital, and at both places we give antibiotics without additional IV fluids running. The antibiotic is, of course, not IV push; it's just mixed in small amount of carrier fluid (usually 50-100 mL normal saline, depends on the antibiotic, though) and given as per schedule. Note that when you set the pump, unless you have a multi-chamber pump, which is not standard in any place that I have ever worked with the exception of ICU, when you piggyback in a medication, the IV fluids that are running will stop until the programmed amount of antibiotic is in; then the IVF resume. So they have nothing to do with the actual infusion or dilution of the antibiotic. Do you see what I mean? Does that make sense?

I have also never heard of mixing PCN with lidocaine. You mean in the bag? Wouldn't that make it a lidocaine drip then? Wouldn't that have a potentially very detrimental effect on the maternal and fetal heart et respiratory rates? I agree with your other suggestions -- larger vein, room temp, slow the infusion rate -- but I am in the dark regarding mixing it with penicillin. Maybe it's something that is routinely done in some places, I don't know. But in our hospital we only use lidocaine for for certain heart arrhythmias, and then only in the ICU.

Yeah that, in regards to Jen's explanation of the difference in treatment modalities for vaginal vs urinary colonization for group B strep. Honestly, unless someone has alot of risk factors, at the birth center we don't worry much about group B strep, and don't have a problem at all with a mama refusing antibiotics. If a mama who had a bladder colonization refused antibiotics, I would be very uncomfortable with that, and would want her to understand the difference between a vaginal and a urinary tract colonization. Absolutely, it woul still be up to her to consent to or decline antibiotics; but to me there is a huge difference between a positive vaginal swab and a positive urine culture.

That doesn't condone your mw's attitude, though. Maybe it was just a bad day for her (we all have them), but she could have done a better job listening to you, and also explaining her reasoning to you. I'm sorry she wasn't more respectful and open to your questions and concerns. That's not okay.


----------



## mysticmomma (Feb 8, 2005)

I've never had my urine tested for this... The only thing I've ever had done with my urine is the little glucose/protein stick each visit. When is this done? Is it just not a universal "standard of care"?


----------



## lorijds (Jun 6, 2002)

We always do an initial urinalysis with the initial blood work, to screen for general kidney function, occult urinary tract infections, etc.


----------



## Nettie (May 26, 2005)

An article on GBS & antibiotics, from Mothering:

http://www.mothering.com/articles/pr...n/group-b.html


----------



## rozzie'sma (Jul 6, 2005)

It should not burn if

1. It is given at a slow rate
2. They use a smaller IV needle, The smaller the needle the more blood surrounding it and diluting the abx. keeping it from pooling in the vein
3. It is properly diluted in the saline solution.


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *lorijds*
I don't see how if the abx is piggybacked or not makes any difference; the main line stops while the abx solution is running.

I work part time at a birth center and full time on the medical floor of the local hospital, and at both places we give antibiotics without additional IV fluids running. The antibiotic is, of course, not IV push; it's just mixed in small amount of carrier fluid (usually 50-100 mL normal saline, depends on the antibiotic, though) and given as per schedule. Note that when you set the pump, unless you have a multi-chamber pump, which is not standard in any place that I have ever worked with the exception of ICU, when you piggyback in a medication, the IV fluids that are running will stop until the programmed amount of antibiotic is in; then the IVF resume. So they have nothing to do with the actual infusion or dilution of the antibiotic. Do you see what I mean? Does that make sense?

I have also never heard of mixing PCN with lidocaine. You mean in the bag? Wouldn't that make it a lidocaine drip then? Wouldn't that have a potentially very detrimental effect on the maternal and fetal heart et respiratory rates? I agree with your other suggestions -- larger vein, room temp, slow the infusion rate -- but I am in the dark regarding mixing it with penicillin. Maybe it's something that is routinely done in some places, I don't know. But in our hospital we only use lidocaine for for certain heart arrhythmias, and then only in the ICU.

Yeah that, in regards to Jen's explanation of the difference in treatment modalities for vaginal vs urinary colonization for group B strep. Honestly, unless someone has alot of risk factors, at the birth center we don't worry much about group B strep, and don't have a problem at all with a mama refusing antibiotics. If a mama who had a bladder colonization refused antibiotics, I would be very uncomfortable with that, and would want her to understand the difference between a vaginal and a urinary tract colonization. Absolutely, it woul still be up to her to consent to or decline antibiotics; but to me there is a huge difference between a positive vaginal swab and a positive urine culture.

That doesn't condone your mw's attitude, though. Maybe it was just a bad day for her (we all have them), but she could have done a better job listening to you, and also explaining her reasoning to you. I'm sorry she wasn't more respectful and open to your questions and concerns. That's not okay.

If you watch a gravity main line, it doesn't stop entirely during the running of the antibiotics -- it does slow down (usually to TKO), but if it stops the abx are running too fast. We run the initial dose by gravity, then on a syringe pump. The mainline stays a gravity line for the most part, and I've never had a ML stop entirely during antibiotics. It could be different on a pump; sometimes I think pumps make things more complicated.

The concentration of lidocaine used for the mix we use is very low (brain fade on concentration). It's not enough to create cardiac effects, and I've never seen a change in FHTs after pen/lido. It does make a tremendous difference in pain, though, and it's used in most hospitals in our area because of that. At a birth center, though, I could see it being difficult to get unless you have an onsite pharmacist, because it doesn't last (24 hours, max) and has to be compounded (as far as I know, it's not commercially available).

There was a shortage of pen awhile ago, and we were using amp instead. It was q 6 hour dosing, and seemed to be less irritating.

doctorjen, you're right that the CDC recommends sensitivity testing for GBS cultures if the woman is pen allergic. However, their alternate antibiotic of choice for clinda-resistant strains is still vanco, which I've literally never seen given for GBS prophylaxis and to me implies a low (at least locally) prevalence of clinda resistance. We don't as a rule run cephalosporins on pen-allergic women, so we don't do cephalexin, but that would be an alternative that might be less irritating.


----------



## illinoismommy (Apr 14, 2006)

Quote:


Originally Posted by *mysticmomma*
I've never had my urine tested for this... The only thing I've ever had done with my urine is the little glucose/protein stick each visit. When is this done? Is it just not a universal "standard of care"?

I had a UTI


----------



## lorijds (Jun 6, 2002)

Quote:


Originally Posted by *maxmama*
If you watch a gravity main line, it doesn't stop entirely during the running of the antibiotics -- it does slow down (usually to TKO), but if it stops the abx are running too fast. We run the initial dose by gravity, then on a syringe pump. The mainline stays a gravity line for the most part, and I've never had a ML stop entirely during antibiotics. It could be different on a pump; sometimes I think pumps make things more complicated.


Okay, I work tonight, and if I have anyone on a piggyback, I'm going to watch and see. I'm pretty sure the mainline shuts down entirely, but tonight, the questions will be answered! I'll ask our pharmacist about the lidocaine in the PCN and why we don't do it.


----------



## metroames (Aug 6, 2005)

I had the antibiotics last time and it didn't burn.









My concen this time actually is not getting the antibiotics in time. I was induced by AROM last time and got both doses of antibiotics and I had a 7 hour labor. I am expecting/hoping that I go into labor naturally myself this time and I would really like to labor at home as long as I am comfortable. With my last labor I was pretty comfortable until the last two hours! My concern is that since my first labor was relatively short that it will be even shorter this time and I won't have time for the antibiotics to take. I also had the GBS show up in my urine this time so I know that I am heavily colonized. What is the best approach for trying to reduce this ahead of time. I read a lot of suggestions from yogurt to galic to tea tree oil soaked tampons to some kind of vaginal cleanse. It is all so confusing!







:

I actually have a midwife appointment today and plan on talking to her about my concerns. I was hoping to start a regiment soon for decreasing the colonization and get tested again near the end of my pregnancy for my own peace of mind....but I still plan to get the antibiotics either way. It's not a risk I'm willing to take, KWIM? Anyway, what is the best natural way to decrease the colonization? How often and how much of something, in particular? What do the midwives here suggest to their clients. I want to have all my bases covered.







Thanks!

Amy


----------



## XanaduMama (May 19, 2006)

Quote:


Originally Posted by *savithny*
Same thing here. Heplock, two bags 4 hours apart, nothing hooked up to me inbetween, didn't feel much of anything. Able to use the tub, they didn't use the IV to push Pit... the IV would have been out before baby if baby hadn't decided to come VERY fast (5cms to birth in an hour).

Me too. I was GBS+, had the heplock, several bags of ABX 4 hours apart, and felt no burn or anything else, didn't even notice the heplock the rest of the time. Actually, I ended up on pit, so labored with the IV in place dragging the IV stand around, which I'd thought would be a real distraction, but didn't even notice it once serious labor got going. I spent tons of time in the tub, moving around, etc: the IV wasn't a problem. Much more distracting was the monitor--I was lucky to get the portable one, but the nurse kept coming in to adjust it every time I changed position.







:

I say don't worry about the ABX or the IV--just be zen about that part, take your acidophilus, and focus on the really challenging stuff! Good luck.


----------



## SABE (May 22, 2005)

I had 1 dose of IV Clindamycin while in labor with ds3 (I'm allergic to Penicillin). I don't remember any burning, and I was unhooked from the IV and left with only a hep lock for the rest of my labor. Because I delivered before getting the 2nd dose of antibiotics, a CBC was run on my son to check for infection. He was fine.


----------



## treemom2 (Oct 1, 2003)

I don't know anything about GBS in the urine (I was tested positive vaginally with DD and refused the test with DS), however I can say that with DD I received the abx and I don't remember any burning.


----------



## mahogny (Oct 16, 2003)

I'm just another person saying that I had abx (for two births) and it didn't burn either time. I wasn't GBS+, but I have a heart murmur. I don't know if the abx for that are different than what you'd be taking.

In fact, for my second birth, I labored at home and didn't make it to the hospital in time for the first round of abx, so I just had the iv done after the birth. (If my memory serves, for my heart murmur, I had to have abx 30 minutes before the birth and another dose a couple of hours later.)

I don't remember anything but just basic annoyance at the tubes and all the juggling I had to do. And most of my memories of annoyance stem from the IV I had after my 2nd birth - it's really hard to juggle a nursing newborn, an IV and pole, and a three year old very excited to see his mama again! Oh, and trying to keep a modicum of modesty about my fancy mesh PP underwear in front of MIL!


----------



## jul511riv (Mar 16, 2006)

I refused it, grrrl and am so glad I did. I found an article online comparing the studies of children who died from GBS to women who died of IV Antibiotics. The results were almost the EXACT same. Then I read another study about the amount of children that survive when their mother dies at birth (in case I was one of those) and lo and behold, they don't fare to well either.

Side effects of killing ALL bacteria (even the healthy bacteria, cause antibiotics don't discriminate) in both you and the new baby during a time of trama are also quite scary.

Of course, you run the risk of a yeast infecdtion (read: thrush) if you are breast feeding. It's happened before...MANY TIMES to MANY WOMEN, so that is certainly worth a thought.

If the baby is sick, they will be treated with antibiotics, and could overdose because the mother was given antibiotics during labor and delivery and there is no way to know how much of those were in the baby's system.

a "septic" workup is also at YOUR discression. NO ONE CAN FORCE YOU DO DO ANYTHING.

Can I repeat that?

NO ONE CAN FORCE YOU TO DO ANYTHING.

Ultimately this is your call and up to you.

Do you know that many "modern western" countries with standardized healthcare don't even TEST for GBS? Israel doesn't. If it was such a real threat, you'd think that they'd do that.

Also, what are your risk factors? Are you HIV+? African American (sorry, but that is one of the known "risk factors" of GBS, look it up)? Premie baby? Water broke 18+ hours before delivery? Running a fever in labor? Much of these things you can't possibly know until you are in labor. You can refuse now and reconsider if a risk factor presents at the time of labor.

I refused "rupturing of membranes" (breaking of bag of waters) for dd. Thank G-d I did! The water broke as I was pushing her out, and the fact that it took 9 min of pushing left her with a almost a 0% chance of any exposure.

I would have taken all those antibiotics for nothing. I would have had all the side effects of huring my and my baby's delicate gut system. I would have risked our lives! FOR NOTHING!

You don't know until you are in the moment. Truly. And if you don't have risk factors...well your chances of "infecting" (notice that is in quotes, cause something that comes and goes in over 70% of women all throughout their lives can't be WRONG) your baby are WAY low. Also, studies have shown that women may pass immunity on to her baby before birth (read, all by herself and without medical intervention! Wow, can you believe that. REAL immunity!) so the baby would be fine anyways.

I was freaked out too. I consulted with midwives, doctors, rabbis, everybody. Ultimately the decision was mine and I made the right one for me. Don't let ANYBODY scare tactic you into making the wrong decision for you.


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *jul511riv*
Also, what are your risk factors? Are you HIV+? African American (sorry, but that is one of the known "risk factors" of GBS, look it up)? Premie baby? Water broke 18+ hours before delivery? Running a fever in labor? Much of these things you can't possibly know until you are in labor. You can refuse now and reconsider if a risk factor presents at the time of labor.

You don't know until you are in the moment. Truly. And if you don't have risk factors...well your chances of "infecting" (notice that is in quotes, cause something that comes and goes in over 70% of women all throughout their lives can't be WRONG) your baby are WAY low. Also, studies have shown that women may pass immunity on to her baby before birth (read, all by herself and without medical intervention! Wow, can you believe that. REAL immunity!) so the baby would be fine anyways.

The problem here is that you're not differentiating between the risk of GBS disease (which does have the risk factors listed above) and GBS colonization, which has no known risk factors. Not having a risk factor does not mean you're not susceptible, only that it's less likely. Obviously, if you're not colonized, it's much less likely.

Colonization is not the issue, since GBS is not a disease in women. GBS sepsis can be devastating in an infant, who does not have a mature immune system, and I have seen infants go from apparently healthy to extremely ill amazingly quickly -- as in, within 6-8 hours. GBs sepsis in a newborn has a very high morbidity/mortality. GBS colonization does not.

Also, I would be interested in data you have showing risk of death from antibiotics is equivalent to risk of death from GBs sepsis in untreated infants of colonized mothers. Certainly, there's a risk of allergy, but allergic reactions (even anaphylaxis) are very treatable.


----------



## lorijds (Jun 6, 2002)

I also am interested in the data regarding the antibiotic reaction. Everything I have ever read does not show that; the risk for morbity and mortality from GBS disease is greater than that of antibiotic reaction in all of the research I have seen. Certainly, we should ALL be aware that taking any any any medication, herbal or vitamin carries the potential of reaction. But that they are equal? I'm not sure I am willing to accept that without seeing some hard data.

We always encourage our clients who choose antibiotics to begin a low daily dose of probiotics at 37 weeks, and then up that to a higher daily dose when labor starts, and continue that for 1-2 weeks after birth. Actually, we just encourage this for anyone who is on antibiotic therapy. Just dont take the probiotic and the antibiotic in the same gulp--take them 2 hours or more apart.


----------



## lorijds (Jun 6, 2002)

Oh, maxmama--
I did not have the opportunity to ask the pharmacist--but I asked an older nurse who had been at the hospital 30+ years. She said that we do give one antibiotic that contains lidocaine, but that thisisn't routine with any other.

Another things is that, yes, with our Baxter pumps, the mainline is completely shut down and does not drip at all during the piggyback. However, I would like to note that although our pharmacy tells us the rate to run the antibiotics, but that is the maximum rate and it is part of our hospital protocols that if we want to decrease the rate due to patient comfort, we can. I'm assuming this is an option at many facilities.

Lori


----------



## laralee16 (Nov 12, 2005)

nak
I had the iv full of [email protected], and it did not burn. it made me cold cold cold.


----------



## schatz (May 6, 2003)

I'll just add my $.02 fwiw.

I had abx with both dc's because they were both preterm (34 and 34.5 wks) which meant they were "more at risk" and I had unknown GBS status. With dd it caused problems afterward because my labor was longer so the abx got into her system which led to thrush by day 4 after birth. With ds we had no thrush problems but the IV was in for only about 2 hrs before he was born cus labor was quick. I also started probiotics right after delivery with ds cus I knew better after my experience with dd. The IV burned both times but it was not a major problem - unpleasant but not a big deal. The bigger problem was the yeast overgrowth with dd (it went on for four months, passing it back and forth between the two of us).

More anectdotal info: a colleague of mine had her baby at term w/o abx as she tested negative for GBS at 35 wks (or whenever that test is). Her ds ended up in the NICU with GBS infection. I don't know the details of her labor but the whole GBS testing/abx if positive/etc is not foolproof.

If I were you, I would be inclined to work naturally to get rid of the colonization in the urinary tract for a healthier you in general. Then, force a retest. If you end up with the same providers for labor that you have now, I would probably be inclined to go with abx on the front end and deal with possible thrush on the back end rather than be labled a trouble-maker and risk having your baby put in the NICU when it's not warranted. You want the docs/midwives working with you not against you.


----------



## lilyka (Nov 20, 2001)

for me it depended on the circumstances. it is rare that it is passed on without additional risk factors. So in the absences of those risk factors (prolonged ruptured memberans, pre-term bith, fever, large amount of bacteria present . . etc . . ) I was leaning towards not doing it. it did mean consenting to an extra 24 hours in the hospital (i was planning on a 6 hour departure which makes 24 hours more seem less dramatic) and blood draw on the baby.

in the end my labor went so fast that I missed it entirely. I went into labor, called to get the results of the culture (which unfortunately were positive) and went in early to my prenatal to discuss options. good thing too. I delivered a few minutes after showing up in my midwifes office.







problem solved. we had decided to go with antibiotics to appease the pediatrition and get out. a big winter storm was moving in and we just wanted to be home. also during my pregnancy I met somone whos ebaby was born early and got group be strep. 3 weeks in the NICU on antibiotics and she her chances of death were 1 in 6. I just couldn't risk that. regardless of how rare it was.

So Ava was obviously born without getting those antibiotics into me and had the blood work. if you opt to go this route ask for the NICU to come and get the blood (its is a vein draw). and do not allow an arterial draw. in the absence of any signs of sickness it is not that important. Avas first blood draw came back very bad (I couldn't understand it, she had no open wounds and my water broke 3 minutes before she came out.) turns out it was just a weird fluke.) they never got any more blood after that. she just wouldn't bleed from a poke and she got my really deep veins. we ended up staying 2 1/2 days for observation.

sometimes even the best laid plans get disrupted by real labor. I really had every intention of getting them but Ava had diffrent ideas









but in the absense of risk factors and symptoms I think all of this is largely unessecary.

since you had such a high conolization i would consult with someone on what to do about that and then be retested. I would be concerned with a high colonization not just for the baby but for you. you want your flora etc to be in balance just because it ought to be and an imbalance in one place genrally means an imbalance elsewhere. So definitely get checked again so you at least know if you have fought it off some. I htink if it were **** showing up in your urine they would tell you. but definitely get tested again. it might not change the fact that you are group b positive but it could mean teh different between weather or not you are willing to risk going without the antibiotics.

Ih ad antibiotics with my first because I didn't make it to the test. they were trying to keep me in labor for 5 days because then we would have been clear. but my water had already broken so they gave me antibiotics every couple hours to stave off any infection. unfortunately I didn't make it very long (8 hours total and they stopped the antibiotics once they realized that all the fluids in the world weren't going to slow things down. So I was on massive amounts of saline (they were squeezing the bags in for a while). t he piggy backed the antibiotics and i couldn't have told you the difference of when they were there or not. I also missed the pit. they snuck in (my poor midwife was fighting a loosing battle. but I admire her willingness to fight it to the bloody death) So if you do have an IV have someone keep an egal eye on what is going in.

its such a hard choice. thre are pros and cons both ways. some things are worth the battle and some things aren't. for me IV antibiotics were somewhere between throwing the Dr. a bone so i could have all the other stuf I wanted and that little voice in my head that said "rare but deadly. can you live with that over a comfort issue?" Everyone has thier issues that they need to sort out. if you do take them or don't being confident in your descision that you are doing the best you can for you and your baby will make it all a lot easier to move forward in peace.


----------



## oregongirlie (Mar 14, 2006)

All healthcare providers need to be as thorough and articulate in their explanations. It would save a lot of hassle and is a lot more respectful than, "You have to do it." Great post Dr.


----------



## khaoskat (May 11, 2006)

Quote:


Originally Posted by *illinoismommy*
"However, a pregnant woman who is a group B strep carrier (tested positive) at full-term delivery who gets antibiotics can feel confident knowing that she has only a 1 in 4000 chance of delivering a baby with group B strep disease. If a pregnant woman who is a group B strep carrier does not get antibiotics at the time of delivery, her baby has a 1 in 200 chance of developing group B strep disease. "

I guess I'll just get the darn thing..... sigh.... has anyone had the group b strep and can tell me it does *not* burn?









2 pregnancies and no gbs for me so far. Will not be tested for this one for about another 3 weeks....and the results will take several days to get.

I did have IV antibiotics when I had knee surgery several years ago, though, and I don't remember any burning. The IV antibiotics are a precaution in the hospital I used, to ensure that if anything gets into your body during surgery it doesn't cause an infection. In addition, I was on oral antibiotics for about 3 days after surgery (could have been longer that was in 2002).


----------



## indie (Jun 16, 2003)

Quote:


Originally Posted by *illinoismommy*
I guess I'll just get the darn thing..... sigh.... has anyone had the group b strep and can tell me it does *not* burn?









I got the antibiotics and it did NOT burn. My midwife said that if it burned she could slow it down, but it wasn't a problem.

Read this article before you decide. I'm not going to get the abx next time unless I have risk factors. I feel that pre-treating something that we'll probably not get opens us up to too many potential side effects. There is not as much research out there as I would like, but I feel that the 1 in 200 number reflects women who have unnecessary interventions like vaginal exams. Who knows how many of those cases are iatrogenic?

It is true that having GBS in your urine means that you have a higher colonization, but you should be able to have further tests and in the end the decision should be yours. Its so frustrating to hear about these docs and medwives who think its there business to decide for us.


----------



## indie (Jun 16, 2003)

I just read the rest of the responses. I had my abx run much faster than 30 min. It was more like 15 min. It didn't bother me at all.

I'm curious why taking steps to eliminate the GBS or at least get it out of the urinary tract and retesting (perhaps several times to make sure) is not recommended? If its so bad that she has it in her urinary tract then wouldn't it be best for mom and baby to try to get rid of it even if she chooses to use abx during labor? Sooner or later GBS is going to be resistant to all of these abx. Then what are we going to do in cases where there really is a strong risk? Why isn't anyone exploring other ways to deal with this? The risks of abx are not limited to thrush, although thrush can be very, very nasty in some cases.


----------



## indie (Jun 16, 2003)

Also, I'd love to see the risks separated out for women who have urinary GBS vs. women who just have vaginal GBS. Is the 1 in 200 a combination of both of these groups?Does any have this information? That would make it much easier for all of us to make informed decisions.


----------



## CEG (Apr 28, 2006)

Quote:


Originally Posted by *lorijds*
I don't see how if the abx is piggybacked or not makes any difference; the main line stops while the abx solution is running.

I just wanted to second this and add that I had the abx with both of my labors. With my first I tested positive. I loaded up on yogurt and Vit C but opted to get the abx as well. I received five doses (long labor) which was excessive IMO but no one knew my labor would go on that long.

With my second, I declined the test and chose to get the abx. My reasoning is that I know I was colonized so I chose to have the abx regardless of status becuase the colonization is transient.

The risk of GBS infection in the newborn to me is low, with a horrible effect if infection occurs. To me, the abx carry their own risk, but low compared with that of GBS.

GL to you and I hope the midwife on call is great. I have been in a similar situation and got lucky with a wonderful on-call provider. I hope the same happens to you.

ETA: the real point of my post was to say I had a ton of doses and never experienced any burning at all.


----------



## orangebird (Jun 30, 2002)

Quote:


Originally Posted by *illinoismommy*
I think so too. Does anyone have any information? I don't want to refuse antibiotics and put my baby at risk obviously....







:

Another thing.... you said there is a way for homebirth midwives to test at home? And if you are positive, and you have a homebirth, is there any way to test your baby at home to see if they didn't get it?

Yes, they can test at home as easy as in the office. The swab used is quite portable, the size of a jumbo straw all together, it's basically just a long q-tip that gets put in this little plastic tube to be sent off for the testing. Shje would have to send it from her office, so it doesn't really matter where the actual swabbing is done, home, office, wherever. I have heard of many midwives letting the client swab herself.

Oh wait, you mean test the baby? Just monitor cloely for any "off" symptoms, like fever. I had my last baby at home after no GBS testing. We pretended I was positive just for the sake of how to treat. I had no ABX but she had me check frequent temperatures the first day or two and was to notify her is there were any signs of him getting sick. Of course I am a NICU nurse so I'm used to looking for symptoms of a baby getting sick, but you should be able to monitor the baby fine at home assuming there are no problems that warrant closer observation at a hospital.

No one can make you do anything. Just keep doing what you are doing. Arm yourself with as much factual information as you can. DOn't buy into the hysteria, use facts and common sense as your guide.


----------



## doctorjen (May 29, 2003)

Okay, I went searching for the rationale behind considering GBS in the urine to be a risk factor for increased perinatal transmission.
The CDC guidelines (which are what hospitals use to determine when to test, when to treat, what meds to use, and what to do with the baby) consider GBS in the urine at any time during pregnancy to be a risk factor requiring treatment in labor. They do not recommend retesting women at 35-37 weeks who have had GBS in the urine.

So then I looked up the references they used for this recommendation. There are 2 studies, one from 1985, one from 1981 about the risk of neonatal transmission in women with GBS bacteruria. One studied also compared the culture rates in the rectum and vagina for women with GBS in the urine. They are relatively small studies - both having around 50 women with GBS in the urine. They found higher rates of illness in infants born to those moms - but the infants were not all tested and proven to have GBS. In fact, I think only 1 infant in either study had GBS sepsis making it pretty small numbers with pretty low statistical value. The one study did find that women with GBS in the urine had higher bacterial loads in the vagina or rectum than women without, though.

Then, I poked around some on medline and found a study from 2003 which looked at women with GBS in the urine during the first trimester. They recultured women at 35-37 weeks, urine, rectal and vaginal cultures and found only a small percentage were still testing positive at 35-37 weeks. This was a small study also, only 53 women.

So it looks like there really isn't great data about why GBS in the urine is considered a risk factor, other than it may be a marker for heavy colonization and some really old studies I found (late 1970s) suggested there were increased rates of illness in infants born to moms with GBS in the urine - but these studies did not culture babies to determine what organism they actually had, and used a urine culture obtained from the mom 3 days AFTER delivery, so I don't know that they have anything to do with what we are talking about.

The 1 in 200 rate of transmission is for all comers, I think. I cannot find real numbers for rates of transmission for different situations (for example, GBS in the urine, in the vagina or rectum, or in folks with risk factors.) The widely used studies that talk about the reduction in risk with antibiotics are projected studies - they estimate what the risk reduction would be, they are not studies that look at what the actual rates were with and without antibiotics. The incidence of GBS sepsis in newborns now is about 0.5 per 1000, but that reflects the current wide spread use of culture and antibiotics in the US. Also, it turns out GBS cases in infants were decreasing before the wide spread use of antibiotics, so it's hard to calculate how much of that is due to current treatment strategies.

I don't know if this data helps or not. I think it's helpful to know the numbers when making your decision, but it's also helpful to know what your providers are going to consider to be their standard and the standard for newborn care to help you decide if you want to swim upstream so to speak.


----------



## ~Shanna~ (Nov 17, 2005)

This thread has been so helpful for me, thank you. I just got a call from my MW yesterday that my urine tested positive at 9 weeks, and they want to put me on amoxicillin.


----------



## kriskriskris (Aug 18, 2006)

Hmm, this is an interesting thread. I was tested for both my pregnancies twice, 1when I was about 5-6 weeks and the other at around 37-38. What's interesting is that alot of you are talking about your urine being tested... my OB did a swab test, she swabbed my vaginal/anal area (not sure but it was "down there"). I was GBS positive every time I tested.

Illinoismommy, if it makes you feel any better, (though I was probably lucky) with my second child I was already 7-8 cm. and even though they started the IV they were pretty sure I delivered before the antibiotics had a chance to work, so they tested my daughter for something... I forgot what twice and she was fine.

I am sure everyone has a different opinion but the ped. said that because I delivered shorty after my water broke, the baby had less chance of picking up the GBS... I do agree with others that have said you need to find someone that will be more open to what YOU WANT and give you another test!

GOOD LUCK! I hope everything works out for you!!!


----------



## kylewilliamsmom (Feb 1, 2004)

When I had my son in 2003 I was Group B strep positive too. I came it at 4 cm dilated with my water bulging after being 10 days late. I labored for 8 hours and pushed out my son after two rounds of antibiotic. The antibiotic didn't burn, they were more than happy to put a hep-lock on so it was easy for me to go from tub to bed to shower etc. I did have to be hooked up for the 30 minutes it took to administer the two doses. My midwife just informed me this week at my 36.5 week appt for baby no 2 that I am Group b postive again. The antibiotics are administered 2 mg the first dose and every 4 hours after at 1 mg.

I definately agree with those who have encouraged you to look for a healthcare provider that is more compassionate and will listen better to your concerns and opinions, this is YOUR BODY and YOUR BABY!

Good luck.


----------



## CookieMonsterMommy (Oct 15, 2002)

Quote:


Originally Posted by *illinoismommy*
I guess I'll just get the darn thing..... sigh.... has anyone had the group b strep and can tell me it does *not* burn?









I can tell you as an antepartum nurse that the docs usually prescribe Ampicillin for GBS, and it does *not* burn. Are you allergic to penicillin?


----------



## mamaverdi (Apr 5, 2005)

Slightly OT: So why no cephalosporins for pen allergic people?

mv


----------



## CookieMonsterMommy (Oct 15, 2002)

MV,

10% chance of a cross allergy. (10% who are allergic to PCN are also allergic to cephalosporins). But then you eliminate a potentially helpful antibiotic, so an allergy testing would be good.

On another OT side note-many PCN allergies are not allergies. They were rash-y reactions that children get and often times out grow. Because of this reaction, people never take them again and no one knows if they were really allergic to it or not. I'm thinking about getting tested to see if mine was a true allergy or not.


----------



## mamaverdi (Apr 5, 2005)

What does the testing involve?

My grandmother has an anaphylactic reaction to PCN. Both of my boys have clustering hives with chepalosporins.

Very very very very nervous now about the PCNs....especially with my youngest who is antibiotic resistant with most infections...at the ripe old age of 2.5 yrs.


----------



## mamaverdi (Apr 5, 2005)

On a more On Topic Note: there was an article posted in Birth and Beyond about antibiotics vs. douching with hibiclens. Anyway, the article showed the antibiotics were much more likely to increase number of E. coli colonies in the baby.

Here it is.

mv


----------

