Where can I find the current protocol for second baby after being found Group B Strep during first pregnancy?

Hi,

Hopefully someone can help, I was found to be Group B Strep+ve with my first baby, was told next to nothing about it by my midwives but was treated with intravenous antibiotics during labour. I am currently 17 weeks pregnant with my second baby and was wondering what the current protocol is for second babies. My midwife is pushing for a home birth this time and tells me it will be fine if my urine comes up negative to go ahead with a home birth. I do not want to take any risk at all and am heartbroken reading about what some of the ladies have experienced on this page, but I also long for a water birth after a less than ideal labour the first time. Any help greatly appreciated. xx

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  • Congratulations on your pregnancy!

    GBS can quite naturally come and go from the vagina so the bacteria can be there one month and not the next ... and back again at some other time (though research has shown that, using sensitive tests, the results are highly predictive of colonisation status for around five weeks). There is currently no good data that can predict carriage of GBS over periods of a year or more. However, since there may be some increased chance of a woman carrying GBS in a pregnancy if GBS has been isolated previously, it is the view of our medical panel that, if possible the pregnant woman should be offered a reliable (ECM or PCR) test at 35-37 weeks of pregnancy to establish whether she is still carrying GBS. If the test is positive, then she should be offered intravenous antibiotics as soon as possible once labour has started.

    If a reliable ECM or PCR test result is not available and labour starts after 37 weeks of pregnancy, then the view of our medical panel is that previous carriage status should be treated as an additional risk factor (increasing the risk of a baby developing GBS infection where preventative antibiotics in labour are not given from an estimated 1 in 1,000 in the general population, to approximately 1 in 500 for a woman whose current GBS status is unknown, but where GBS was isolated before the current pregnancy). Our medical panel's view is that the 'previous carrier' risk factor alone is insufficient to recommend offering intravenous antibiotics in labour against GBS infection in the baby, unless another clinical risk factor was also present.

    Urine isn't a good indicator of carriage - if GBS is in the urine, then that's an infection and needs treatment at the time plus antibiotics in labour. GBS not being found in the urine doesn't mean it's not present in the vagina and/or rectum so you can't assume that. The only way really to find out if you're carrying it this pregnancy is to test for it this pregnancy. You can find out the hospitals which do test (and the private clinics) using the 'gold standard' ECM tests at gbss.org.uk.

    Water births aren't contra-indicated for women carrying GBS - there's some info on the FAQ pages of our website gbss.org.uk/content.php?sec... together with links to an article you might find useful.

    Hope that helps - do contact us on info@gbss.org.uk or call us on 01444 416176 if we can help at all. And we hope all goes well!

  • That is very helpful thank you. I am going to plan for a water birth then wether that be at home or in hospital but also ask to be tested at 35-37 weeks with a swab. I need to look into the idea of a hospital allowing me to have intravenous antibiotics between getting in and out of a birthing pool, I would be willing to sign a disclaimer and as a registered nurse I would hope that they would know I am sensible enough!!! Thank you again and I will look at the info on the links xx

  • Hi,

    As both a registered midwife and someone who has personal experience of the devastation that GBS can cause I despair at the lack of knowledge and information you're midwives have !

    My son who is now 6 contracted GBS meningitis at 2 days old and has numerous problems as a result.

    However on a positive note I8 months ago I gave birth to a healthy baby girl. I did however test positive for GBS on several swabs during the pregnancy and postnatally.

    During my pregnancy I felt as though I was nagging my consultant and community midwife re the GBS thing but naturally I was a bit worried by it !

    Anyway I made sure that a copy of the hospital guidelines was in my notes both for labour and the neonatal period in case I didn't get chance to have the iv antibiotics and in the end actually ended up having 7 lots in total because it was such a plod.

    My advice would be to be pushy with the swab and a plan etc. Get everything in writing so that everyone knows what the story is and then sit back and enjoy your pregnancy and your waterbirth with the confidence that you have done everything necessary to protect your bubba. x

  • Well as far as am concern I would not take any chances when it comes to strep b group. When you loose a baby all that will be said is how sorry they are for your not but in the end it's not their lose it's yours. You have to take your health in your hand.I was tested and Iv'e got strep b group and that was what causes my miscarriage. NHS is just not informing women how dangerous it is, it can affect you in early and also late pregnancy. If I was like you I would forget about water birth or home birth becuase when you are tested postive you cannot take chances because you need to get liquid antibiotic instantly becuase it's an infection that spread rapidly, so you need to think if your choice of water birth or home and your baby health worth taking the risk.

  • Thank you guys.

    The lack of information and flippancy from my midwives are what bothers me most. When I got the call to say I was positive it was a "you have Group B Strep but don't worry about it" call....I was left wondering what on earth it was and of course thats when google comes into play which terrified me.

    I appreciate your advice Monika15, and of course I would never put myself or my baby at risk, but I ended up having difficulty pushing my baby out the last time due to being stuck in bed on an IV drip-not my idea of a good birth at all and I ended up with nasty tears. I would like the best of both worlds this time and have IV antibiotics whilst spending as much of my labour as possible in water.

    My community midwife is just so nice that I don't want to be a know-it-all but I want to be taken seriously about how concerned I am about the Group B Strep and struggling to push my baby out due to being made to lye down to give birth!

    xx