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View Full Version : For mom with positive GBS, will you go to hospital early?



moonsky
06-29-2010, 02:39 PM
As this is my third, my OB told me that I should head to the hospital as soon as I have a first contraction to make sure that I have two doses of antibiotics. With my first two, I wasn't there till my contraction was five minutes apart and very strong. It worked for me as I had mininal of interventions and could have a good labor.

My OB went over my birth plan and thought that they were all reasonable, i.e, no pain medication, free labor position, no medication beside antibiotic. The only thing I was afraid of was he might not be available at that time. He is in a medical group and has partners who rotate on call schedule. Though, he mentioned that my birth plan was reasonable and his partners should be able to accomodate it.

Also, how do you make sure that the person who do vaginal exam will not break your water? WWYD?

swissair81
06-29-2010, 02:55 PM
I personally go to the hospital early anyway, because my labors are 3-4 hours long & I don't want to have the baby on the way. My 1 GBS+ baby, the results weren't even back from the lab yet. I didn't even get an IV, she was born so quickly.
I would for sure go if your water broke, because the baby could be exposed to the infection then.

As for your birth plan, as you meet the partners I would discuss it with them. Unless you give them a copy in the office, they won't see it & they usually give all the orders to the nurse over the phone. I'm lucky that my Dr only has 2 partners, so I will get to see all of them more than once. My Dr knows my wishes, he was at my last delivery. I discussed my labor wishes today with one of his (two) partners. She agreed with intermittant monitoring, heplock only unless i am GBS+ (and then I would only be hooked up for the duration of the medication), showering, jumping around the room if I feel like it & pushing in any position that i feel comfortable in. She knows my wishes even without a birth plan, because we discussed it. I plan to do it with his other partner. I don't anticipate any problems because their philosophy is similar to mine. This may work better in a small practice like mine, especially because I know they have similar philosophies.

As for the vaginal exams, do you have to have them? My Dr's offices usually give me a choice. Dilation before labor means nothing anyway. Unless you can trust the person doing the exam, you really have no assurance of anything. Even then... I trusted my dr not to give me an episiotomy with my oldest. He gave me a huge one, for a 6 lb 5 oz baby. I was so annoyed.

moonsky
06-29-2010, 03:10 PM
I personally go to the hospital early anyway, because my labors are 3-4 hours long & I don't want to have the baby on the way. My 1 GBS+ baby, the results weren't even back from the lab yet. I didn't even get an IV, she was born so quickly.
I would for sure go if your water broke, because the baby could be exposed to the infection then.

As for your birth plan, as you meet the partners I would discuss it with them. Unless you give them a copy in the office, they won't see it & they usually give all the orders to the nurse over the phone. I'm lucky that my Dr only has 2 partners, so I will get to see all of them more than once. My Dr knows my wishes, he was at my last delivery. I discussed my labor wishes today with one of his (two) partners. She agreed with intermittant monitoring, heplock only unless i am GBS+ (and then I would only be hooked up for the duration of the medication), showering, jumping around the room if I feel like it & pushing in any position that i feel comfortable in. She knows my wishes even without a birth plan, because we discussed it. I plan to do it with his other partner. I don't anticipate any problems because their philosophy is similar to mine. This may work better in a small practice like mine, especially because I know they have similar philosophies.

As for the vaginal exams, do you have to have them? My Dr's offices usually give me a choice. Dilation before labor means nothing anyway. Unless you can trust the person doing the exam, you really have no assurance of anything. Even then... I trusted my dr not to give me an episiotomy with my oldest. He gave me a huge one, for a 6 lb 5 oz baby. I was so annoyed.

My last labor was less than 4 hrs. My OB said that most likely this one would be shorter. There are 5 partners in the same office. I never met others beside my OB. My birthplan has been scanned and is in my medical record. At this point, I am not sure the possibility in meeting his partners before my labor.

How do you know the progress of the labor and whether you are fully dialate and ready to push if you don't let them do vaginal exam?

swissair81
06-29-2010, 03:15 PM
You know. I've told them when I was ready to push twice now. If you are GBS+ they shouldn't be breaking your water or checking you a lot anyway. They may check you when you come in, just to see if they can admit you.

How far along are you? Hasn't your OB made you see his partners yet?

As for the birth plan, how would his 3rd partner (who hypothetically is on call when you go in) know what is in your medical record in the middle of the night when you go into labor, if he's never seen you or read your chart?

SnuggleBuggles
06-29-2010, 03:19 PM
That is surprising that you haven't met the other members of the practice. They had me schedule at least one appt. with each OB in the practice even though I wanted the CNM to deliver me. In my CNM practice I rotated and got a different CNM every time since you never knew who would be on call. I'd see about at least meeting them before birth so you have a sense of them. Stinks to spend this many months building up a relationship with one but odds are low of getting them.

My CNMs were very hands off during labor. When the time to push comes, there is little reason to check. I consented to each check. It is easy to have someone be on the lookout for AROM because they usually use a tool to break the water- someone would see them reaching for it. You could just firmly tell anyone coming near you that either you don't want to be checked or you don't want AROM. With the GBS+ it is very, very reasonable to avoid checks, it should be standard (though sadly it normally isn't).

Beth

swissair81
06-29-2010, 03:26 PM
I went to a larger practice with my last baby. I met 7 of 8 partners & guess who showed up when I was in labor- #8. It happens to be that he is so awesome that I switched practices for this pregnancy, but you can't expect that to happen. If it had been another of the partners, I might have been in for a nasty surprise. I didn't care for some of them at all.

SnuggleBuggles
06-29-2010, 03:33 PM
I didn't care for some of them at all.

With ds1 I had my CNM write down the OBs that were on call b/c she went on vacation around my EDD. I was determined to stay home and labor longer if it meant not getting the one I disliked. :) Luckily ds1 was late so my CNM was back in time.

Beth

moonsky
06-29-2010, 03:36 PM
You know. I've told them when I was ready to push twice now. If you are GBS+ they shouldn't be breaking your water or checking you a lot anyway. They may check you when you come in, just to see if they can admit you.

How far along are you? Hasn't your OB made you see his partners yet?

As for the birth plan, how would his 3rd partner (who hypothetically is on call when you go in) know what is in your medical record in the middle of the night when you go into labor, if he's never seen you or read your chart?


It may sound odd, but I never pushed till they told me to. How do you know when it is time to push?

I am 37 wks. All the medical records are in the database where medical staffs can access in any hospital computers.

moonsky
06-29-2010, 03:38 PM
That is surprising that you haven't met the other members of the practice. They had me schedule at least one appt. with each OB in the practice even though I wanted the CNM to deliver me. In my CNM practice I rotated and got a different CNM every time since you never knew who would be on call. I'd see about at least meeting them before birth so you have a sense of them. Stinks to spend this many months building up a relationship with one but odds are low of getting them.

My CNMs were very hands off during labor. When the time to push comes, there is little reason to check. I consented to each check. It is easy to have someone be on the lookout for AROM because they usually use a tool to break the water- someone would see them reaching for it. You could just firmly tell anyone coming near you that either you don't want to be checked or you don't want AROM. With the GBS+ it is very, very reasonable to avoid checks, it should be standard (though sadly it normally isn't).

Beth

I will sure lookout for AROM. Thanks for the tip. BTW, can they break the water with just using their finger/without using the AROM?

SnuggleBuggles
06-29-2010, 03:38 PM
It may sound odd, but I never pushed till they told me to. How do you know when it is time to push?

I am 37 wks. All the medical records are in the database where medical staffs can access in any hospital computers.


Did you go without an epidural? If so, maybe your body was just taking a bit of a down time before time to push (that happens and it's a wonderful thing!). But, with both of my boys (no pain meds), the urge to push was overwhelming. It felt like I really, really had to go to the bathroom. So much pressure!

Beth

moonsky
06-29-2010, 03:43 PM
Did you go without an epidural? If so, maybe your body was just taking a bit of a down time before time to push (that happens and it's a wonderful thing!). But, with both of my boys (no pain meds), the urge to push was overwhelming. It felt like I really, really had to go to the bathroom. So much pressure!

Beth

Yes, I didn't have an epidural last time. My OB broke my water. I was in so much pain after he broke the bag. So, I didn't remember about the urge to push, more like a lot of pain from scale 5 to 10 right after the water was broken. I felt like I was going to pass out but kept pushing when they told me too and recalled screaming for an epidural. Fortunately, it lasted only 15 mins from the time he broke my bad till the baby was born.

YouAreTheFocus
06-29-2010, 03:43 PM
If you are GBS+ they shouldn't be breaking your water or checking you a lot anyway.

I was GBS+ and had a scheduled AROM. I was dilating about a cm a wk for the 6 wks leading up to my due date. I was around 8 cm when I went to the hospital for my appt (w/o any contractions). My Dr basically said she couldn't have me walking around like that anymore, or my husband would end up delivering the baby. The GBS+ was also a concern, in that there would be no time to do the IV. I guess she was right, I had the baby 1.5 hrs after the AROM.

swissair81
06-29-2010, 03:47 PM
With my oldest, my dr's office used to give out a call schedule to women in their 9th month. They stopped doing it though, because people would try and wait at home if it was a dr they didn't like.

swissair81
06-29-2010, 03:49 PM
It may sound odd, but I never pushed till they told me to. How do you know when it is time to push?

I am 37 wks. All the medical records are in the database where medical staffs can access in any hospital computers.

do you get epidurals? that might be why you don't feel the urge to push. the longest I've ever pushed (30 minutes) was with my oldest & an epidural. the other 2 times I knew when I needed to all by myself. I can't tell you what it feels like, but if you felt it, you'd know.

swissair81
06-29-2010, 03:50 PM
I was GBS+ and had a scheduled AROM. I was dilating about a cm a wk for the 6 wks leading up to my due date. I was around 8 cm when I went to the hospital for my appt (w/o any contractions). My Dr basically said she couldn't have me walking around like that anymore, or my husband would end up delivering the baby. The GBS+ was also a concern, in that there would be no time to do the IV. I guess she was right, I had the baby 1.5 hrs after the AROM.

8 cm is kind of different. They assume (usually correctly) that when they do AROM at 8 cm, the baby will be forthcoming shortly. AROM is a heck of a lot better than other methods of induction.

moonsky
06-29-2010, 03:55 PM
8 cm is kind of different. They assume (usually correctly) that when they do AROM at 8 cm, the baby will be forthcoming shortly. AROM is a heck of a lot better than other methods of induction.

With DC#2, I was fully dialated 10cm when my OB did AROM. I still wonder whether it was necessary and it would be better trying to push the baby out while DC still in the bag.

citymama
06-29-2010, 04:42 PM
I didn't go in early either time (I was GBC pos both times). I was about 5 cm when I got to the hospital the first time and 7 cm when I got to the hospital with the second. Both times, I had enough time to get 2 doses of the antibiotic. I would have been fine with getting one dose, if things had gone quicker the second time.

swissair81
06-29-2010, 06:15 PM
With DC#2, I was fully dialated 10cm when my OB did AROM. I still wonder whether it was necessary and it would be better trying to push the baby out while DC still in the bag.

I fail to see the point of AROM at 10 cm. It's really cool when the baby comes out in the sac. There's a name for it. I just can't remember it right now.

AnnieW625
06-29-2010, 06:24 PM
I had GBS with DD1 and I went to the hospital way earlier than I should have because I thought the braxton hicks I was having were the real thing as 4 days before my dr. told me that I was 4/1/2 cm. dialated. To make a long story short I got in at midnight, admitted by 1 am, and got my IV of penecilin at 1:30 am, by the time I was finally ready to push with DD I was on my third bag of penicilin. I was bound and determined to have DD1 before I had to start that fourth bag of penicilin, I had her with 30 minutes to spare:). In the middle of all of this my water was broken (I should've made the choice to go home), but had stalled labor too so I also had pitocin.

SnuggleBuggles
06-29-2010, 06:45 PM
OB doesn't want to get splattered if the sac burst as baby is coming out (not that that's a good reason, imo). Being born in the caul is good luck in some cultures.

Beth

babysalvador
06-29-2010, 07:50 PM
okay, i am new to this forum, and i am expecting my first one, forgive me for sounding so ignorant, but what is GBS?

swissair81
06-29-2010, 07:55 PM
Group Beta Strep. It's normal bacteria that can sometimes colonize the vaginal canal, and can cause infant sepsis if the baby is exposed on the way out. They usually culture at 36-37 weeks & give IV antibiotics during labor if you are positive. There are some issues with this approach, but I won't go into that now.

SnuggleBuggles
06-29-2010, 07:55 PM
group beta strep. They test mom for it around 36-38w and if she is + they need to decide what the best course of action is. Many women, at some point in their lives, test +. In fact, mom could test positive at 36w but be negative a few weeks later- it's very transient. There are possible health risks to baby if they are exposed so they usually do antibiotics in labor to help avoid that.

Do you have great pregnancy books (by great I mean not "What to Expect..." :))? I haven't read the Fields' one yet but I will. Till then I recommend Baby Center's Essential Guide to Pregnancy and Birth, The Birth Book by Dr. Sears, and any books by Penny Simkin.

Beth

Beth

swissair81
06-29-2010, 07:59 PM
adding pregnancy/labor authors to Beth's list:

Penny Simkin (she's good enough to repeat)
Sheila Kitzinger
Ina May Gaskin
Henci Goer
Barbara Harper
Pam England
Janet Balaskas
Michel Odent
Marsden Wagner

oh and Jack Newman has one of the best breastfeeding books out there.

babysalvador
06-29-2010, 08:07 PM
wow thanks for the answers, now i know, i am still on my 34th week, so i guess my doctor would tell me about it in the next few weeks,

SnuggleBuggles
06-29-2010, 08:20 PM
wow thanks for the answers, now i know, i am still on my 34th week, so i guess my doctor would tell me about it in the next few weeks,

I highly encourage you to read, research and write a birth plan on your own time and not wait to hear what the Dr. tells you. Some are fantastic about really explaining things so you can make truly informed choices but a lot more are not. It stinks but often it really is up to you to do the leg work so you can help up the odds of a safe, satisfying birth experience.

Beth

swissair81
06-29-2010, 08:31 PM
I highly encourage you to read, research and write a birth plan on your own time and not wait to hear what the Dr. tells you. Some are fantastic about really explaining things so you can make truly informed choices but a lot more are not. It stinks but often it really is up to you to do the leg work so you can help up the odds of a safe, satisfying birth experience.

Beth

:yeahthat:

moonsky
06-29-2010, 09:57 PM
I highly encourage you to read, research and write a birth plan on your own time and not wait to hear what the Dr. tells you. Some are fantastic about really explaining things so you can make truly informed choices but a lot more are not. It stinks but often it really is up to you to do the leg work so you can help up the odds of a safe, satisfying birth experience.

Beth

I totally agree. Thanks for suggesting on books. I got to read one of them: the Creating Your Birth Plan by Marsden Wagner. I found it is very informative.

moonsky
06-29-2010, 09:59 PM
adding pregnancy/labor authors to Beth's list:

Penny Simkin (she's good enough to repeat)
Sheila Kitzinger
Ina May Gaskin
Henci Goer
Barbara Harper
Pam England
Janet Balaskas
Michel Odent
Marsden Wagner

oh and Jack Newman has one of the best breastfeeding books out there.

Thanks for list of books. I may pick up some more to read. I finished one from Marsden Wagner about a weeks ago.

swissair81
06-29-2010, 10:00 PM
I have a whole library. I'm starting to put a course together to teach childbirth ed around my neighborhood. My OB was actually the one who suggested it (while I was in labor). I was quite flattered.

moonsky
06-29-2010, 10:03 PM
Group Beta Strep. It's normal bacteria that can sometimes colonize the vaginal canal, and can cause infant sepsis if the baby is exposed on the way out. They usually culture at 36-37 weeks & give IV antibiotics during labor if you are positive. There are some issues with this approach, but I won't go into that now.

May I know the issues you are referring to? Thanks.

wellyes
06-29-2010, 10:11 PM
Wanna hear something funny? I had my baby today! Online relaxing for a few min tonight after the whirlwind of labr, delivery , guests etc. Anyway I was GBS pos & meant to come in at 6-8 minutes but short labor & lots of am traffic meant I didn't get to the hospital until it was too late for antibiotics. They took my new baby up for bloodwork, no other consequences. It is too early for results, but thankfully no one seems worried. Baby is well and beautiful. So based on my experience I'd say try to get there early but don't panic of you can't.

swissair81
06-29-2010, 10:20 PM
May I know the issues you are referring to? Thanks.

just because you test positive at 36 weeks, doesn't mean you will be when you go into labor.

just because they pump you full of antibiotics, doesn't mean that the baby benefits from it- especially if you have quick labors. you are supposed to have 2 doses that are finished an hour before delivery. not sure about you, but that's not happening over here.

in some hospitals, if you are allergic to penicillin (like yours truly), they don't consider you treated, even if you did get the full regimen & your baby gets subjected to all kinds of testing, possibly for no reason. The same goes for anyone of unknown GBS status or anyone who didn't get treated enough times during labor. So why bother?

Also there are studies that none of this is really effective anyway.