For mom with positive GBS, will you go to hospital early?

[moonsky]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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