in which Sherri breaks her silence to talk about GBS and other icky critters

So, I'm thinking about Just Saying No to that darn penicillin drip (and the heparin lock itself) during labor.

Why?

  • It HURTS. Not the needle itself, but the solution entering my veins. I think they keep that stuff in the deep freeze.
  • It wipes out the GBS, sure, but it also wipes out tons of valuable flora that are highly beneficial to both me and my baby.
  • Having the heparin lock in place, even though it theoretically allows me mobility, still reduces my comfort level and inhibits me from moving as freely as I'd like during labor-- thus reducing my overall ability to deal with labor naturally and without unnecessary medical intervention.
But here's the kicker: before I thought I didn't have much choice, ethically. After all, why risk my baby's health for my own comfort? But then I discovered that, while GBS positive moms who receive IV antibiotics during labor have a 1 in 4,000 chance of their babies getting sick, the ones who don't use antibiotics have a 1 in 200 chance. Comparatively, that sounds like a big risk until you realize that a 0.50% chance of infection is still comparable to some estimates of my chances of having a uterine rupture during VBAC. If I can reasonably and ethically choose to VBAC then I can reasonably choose to avoid IV antibiotics during labor, even if I am GBS positive.

I do not anticipate the hospital staff being real happy about it if I opt out of all this, but I'm not paying them to make themselves happy.

But I haven't made the decision yet. I'd welcome any input from you mommas, midwives, etc out there about this.

8 comments:

Mandy said...

well...this is a hard decision to make! I have a tendency toward thrush/yeast infections so I personally would have tried to opt out of the IV as much as possible. I assume they can't force the IV in your arm, but as long as you are prepared for the "what's best for baby" talk then I would not take the IV. FWIW, I wasn't even asked if I was GBS positive until after Seth was born (but we got to the hospital super late at 8cm so I delivered quickly). Wishing you the best, whatever you decide to do!

Aimee Crane said...

I agree with your analysis. It is NOT an unreasonable decision on your part to decline the IV prophylaxis. Since you're having a hospital birth, I encourage you ou to find out what the ramifications might be for the baby if you are "untreated." (Some places use that as justification for a spinal tap on baby as part of "an infection work-up." You just want to know what you're getting in for.
Many homebirthing mommas choose not to do the GBS meds....Read about use of Hibiclens to kill GBS, it's an alternative some women choose. As far as declining the hep lock, again, from my perspective NOT an unreasonable request. They'll be grouchy, but hey, it's your birth.

Mary-LUE said...

I can't even recall ever being tested for GBS. I wonder when the testing for it became routine?

I think you've carefully considered the risks and I remember how much the annoyance of an IV and that dang blood pressure cuff really bothered me during labor.

Unless you discover more information later on that changes your assessment of the risk, I think you're making a good choice.

Sarah said...

I was GBS positive for my third pregnancy, which was also my first VBAC. Hospital birth with a CNM, and committed to natural childbirth.

I chose to go ahead with the IV and hep lock. Yes, the solution hurt--enough that I was distracted from labor pains while approaching transition. But I felt it was worth it, and would have done it again had I been positive during pregnancies four and five.

My thought process was this: I chose a VBAC, knowing the risk for uterine rupture (and also knowing induction is contra-indicated for VBACs). Knowing there is that risk, though, I chose to deliver in a hospital and tolerate more monitoring than I otherwise would have wanted, just in case of uterine rupture. Weighed the risks, did what I could to mitigate them, and then went for it.

You'll have to make this call yourself, but I do agree with Aimee to find out what might be the hospital's response to your refusal. I've heard horror stories of spinal taps, social worker involvement, and admission to the NICU for observation (with no symptoms). I've heard these stories online and can't cite them, but you should be aware of the possibilities and look into it.

It's always such a balance when using the medical system between following their standards and following your own convictions. I hope you find the balance you're comfortable with, and your birth is easy and happy.

Sarah said...

I was GBS positive for my third pregnancy, which was also my first VBAC. Hospital birth with a CNM, and committed to natural childbirth.

I chose to go ahead with the IV and hep lock. Yes, the solution hurt--enough that I was distracted from labor pains while approaching transition. But I felt it was worth it, and would have done it again had I been positive during pregnancies four and five.

My thought process was this: I chose a VBAC, knowing the risk for uterine rupture (and also knowing induction is contra-indicated for VBACs). Knowing there is that risk, though, I chose to deliver in a hospital and tolerate more monitoring than I otherwise would have wanted, just in case of uterine rupture. Weighed the risks, did what I could to mitigate them, and then went for it.

You'll have to make this call yourself, but I do agree with Aimee to find out what might be the hospital's response to your refusal. I've heard horror stories of spinal taps, social worker involvement, and admission to the NICU for observation (with no symptoms). I've heard these stories online and can't cite them, but you should be aware of the possibilities and look into it.

It's always such a balance when using the medical system between following their standards and following your own convictions. I hope you find the balance you're comfortable with, and your birth is easy and happy.

Recovering Sociopath said...

W00t! I tested negative for GBS, so it's a moot point.

I have decided to refuse the heparin lock, though. That'll be fun. :)

Sarah said...

Yay!

Refusing the hep lock shouldn't be too big a deal. Hope your birth goes smoothly!

Kathleen said...

I think you should go with your gut (natural) instinct on this. Mom's always put their kids first... just natural.