GBS+ and Homebirth: Compatible

Well, my beta strep test came back positive.  I've never been positive with any of my pregnancies before, but, considering that beta strep is a bacterium that 30% of the adult population has at one time or another, it's not hugely surprising.

Beta strep is a bacteria that is part of the natural bacterial flora of your body, it's usually harmless to you.  But it can be passed to your baby during birth.  This can cause complications, some very serious.  The good news is that even for GBS+ moms, the odds of passing it to your baby are extraordinarily low.  Like, crazy low (see the previous post).  So I'm not stressing about it.  Basically, I and my midwife will be monitoring the baby's temperature every 4 hours for the first week of life to make sure she's alright.  After that, we're in the clear.  There is late-onset GBS infection that can affect babies until 3 months old, but that seems to be unrelated to having GBS at birth. 

I scoured PubMed for loads of studies on this, and the scientific literature isn't clear on what's best to do to minimize transport of beta strep from a mom to her baby.  In the hospital, standard practice is to give GBS+ moms antibiotics through an IV for a minimum of 4 hours before the baby is born.  If I was delivering in a hospital, that wouldn't work- there's no way I'd be there 4 hours before my baby is born.  It'd be more like 40 minutes.  In that case, they'd take a blood sample of the baby after he or she is born and test it for C-reactive protein, an indication of an infection.  If the baby's levels of C-reactive protein indicate infection, he or she will then be treated with antibiotics.

Reading the studies made it clear that the medical community itself is not united on this. 
Many studies showed that IV antibiotics didn't do anything to prevent GBS in babies, and in fact, left the baby more vulnerable to other infections and to antibiotic-resistant superbugs (now that's scary!).  Some studies did show an effect.  And again, late-onset GBS is completely unrelated to whether or not a mom gets an IV of antibiotics.  The studies WERE clear on that. 

Also, beta strep (GBS) is something that a woman (or man) can have one day, and gone the next.  So testing at 36 weeks is not necessarily indicative of whether or not I'll have it during my actual delivery.  I read a few things saying that Europe doesn't even screen for GBS (but I have to research that a bit more, that may be heresay).  Several studies- in peer-reviewed scientific journals, people, not Self Magazine- questioned the veracity of screening and treating mothers for GBS the way we do.  The antiobiotic-resistant strains of bacterium developing in recent years is causing many in the medical community to question the practice of pumping every GBS+ mom with antibiotics.

There are a few important signs that I will have to pay attention too, however, that will put my baby more at risk for having a GBS related problem.  If my water breaks too early (like 16 hours or something before labor starts), if I have a fever during labor, or if my midwife performs lots of cervical exams during labor I will be putting my baby more at risk to contract the bacteria.  

My midwife already agreed she wouldn't check me (I haven't been checked before or during labor in either of my last two pregnancies and deliveries, so no biggie).  If I have a fever, or my water breaks too early, I may have to transport to the hospital.  But we'll cross that bridge when we come to it.

If the baby does develop a temperature in that first week of life, we'll take her into the hospital and she'll be treated with antibiotics.

I asked my midwife if she's ever had any other GBS+ moms, she said oh yes- lots.  Had any of them had GBS problems with their babies? No, she said.  In fact, she's only ever had one baby that had GBS, and that baby was a planned hospital birth to a mom who had tested negative.  See, it can be gone one day, and there the next.  My midwife's apprentice told me she had been GBS+.  So it's not unusual, and even though it CAN be serious, the likelihood of it being so are so slim, and the treatment options in the hospital not really being an option for a fast-birther like me, that I'm not stressing over it.  I also firmly believe that my baby is in God's hands, and faith plays a major role in my decision making process in all aspects of my life, including having my babies. 

p.s. Camping was awesome- I slept like a baby. Seriously, better than I have been at home! 
Also, I have almost 20 freezer meals prepped and in my freezer! AND I'm 38 weeks! SO CLOSE!!!!