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Homebirth after positive Group B Strep, by Lucy B

Rose Heidi with her parents, just after birth.

Background:

My first birthing experience in 2005 with Beatrice had not gone to plan (which was a home water birth). I had premature rupture of the membranes 11 days before the due date and after 48 hours with no commencement of contractions, I was induced and had a very painful, long labour, ending in epidural, episiotomy, forceps, jaundiced baby who took a long time to learn to breastfeed, and who had to go on IV antibiotics for 48 hours when it was found out that I carried Group B Strep (the GBS test came back negative for the baby after the 48 hours). I suffered an infection and haematoma of the perineum and had to have antibiotics for this. It has caused permanent damage which will need surgical correction once I have completed my family. I had no complaints about the hospital or staff – they were all very professional and always explained procedures and asked for consent.  

In this pregnancy, due to my history, I was tested for group B strep with a lower vaginal swab and was found to be a carrier again. GBS is a bacteria that lives in about a third of the population and it occurs naturally and is not transmitted in any way. GBS is not usually harmful for adults who are fit and healthy and does not need to be treated, however GBS can occasionally cause serious infection in some babies. Because it was also found in the urine which is considered an additional risk factor, I was advised to have intravenous antibiotics during the labour to reduce the chance of the baby contracting GBS.  If the baby is born after 2 hours of the mother's IV antibiotics it is recommended that the baby have neonatal observation for 24 hours. If born before 2 hours or there is an additional risk factor then the baby would need to go on IV antibiotics from birth until a blood sample from the baby was cultured and showed to be negative for GBS.

Normally a home birth wouldn't be advised because the IV antibiotics can set off an anaphylactic shock which can be fatal (but would occur shortly after introducing the IV fluid). I had done a lot of research on GBS and home births and it was agreed with the consultant midwife that I could have the IV antibiotics (Clarithromycin 500mgs) in hospital in early labour and then go home to have the baby. I would need a second oral dose of antibiotics after 8 hours and a dose of IV antibiotics after 4 more hours if the baby had not yet been delivered. I had read that a peeled garlic clove in the vagina will kill off GBS bacteria.

Heidi Rose

Weds 2nd July, 3 days over the due date (from the scan), but 3 days under the due date (estimated by me from ovulation). For the last 2 days I had felt the baby's head had dropped further into the pelvis.  

01:00 First half garlic clove on a thread, into vagina. Go to bed. Baby starts moving round a lot and contractions start. Can't sleep. (Maybe I was already a bit dilated and the garlic was irritating the baby)

02:00 Contractions about every 10 mins, uncomfortable but not painful. Knelt on floor with head on chair. Read between contractions.

03:30 E-mailed people about the “breastfeeding in public’ to say there was to be a change of venue in case of rain and I might not be there. Contractions became 5 mins apart. Phoned labour ward who said come in for IV antibiotics.

04:00 Phoned Mum and Chris to come over to look after Beatrice, woke Angus.

05:00 Mum and Chris arrive, Beatrice asleep.  Contractions still not painful. At hospital, contractions stopped. Midwife said I was only 2cm dilated and advised to wait until I had 2 hours of 5 minute apart contractions to prevent needing a second dose of IV antibiotics after 12 hours. Go home and contractions start again.

07:00 everyone to bed except me. I breathe through the contractions kneeling on floor, head resting on large inflated ball or standing and leaning against kitchen worktop

Big sister Beatrice guarding a sleeping Heidi Rose.

07:30 Beatrice wakes up and I bring her down to watch videos.

08:00  People start getting up, have breakfast with them. Angus does cooked breakfast, so have that too. Contractions still easy to cope with. Mum and Chris take Beatrice out

11:00  Had hour of sleep in Beatrice's bed

12:00 Woke up with quite strong contractions. Stay in Beatrice's room, kneeling on floor, head on her bed, curtains closed. Want to be alone.

12:23  measure contractions: 3,2,4,5 minutes apart. I phoned labour ward, who said come in.

13:10  Arrive at labour ward. Blood pressure high. Midwife says it may be due to being in labour, or it could indicate preeclampsia (but I didn't have any of the symptoms and felt normal between contractions). She took blood sample. 3 – 4cm dilated now.

13:50  started the IV antibiotic drip. It was supposed to take an hour to drip through, but it only took 35 mins

14:40 Drip disconnected. Then we were asked to wait an hour, because blood result not yet back and there were no midwives available to do a home birth. We said we wanted to go home. If the blood result showed a problem, we could come back in again (we live only 5 mins from the hospital). Also we knew a midwife (Elizabeth) and birth attendant (Sally) both who had said to phone them if any problems, so we thought we may be able to get an experienced person at the birth even if there were no on call midwives available.

15:00  Leave hospital. 2 contractions in car – painful now

15:05 Mum, Chris and Beatrice arrive home

15:10  Angus and I arrive home. Angus phones Elizabeth, who says she can be with us in an hour. Contractions strong, but I still didn't want to attach the TENS machine or have massage. Wanted cold flannels on my forehead and neck. Knelt on floor in playroom, with head on inflatable ball, curtains half drawn. Came into kitchen to see what was happening with filling the pool. Stood for contractions, holding onto dresser. Kept reminding myself of Sally's antenatal class instructions: “the contraction will last no more than a minute, and then it will all be over. Breathe it out..’ After the contraction, it was true, I felt normal and could walk around. Angus got the fan. Then the contraction sensation changed and I wet my trousers a bit. Took them off and sat over a bucket. I realised I must be in the pushing stage, but it felt different from how I expected – much lower down and not so intense. I wanted to get into the pool, but it was still too hot. Angus cooled the water and I got in – it felt so soft and supportive and the water was soothing.  Beatrice got in the pool too. For each pushing contraction, I'd lean over the side of the pool and make groaning noises. I wanted Mum and Beatrice to massage my lower back really strongly. Angus tried to phone the hospital to say I was now in 2nd stage, but the phone was engaged (they were phoning us to say they were on the way). I had my hand on my perinium and could feel the head coming out. Mum frantically reads through birthing book to see what to do.

16:20  2 midwives arrive. Angus phones Elizabeth to say no need to come now. Mum calls to Angus to hurry up “the baby is coming!’

16:25 head and one hand delivered

16:27 body delivered. Baby girl, Rose Heidi. She looks perfect. Sat in pool a long time, admiring baby and waiting for contractions to start to deliver placenta.

17:15 Still no contractions. Rose is cold and needs to be wrapped up. Cut cord and Angus held Rose. I got out of pool and had injection to deliver the placenta

17:30  placenta delivered. No stitches needed.

Rose's temperature too low and face blue. Did skin to skin with me (but my skin was cold, so not the ideal person to do skin to skin with),  baby still too cold. Wrapped baby in blankets, but still cold and blue. Transferred to hospital for checking. Rose was warmed under a heat lamp. Advised that baby have IV antibiotics as a precaution until results of blood test known (after 48 hours) as abnormal temperature can be a sign of GBS infection and also because my IV antibiotics had only been in 2 hours before the delivery of baby.

We stayed on  Broadlands ward until Saturday 5th July. The blood test came back negative, so we were discharged. (The blood test in labour for my high blood pressure was also normal).

In hindsight, we should have got out of the pool earlier to ensure that the baby kept warm (it was difficult to keep the whole body under the water and the mouth and nose above) and even if we had got out when we did, we should have warmed the baby with a warm person for skin to skin and a hot water bottle. That way we would have avoided the hospital stay and the unnecessary antibiotic treatment for Rose.

The homebirth itself was really great and it was so nice to have close family to share the experience. It was lovely too to have Beatrice in the pool and for her to see her little sister being born. (She had seen the NCT birthing video many times so knew what to expect). What a change from my first birthing experience!

Lucy tandem nursing her daughters.

Two beautiful sisters enjoying the best meal in the world! No wonder Beatrice looks happy to have a baby arrive - lots more milk!!!

Related pages:

Group B Strep - your options for homebirth, and choices regarding antibiotics.

Fast Labours - is quicker always better? What do you do if your baby is arriving faster than your midwife?

Pain relief - what are your options at home?

Waterbirth at home

Siblings at a home birth - what to do with your older children? Should they be present?

The Third Stage of Labour - what are your options, and the pros and cons of each?

Homebirth UK email group

Home Birth Stories

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