Nicole,
There has been some research done on the effects of antibiotics in labour to
prevent the transmission of GBS to babies. What appears to be the case from
current research is that the rates of GBS transmission do not change
significantly as a result of the antibiotics but the babies who are exposed
to the GBS are less liekly to become ill from GBS infection. However, there
is an increase in the risk of e-coli and other infections that are resistent
to the antibiotics, and therefore can result in more devastating infeections
as they cannot be treated with standard antibiotics. So yes, the risk of GBS
illness is reduced, but the risk of other antibiotic resitent infections is
increased.
I am fascinated to note that having now worked in the UK, Australia and Asia
as a doula and in my role as a doula trainer have students from all over the
world, the risk of GBS illness is so much higher in the USA than other
comparitive developed countries.
Another thing I struggle to understand on the topic of GBS. If the GBS is
diagnosed it is determined that it came from the mother if she was GBS
positive. However, a significant portion of woman can be GBS at any given
time. If the baby is separated from the mother at birth and taken to the
nursery, as is the case in the USA in most birth settings, and increasingly
happening in other countries, or if the baby is routinely handled by staff
at birth who may have been exposed to other babies or woman with GBS (e.g.
handling soiled materials from a mother who had already delivered and was
GBS positive), how do we know that the GBS was transmitted by the mother and
not by the staff? I noted when I worked in the UK that GBS was rare, and
babies were not handled by the staff as much as in the USA and certainly
never went to nurseries because there weren't any in the public hospital
system. here in Singapore, I have never seen a GBS affected baby amongst our
clients, despite having had clients who were GBS positive (some took abx and
some did not), but it is seen more commonly amongst other women here - the
difference? The clients we work with have their babies roomed in, have
minimal handling of their babies by staff etc, whereas the majority of woman
have their babies taken to the nursery and held, bathed, fed etc by staff.
Would be interested in seeing research that compares GBS infection rates
amongst woman having low intervention births in settings that have close
mother/baby contact compared to those rates in more actively managed
settings.
Nikki Macfarlane
Childbirth International
www.childbirthinternational.com
----- Original Message -----
From: "Nicole Carver" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Friday, November 17, 2006 8:01 PM
Subject: RE: [ozmidwifery] Alternative GBS
Hi Melanie,
I suppose it is all about comparing the risks associated with having
antibiotics with the risk of the baby being affected by GBS. The
antibiotics
are unlikely to do harm, except perhaps by damaging the woman's normal
flora
for a time. The consequences of things going wrong with the baby should it
contract GBS are devastating. The chance of complications of either is
small
but the complications of GBS are so devastating as to warrant giving the
antibiotics, I believe. Not all intervention is bad.
All the best,
Nicole.
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