A girlfriend had a priv Obs for 1st baby who did not test routinely for GBS, said research wasn't supportive. By chance Mum was found to be GBS + post birth, cant remember if treated,etc. 2nd pregnancy saw same Obs again who said she would need antibiotics in labour as she tested GBS + last time. It wasn't administered thanks to a change of care provider and a confident informed Mum. How can we trust the recommendations when there is such contradiction of practice, even within one practice? Megan
_____ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Sue Cookson Sent: Sunday, 19 November 2006 8:19 AM To: [email protected] Subject: Re: [ozmidwifery] Alternative GBS Hi, Some more on the GBS line. Propolis tincture taken orally is supposed to be effective against GBS - again, little research in the alternate area perhaps because of the mega$$ pharmaceutical and diagnostic industries around childbirth. And the research really shows that although IV antibiotics decreases the number of babies with GBS, it also increases the number of babies with other blood borne infections that can also be dangerous (the ABs killoff the GBS but allow other bugs to gain resistance). And the babies whose mothers were given IV antibiotics in labour have an increased resistance to that antibiotic - obviosly more of an issue for premmie and sick babies... An interesting article by Christa Novelli 2003 which discusses the risk of the mother taking antibiotics as well: www.mothering.com/articles/pregnancy_birth/birth_preparation/group-b.html "How great is the risk from antibiotics? The recommended antibiotic for treating GBS during labor is penicillin. Fewer bacteria currently show a resistance to penicillin than to other antibiotics used to treat GBS. The options are fewer for women known to be allergic to penicillin. Up to 29 percent of GBS strains have been shown to be resistant to non-penicillin antibiotics.46 For women not known to be allergic to penicillin, there is a one in ten risk of a mild allergic reaction to penicillin, such as a rash. Even for those women who have no prior experience of a penicillin allergy, there is a one in 10,000 chance of developing anaphylaxis, a life-threatening allergic reaction. We can compare this to CDC estimates that 0.5 percent of babies born to GBS-positive mothers with no treatment will develop a GBS infection, and that 6 percent of those who develop a GBS infection will die. Six percent of 0.5 percent means that three out of every 10,000 babies born to GBS-positive mothers given no antibiotics during labor will die from GBS infection. If the mother develops anaphylaxis during labor (one in 10,000 will), and it is untreated, it is likely that the infant, too, will die. So, by CDC estimates, we save the lives of two in 10,000 babies-0.02 percent-by administering antibiotics during labor to one third of all laboring women. We should also keep in mind that this figure does not take into account the infants that will die as a result of bacteria made antibiotic-resistant by the use of antibiotics during labor-infants who would not otherwise have become ill. When you take that into account, there may not be any lives saved by using antibiotics during labor." Nothing we do or take in life can be an absolute - and some of this stuff takes lots of sorting out. Where I have been doing my clinical placements, if a mother had GBS in her previous pregnancy (but not necessarily this one) she is still treated with IV antibiotics. Yet the research clearly states that a previous baby with GBS disease is an indicator for GBS treatment in subsequent pregnancies, not merely being GBS positive in the previous pregnancy. So midwives, women and the medical profession seem to be all over the place with different interpretations of research and policy directives. It must come down to individual's perception of risks and safety - and that there can be no assurances that treatment or non-treatment will work. As Novelli states, women with negative GBS cultures still have a 1:2000 risk of her newborn developing GBS disease. I guess all we can do is give the information and trust that the decision made by the parents will be one that they are happy with ... Sue
