Originally Posted by IndieMidVic
As for actually doing the test, I tend to take a very cautious stand on this as it opens a huge can of worms and as an independent I then have a fight on my hands to keep women at home with consultants on my back!
The research isn't conclusive on the benefits of giving prophylactic antibiotics in labour in women with GBS as there have been cases where babies have contracted GBS and then septicaemia even when mum has had antibiotics. There is also contradictory advice on method of admission of ab's. Most units use the IV method but some are using oral ab's.
Basically, if a woman has had a pos GBS result in the past, I discuss the subject thoroughly, give her all of the current research and give her the option to have the ECM test, but don't recommend it. If she goes for it, I counsel her on the possible results so she knows what she's getting herself into, then we have the problem of ab's in labour...is she going to have them or take a watch and wait approach?
If a woman hasn't had a positive result in the past, I don't even bring it up if she doesn't mention it as it isn't relevant to her.
Our booking clinics are so busy, it's like a production line and I personally cannot see midwives being given more time to properly explain GBS testing and it's implications etc....
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Vicky hope you dont mind me cutting bits out of your wonderful post. I just wanted to comment on the bits I have left in.
Huge can of worms is exactly what it is.
IF I had been given
full information about what GBS is, what would be the recommended treatment if I tested +ve in pregnancy and
therefore what the implications would be (ie hospital birth) I would not have had the test. I did have the test, it came back +ve and the lovely NHS midwives then had their hands tied. They were no longer
able to fully support my decision to have a HB (as I had had with baby #2) because I was 'going against policy' and the then HoM said 'putting my baby at risk'. I chose an IM and it was a wonderful decision for me but not all women can/ want to do that. Now pg with baby #4 I'm in the same situation - NHS mws will
support me this time but we'll see. It is very frustrating as a student and as a mother!
IMO not only are booking clinics too busy to allow luxury of time to explain properly but the system is so paternalistic 'we know best' and then there's litigation to worry about.
Probably said too much now...........!