Archive for the ‘childbirth’ Category

Group B Streptococcus (GBS) are common bacteria found in the vagina or rectum of 5-40% of healthy adult women. (Greenspoon 1S 1991, MMWR 1996) This is not the same bacteria that causes Strep throat (Group A Streptococcus.)

About GBS

GBS does not generally cause problems for the mother, however, during childbirth, GBS can be transmitted to the baby. Between 40-70% of colonized mothers pass the bacteria on to their babies during the birth process. While most babies are not affected by the bacteria, a very small number (1-2%) (SOGC) will become ill. Newborns exposed to GBS may develop mild to severe infections, which include pneumonia, sepsis (infection of the blood) or meningitis (infection of fluid lining the brain.) A small percentage of infants with GBS infection may be at risk for permanent handicaps or even death.

Without knowledge of the mothers GBS status, (women who have not been tested) pregnant women in the general population have a 0.06% to 0.56% chance of having a baby develop GBS infection.
Women who tested positive for GBS have a 0.4% to 1.4% chance of having a baby develop GBS infection.

Your Choices: To Test o Not to Test

There are two accepted options for screening from the Society of Obstetricians and Gynecologists of Canada (SOGC)

• Cultures for GBS are taken from all pregnant women between 35 and 37 weeks of pregnancy, by performing a low vaginal/rectal swab. Those mothers who are positive are offered antibiotic treatment in labour.

• Not routinely test all women and treat only those mothers who present with risk factors for GBS infection in the baby.

Risk Factor’s for GBS Infection

Women are at higher risk to pass GBS on to their babies if they

1. Start labour before they reach 37 weeks gestation.

1. Rupture their membranes (water breaks) and it seems as though the labour will last more than 18 hours.

1. If they have an unexplained fever during labour (380C or higher)

1. If they already had a baby who had a GBS infection

1. If they have (or had) a bladder or kidney infection during pregnancy, which was caused by the GBS bacteria

1. Note: up to 50% of cases develops in infants of mothers without risk factors. (Factor SH 1998, Lieu TA 1998)Your Choices: To Treat or Not to treat

It is recommended that women who test positive for GBS or present with risk factors for GBS infection be offered intravenous antibiotics in active labour (usually Penicillin; – Erythromycin or Clindamycin are used if you are allergic to Penicillin) These antibiotics are most effective if they are in your system for at least 4 hours after the baby is born. Some women who test positive for GBS may choose not to be treated unless they develop one or more of theriskfactors.

Summary

Research has shown that giving GBS positive mothers and mothers that present with risk factors, intravenous antibiotics during labour, can significantly reduce the frequency of GBS infection in the baby. Both screening options will treat many women and babies unnecessarily and will miss some babies who really do need treatment. The increasing number of antibiotic resistant bacteria due to overuse of antibiotics is a global issue. Antibiotics can also cause other side effects such as diarrhea, yeast infections, and allergic reactions. The problem of GBS is one that has no easy solution. We encourage you to read more about this topic and discuss any questions you have with us.

At Birth 2 Enjoy we were always concern about unnecassary interventions due to a “clinical impatience”.

When I was 2 days before my ” official” due date, my OB sugested me an induction. Among his reasons were: he was on duty that night, so he will deliver my baby,; hospital was not very busy; it was before a weekend…. We stood our grounds and refused, in spite of numerouse suggestions and even pressure.

I’m so glad to see that there are some studies to confirm that kind of practice may present real risks. Please, check this study out.

Conquering the Fear (childbirth without dismay)

 Nothing in life is to be feared.  It is only to be understood.  ~Marie Curie

I once heard a story about two kids who were trying to help a new butterfly to emerge from its cocoon. The result was devastating, as when the butterfly was delivered from its cocoon, it did not have those beautiful full wings.

What had happened? Apparently this is a part of the struggle the caterpillar goes through when it is emerging from its cocoon… The struggle helps to develop strong, beautiful wings….

Could it be that as women we also need a struggle during labour to become beautiful, strong mothers, who are able to meet the challenges of motherhood?

Could it be that we need labour to birth our children, not to be delivered from them.

Could it be that we need labour  to learn to love ourselves and to learn to trust our bodies, to learn to listen to our instincts…

 There is so much fear in our society associated with childbirth, and yet it is the most ancient and proven-to-succeed “technology” of our bodies.

I always wonder where those fears come from. What is their origin? While I’m searching for answers to these questions it looks like those fears and superstitions around childbirth are definitely well maintained by the media, Hollywood and medical authorities.

 Fear plays a huge role in our ability (or actually inability) to birth peacefully, drug free and joyfully.

When we are fearful or anxious our body produces certain hormones, which have a tensing affect on our muscles, blood is drawn away from internal organs to extremities, as body enters “fight or flight” mode.

On the contrarily when labour begins a woman needs to be as open as possible and as relaxed as possible.

Easier said than done, you might think.

 Well, the first step in conquering that fear of childbirth is to understand the process.

The more you and your partner know about labour, what is happening and why, the more confident you will be with your body functions and the process itself.

Part of that knowledge is to understand medical procedures, their pros and cons, and to know your options as an educated consumer.

The next step is to learn what you can do to stay healthy and low risk during pregnancy, how you can prepare your body for the physical challenge of labour.

Last, but definitely not least, is how your partner can get ready to be involved during labour, how he can support you and become your labour coach, not just an observer with no control over the situation.

Fear can survive only in the midst of uncertainty…

The more you do as a couple to build up confidence in each other and in the birth process itself, the less you will feel the grip of fear, the less you will succumb to its debilitating power.

You will face the challenges of childbirth with delight and understanding how valuable it is for you and your child.

You will bring out the best in yourself, the best in each other and the best in your care provider so you can give birth with confidence and joy.

You will develop those strong, big and beautiful wings which will help you to fly over the challenges of parenthood.