Re-post About Strep B

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This was a post I did last year from a patient. I am re-posting as this is coming up for a few people and I think it may be helpful to bring back into the forefront.

It has been four years, two months and twenty- two days since I began treatment at ICAMA. In that time, I have made empowering relationships, become pain–free, transformed my lifestyle and expanded my family. In a recent appointment with Matia, she asked me to share a few thoughts regarding the research and consequent decisions my husband and I made about the recent birth of our son, Andrew. I strongly believe each woman has to make decisions that feel right to her; however, I would have benefitted from fellow patients sharing their experiences. There are four waiver forms I was legally obligated to sign to have my wishes carried out during delivery at a hospital in Ohio: Hepatitis B Vaccine, administration of antibiotic eye-drops ( the waiver is not available in NY), administration of pitocin in the third stage of labor ( which is now part of Labor and Delivery Protocol), and administration of IV antibiotics for Group Strep B. My OB has known me since I was four years old. He delivered my first two children and is a good man and an excellent surgeon. However, as my pregnancy progressed with Andrew, it was clear that the more active role I took in creating my birth choices was uncomfortable to him. As I began to feel empowered in the choices I made based on research I had done on various child-birth models, the stronger his paternalistic energy became during our appointments. Ultimately, he asked my husband and I to sign an “Informed Consent” form in an office visit as a direct response to my conversation about what I planned to refuse during delivery and why. At the end of that appointment, at 37 weeks pregnant, I left my OB and chose to be delivered by a midwife. It was a very difficult decision to leave the safety of this talented surgeon with whom I had a personal relationship. As we have learned in treatment, energy is a powerful force, and I simply was no longer comfortable with him performing my delivery. He has good reasons to have wanted to protect himself legally from a patient who seemed to want to take more risks than he was comfortable taking. Our Doctor/ patient relationship was no longer the right fit for who I had become and for the healthcare PARTNERSHIP I craved in my delivery. The mission statement of the midwifery group I delivered with was a much better energetic fit for Andrew’s entrance into the world. The sensitivity about discussing vaccinations openly in our society upsets me. If a parent doesn't conform to CDC recommendations, there is this sort of public witch hunt that ensues. It seems the “conversations” I have witnessed seem to be divided into two camp, Pro and Anti. It is not that simple. Is it? My two older children did receive the Hepatitis B vaccine, but neither of them received it at birth. Hepatitis B is a disease transmitted sexually or through blood. I do not have it, and therefore I found it very unlikely my newborn would be sexually active anytime soon;-) When I asked my pediatrician why the CDC recommends this vaccine at such a young age, he shared with me that it is because the population most at risk for Hepatitis B may not receive regular medical care from pediatricians; therefore, we can “catch” these kids before they are released from the hospital at birth. For this reason and for many others (for which I would like to write a book;-)), my husband and I chose not to vaccinate Andrew against Hep B at birth. This history of the antibiotic eye drops in infants is an interesting one. During the 1800’s, about 10% of newborns developed ophthalmia neonatorum (ON). ON is a type of pink eye that caused blindness in 3% of those affected or roughly 3/1000. Dr Crede in 1881 found that the ON was caused by the mother carrying gonorrhea and administering silver nitrate into the infant’s eyes would prevent blindness. Silver nitrate is very irritating to the eyes, so when antibiotics were developed in the 1900s, their administration became routine use in hospitals for newborn care. The hospital REQUIRES a sexually transmitted disease panel for anyone who becomes pregnant. When my results came back with no indication of ANY STD, I saw no reason to expose my newborn to antibiotic use for a disease for which he is not at risk. My husband and I chose to waive the antibiotic eye-drops for our son. It is important to note that in New York, your choice has already been taken away, and waiving eye-drops in hospitals is no longer an option. I was induced for the birth of my oldest daughter in 2003. There was not any medical reason to have done so except that she was suspected to be “large.” At 22 years old, after a very tough pitocin induced labor and a huge episiotomy, I delivered a normal 8 lb 13oz baby. Her delivery was medically invasive, and I did not feel this was the optimal birth experience. Happy and thankful for a healthy baby girl, I decided that I would not dwell, but would rather learn from this experience and not allow Pitocin to enter my body again. As a side note, if you have not watched “The Business of Being Born,” log onto Netflix now and do so. It contains a wealth of information. I declined pitocin for the birth of my daughter, Cecilia, in 2010 for the reasons I just discussed. When I became pregnant with Andrew in 2014, I had developed an autonomic heart condition, which is dramatically affected by synthetic hormone use. In addition to the stakes being higher for my personal health, the hospital had added ROUTINE pitocin use in the third stage of labor via IV to prevent postpartum hemorrhage. Postpartum Hemorrhage does occur and is very serious. If that does occur, please intervene, that is why I chose to be in a hospital. However, when a normal birth is going smoothly, the use of synthetic hormones before or after birth can cause significant issues. Be informed and know what your hospital protocol is regarding administration of pitocin. It should be your decision. My husband and I chose to waive the administration of synthetic hormones as a preventative measure during Andrew’s birth. The fourth and final waiver of IV antibiotic use for a positive Group Strep B test necessitated the most research by my husband and I. It also, turned out to be the most controversial waiver from the hospital’s perspective. I encourage you to look to the UK model of childbirth for unbiased, medical-based information in addition to the Cochrane Collaboration. The high profits of the American pharmaceutical industry have defiled what was once an innovative and well-intentioned medical industry in the United States. Group Strep B is a bacteria present at all times in a woman’s vaginal/intestinal tract. When it reaches a certain level, a woman tests positive for Group Strep B. Interestingly, there is no level given in the results so one cannot know the extent of the imbalance. Also, Group Strep B can be present one week in larger numbers and much lower the next. Due to its transient nature, 10-20% of women who test positive are actually negative at the time of delivery. Conversely, there are the same number of women who test negative and are positive at the time of delivery. And yet, there is not a spike in the number of newborns developing Group Strep B anywhere in the Western World. The test simply reads positive or negative and which antibiotic is recommended to eradicate the Group Strep B and consequently, your newborn’s delicate gut flora during delivery. There are two types of models used to determine the protocol for Group Strep B. The U.S uses the Universal Model, which administers every woman in the United States who tests positive for Group Strep B intravenously for 4-8 hours before delivery. Keep in mind between 30%-36% of women test positive. That is a whole lot of antibiotic use! Testing positive also results in an additional required day being added to the hospital stay, so clearly, both the hospital and pharmaceutical companies profit from this policy. The U.K. utilizes the Risk- Based Protocol, which states any woman who tests positive for Group Strep B AND falls into a risk category of: being African American, had a previous child with GBS, is under the age of 17, is delivering before 36 weeks, has been laboring for over 18 hours after her water breaks, or currently has an infection or fever can choose to have IV antibiotics administered during delivery. Please note that none of these risk factors applied to me. Based on the statistics my husband and I read, the rate of transmission is roughly 1/500. Some statistics would indicate 1/4000 after eliminating all the risk factors, but I will take the conservative estimate. With a high estimate of 8% of babies actually being saved by intravenous antibiotics, roughly 1/5000 babies will be saved, while 1/3 are given unnecessary antibiotics. The use of these antibiotics can increase the onset of antibiotic resistance infections such as MRSA, sepsis and e-coli. Further GBP positive status alone is a poor indicator of which babies will become ill. Keep in mind, this protocol does nothing to prevent late onset. This is a very difficult decision because although the statistics are numbers my husband and I are comfortable with, if Group Strep B did develop, it could be fatal. To throw another factor into an already difficult decision, there are two types of Group Strep B…early onset and late onset. Early onset occurs in the first six days of your newborn’s life and is mostly preventable through the antibiotic use. Late is most likely to occur around 3 months, has no prevention and no known catalyst. My husband and I chose to waive IV antibiotics for a positive Group Strep B test. Choosing to become a parent is wrought with all sorts of risks. Of the risks that are partially within our control, only you can make the decision as to which risk assessment you are the most comfortable with. Because of my heart condition, I chose to have a hospital birth with Andrew. I surrounded myself with the best team of advocates I could… husband, my mother, my doula and a midwife. The labor and delivery nurse, however, was not of my choosing. I joke that a week after a natural childbirth the only part of me that hurt were my hands—where the nurse had blown three veins;-). IV insertion was the only aspect of delivery I could not waive. My heart did beautifully in delivery, and if I am blessed to have more children in the future, I am undecided as to whether the stress of a hospital birth will be my choice. Andrew’s entrance into the world was one of the most empowering, terrifying and important moments of my life. After he was born without a tear, the midwife cleaned him on me where we were able to rest and bond for two hours. During that time, we stared at one another, nursed and cried. I am forever grateful that being a mother is part of my journey and that Matia has been my partner and guide in finding my way to optimal health. My sincere hope is that the information I have acquired throughout my childbirth process is helpful to another.


deir's picture

I absolutely love this. I shared it with my friend who is a doula and she was also blown away. If only more people wold take teh time to educate themselves. This is truly a woman's rights issue.