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Ask A Midwife

Q. Good Day,

I would love to have a question answered, if you are not too busy. Thanks for having such an imporant question/answer board around for moms like me.

I had a baby girl 15 months ago, and we are considering having another child next year. My daughter's birth was very complicated, and we are nervous that the same complications will happen if we try again for baby number 2.

At 39 weeks, I thought I was leaking amniotic fluid, so I went to a busy, well known hospital (in the city), had the water tested, and was sent home. I was group b strep positive and reminded the doctors of that, but they still sent me home.

Four days later, I had contractions, leaking, bleeding, etc. I went to the hospital, they sent me home saying I only dialated to 3 cm, they would not admit me unitl I was 3.5 cm. Finally 10 hours later, they admitted me.

During a 24.5 hour labor/delivery, I was given antiobotics for the last 3 hours (according to the peditrician). My ob/gyn will not admit to that however. My fever was 103 the whole time, and my daughter's heartrate was 200 the entire time (Yes, I was very scared). The dr. broke my water, nothing came out except meconomim. She asked if I experienced any leaking, I screamed YES, I WAS here on SATURDAY!

The baby came out with forceps, and was in NICU for treatment of infection. The dr. never admitted to any of these problems, as I asked to speak to her about it at the postpartum appointment. Her answer was "your daughter was doing jumping jacks, that was the only problem/complication".

I switched doctors and hospitals, and I was wondering the likelihood of having this experience again, if it was my fault, or the dr., and if I should go for it and get pregnant.

I am sorry for such a long letter, I have been really interested in getting pregnant again, yet at the same time, very scared.

Thanks for your help.

A. Nice to hear from you, and first of all, good for you for doing your research ahead of time.

Here are some Web Sites that will give you more information about GBS:

• http://www.groupbstrep.org (very helpful and very informative site.
  There is also a GBS Email Mailing List you might find very helpful)

• http://pregnancy.about.com/ (go specifically to the section Group B
  Strep. March of Dimes has some handouts On Line)

• http://www.cnm.wa.org/websites.htm (go to Organizations)

GBS is a very complicated infection, and different providers approach it differently. In 1996 Guidelines for GBS were published by the American Academy of Pediatrics and The American College of OB/GYN's, and providers are supposed to follow these guidelines.

Once it is determined someone is GBS +, specific treatment plans are spelled out in these guidelines.

I think the important thing with GBS is your own awareness of the bacteria and how your care should be managed. About 40% of women carry a strain of this bacteria that puts them and their baby at more risk. By no means does this mean you shouldn't have your second baby, you just need to be well prepared.

Please ask me further if you have more specific questions.

Pat Sonnenstuhl is a semi-retired nurse midwife with over 30 years of experience in health care (first as an RN, then as an ARNP, CNM). She has experience with hospital nursing/midwifery and home and birth center midwifery.

Two areas of special interest to her are GBS and nutrition.

She is about empowerment, and helping folks find their own answers, what is right for them, not what is right for her. But, she wants you well informed.