[lavatea]

I am currently working on getting into a BSN program and my plan is to become a CNM eventually. I have a question based upon my own birthing experience. I am strep B positive (I think that's what it is called) and my OB gave me an IV for this. Do CNMs follow that as well? I always wanted a birth free of IVs, etc, and although that has yet to happen, I still dream that I will one day deliver naturally. Is this an issue that will always make my dream impossible? Or is this just an example of defensive medicine?

BTW- I'm not looking for medical advice on my situation, so please don't misread my post this way. I'm actually just using my own experience as an example of a question I have regarding the basic philosophy of CNMs vs. OBs. I hope I'm making sense.

[april&em]

Untreated Strep B is not something any medical professional wants to take a risk on. I was tested by my CNM so that I didn't have to have the antibiotics prior to birth, but my sister is a lay-midwife and they will not do a home birth at all if a person tests positive for Strep B

[beckinben]

Originally Posted by lavatea

I am currently working on getting into a BSN program and my plan is to become a CNM eventually. I have a question based upon my own birthing experience. I am strep B positive (I think that's what it is called) and my OB gave me an IV for this. Do CNMs follow that as well? I always wanted a birth free of IVs, etc, and although that has yet to happen, I still dream that I will one day deliver naturally. Is this an issue that will always make my dream impossible? Or is this just an example of defensive medicine?

BTW- I'm not looking for medical advice on my situation, so please don't misread my post this way. I'm actually just using my own experience as an example of a question I have regarding the basic philosophy of CNMs vs. OBs. I hope I'm making sense.

I offer testing for GBS. Most women accept testing. I do believe that all women have the right to decline testing if they desire. I follow the CDC guidelines for GBS pretty religiously. There are a lot of providers (especially OBs) out there that do not, which irritates me, because usually they are overtreating and contributing to overuse of antibiotics. If someone declines GBS testing, I treat her as "unknown" per the CDC guidelines, which basically means no antibiotics unless there are risk factors (fever, prolonged ROM, or prematurity). If someone tests positive, I do give antibiotics in labor. That means being hooked up to the IV every 4 hours or so (depends on abx given), the rest of the time, she can have a heplock only. IV antibiotics for GBS is not a reason to have a continously running IV.

There are midwives who will do a homebirth with a GBS positive woman. Some midwives have the ability to do intermittent IV antibiotics at home - it depends on the laws in each state and what type of midwife it is if that is possible or not. Many homebirthing women, I would bet, don't bother testing in the first place.

And, FYI, the CDC guidelines also state that being GBS positive in one pregnancy does not mean a woman should be treated as automatically positive in the next pregnancy. I have seen women test positive in one pregnancy and negative in the next.