Daughter told to do her own cultures...

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Is this something new? My daughter's midwife told her to do her own beta strep cultures and she called me asking how she was supposed to do this. Of course I told her under no circumstances was she going to go poking things inside of her. She said she couldn't anyway because she wouldn't be able to stretch around her belly to see what she was doing. They wanted one from her rectum as well. She was like: "eeeeeewwwww" :roll

My question is why?? I know it is a simple swab, but why have the woman do it if she is coming in for her visit anyway? I just don't get why the provider would have the pt do that herself. All you need is one sick kid with GBS who had a mom test negative because she did her own culture and the lawyers would jump on it!

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Why? Because it's not rocket science. Because there is no need to have a person with a license or medical degree do it. Because some women don't want just anyone fiddling around their lady parts and rectum.

As far as a legal issue--what's the issue? The GBS swab is incredibly inaccurate anyway. How can you possibly say that someone who swabbed negative at 35 weeks is still negative at 41 weeks? The GBS swab is no guarantee, especially if it's negative. We are following ACOG guidelines in swabing at 34-35 weeks, following our standard of care. And frankly, we aren't very concerned with what the lawyers would do. We haven't ever been sued. When women feel like they are in charge of their care, when they feel like they are partners in the entire process, and their bodies and wishes are respected, they don't sue. If you are following standards of care, neither can the state.

We also don't do routine lady partsl exams, ESPECIALLY prenatally. Certain instances, sure. But we don't need to be messing around down there. It's really freak you out to know that we have women who routine refuse the GBS swab. We recommend they do the swab, but we really encourage it to be an educated choice, one way or another. Their educated choice.

I guess I'll turn it around and say "Why not?"

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My question is why?? I know it is a simple swab, but why have the woman do it if she is coming in for her visit anyway? I just don't get why the provider would have the pt do that herself. All you need is one sick kid with GBS who had a mom test negative because she did her own culture and the lawyers would jump on it!

Because some women like a little empowerment every now and then. And why not collect a simple swab yourself rather than lie in a paper gown on a cold exam table with your bottom half exposed for a smiple swab?

And I'm sure there are many tests performed by practitioners that come back with a false negative. It's not really all that accurate. The only reason I agreed to it, was in the off chance that I delivered at the hospital, I didn't want them to insist on a course of abx because I was GBS unknown, or insisting that baby stay longer in the hospital if I refused tx, kwim?

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Specializes in OB, Telephone Triage, Chart Review/Code.

Hey mitchsmom...thanks for the info! My daughter is not the only one who feels this way about breastfeeding. Lately I have had some patients who feel the same way.

As far as the cultures go, I feel that if you are in the office anyway, why not just go ahead and get the cultures. Or at least give her the choice of doing them herself or having it done.

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My question is why?? I know it is a simple swab, but why have the woman do it if she is coming in for her visit anyway?

Hmm, did I misinterpret this perhaps? Were you thinking that the cultures weren't obtained in the office? The cultures are obtained in the office, it's just that we have the woman collect the specimen instead of us. I mean, we also have them collect their own clean catch, midstream UA. We *could* do it with a straight cath, it'd be more accurate that way. But we don't, and most practitioners don't, either. That's how we look at the GBS swab collection.

Did that maybe clarify it a bit?

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Good info, mitchsmom!!!! You are a fountain of wisdom.

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My clinical setting offers women the choice between us doing the swabs and doing the swabs themselves. Virtually all of our moms choose to do the swabs themselves....

Becki, SNM

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