Pregnancy Anxiety and GBS

>> Monday, May 16, 2016

If you've been reading a few years, you sort of "know" me and my tendencies to be, well, wound. I'd say over the last several years, my levels of anxiety have certainly been heightened, especially related to medical stuff.

I mean, I had a terribly irritable uterus in my first pregnancy and always feared I was going into labor from week 17 onward. Then Ada was diagnosed with a brain issue and had a craniotomy with all sorts of risks. After that, we had a short reprieve before the miscarriages started. Oh, and Ada ended up getting the second stage of Lyme disease last summer and I'm not adding in some medical stuff other immediate family has dealt with.

During pregnancy, I've had worry that's both generalized and specific. Of course, I worried early on that I'd miscarry again. But I also received news at an early appointment that I was "highly colonized" with group B strep (GBS) in my urine. This is totally different from the swab at the end of pregnancy. Having this bug in your urine means active infection that needs treatment with antibiotics at the time of diagnosis and then again at delivery. It also increases your chances of passing on GBS to your baby four-fold over regular carriage.

I found out in my second trimester and then again last week that the bacteria was back (so, three times now -- same "infection" levels). I didn't have symptoms this last time at all really, but I asked to be tested out of curiosity. GBS in the urine, which is only found in like 5 percent of women, can put you at risk for preterm labor, premature rupture of membranes, low birth weight, and a host of other bad things, even possible passage of the bacteria to the baby before birth, though rare.

Compared to a woman who simply tests positive with a GBS culture between 35-37 weeks, there's like a 1 in 25 versus a 1 in 200 chance the baby will get the bacteria at birth, too. This figure is if the woman does not receive a dose of antibiotics during labor at least four hours before delivery (doctors prefer to give two doses over 8 hours). And my labor with Ada was like 5-1/2 hours. I am also allergic to the "most effective" drug of choice, penicillin.  

(Other high risk factors include if you gave birth to a child previously infected with GBS, if you deliver before 37 weeks, if you have a fever during labor, or if your water is ruptured more than 18 hours before delivery. I don't mean to overwhelm. I do medical writing over at Healthline these days, so I suppose I'm in the habit of being thorough.)

So, as you can imagine I've been more than slightly freaked out about this situation. The storm clouds are seriously looming over my head. My midwife assures me everything is fine. GBS is no biggie. That complications are rare. That I seem to have "antepartum anxiety" that is leading me to make a bigger deal of this than needs to be. The thing is, though, I'm not entirely sure this "anxiety" is unfounded. Ada's brain condition is one that affects less than 1 percent of people, mostly males. Having three miscarriages back-to-back only happens to roughly 1 percent of women.

We're like the family of rare stuff over here. I try my best not to feel doomed . . . but I also have a history of being blindsided. I want to be prepared and educated about something that could potentially be serious.

So, now I'm deciding what to do. I have an appointment on Friday and I truly feel like all my words are lost. Like I am not being taken seriously with my concerns. I am planning to deliver at the hospital in the area that doesn't have a NICU, but part of me wants to consider changing that plan in the event that something "rare" again happens to us, to our baby.

I understand that there's a good chance everything will be fine. But if something went wrong, I feel like I wouldn't be able to forgive myself for not trying my hardest to set us up for the best-case scenario. Like I said, I just don't feel confident I'll get the IV meds before delivery if it's as fast or faster than when I had Ada. Even if I do, I'm that high risk group and allergic to the best med -- how effective will it be?


I'm also frustrated that doctors seem to treat this condition in different ways. Mine only wants to give meds if things are causing symptoms. We haven't done follow-up tests after the meds to make sure it has cleared, which is why I've ended up asking for additional tests. Others the the whole "test of cure" after meds are over. And they continue medications -- sometimes low-dose suppression therapy throughout pregnancy -- if the bacteria persists.

The thing is: This stuff isn't making my cry. I'm not having panic attacks. I'm even sleeping quite well at night. (Though, I should probably stop reading websites like The Jesse Cause.) At what point is genuine, founded concern something that morphs into irrational anxiety? I suppose this is a question I should explore with a therapist or something. I don't really know. Writing is helping me sort out the discussion I plan to have at my next appointment. In my head, I feel I'm being incredibly rational and level-headed.

Thanks for listening. And I know I'm generally in the whole crunchy way of doing things, but I really don't believe in all the methods I've been reading across the internet to trick the GBS swab test. I mean, who is that going to benefit? Of course having medication when it may not be necessary is a concern, and gut flora is important, and yadda yadda. But, please, don't go and try to trick a medical test for something that could have consequences if not properly diagnosed. That's just my plea from all the forum posts and blog posts I've come across (written by people like me who have no business giving medical advice!).

At the same time, some of this information can be useful. I am attempting to help lower my colony counts by drinking unsweetened cranberry juice, eating garlic, taking two Femdophilus probiotics per day, eating lots of yogurt, and dramatically lowering my sugar intake. I figure these measures can't hurt -- but so far, I've still got the bug. I am surely getting the IV meds (or at least really hope I'll be able to in time).

BTW: I know this post was no fun! I'll be back tomorrow with a Green in 15: Dishwasher tablets recipe.

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