Special points of interest:

• A human pregnancy is 9 full months  (40 weeks).
• A human pregnancy is 280 days from conception.

More than 80% of babies are born between two weeks before to two weeks after their due date. These babies are not considered early or late. Only 5 out of 100 babies are born on their ‘due date’!!!

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Group Beta Strep: GBS

     Group B Strep, also known as Beta Strep or GBS is a bacteria that can live within humans. About 25% of women are carriers of this bacteria and don’t even know it. They don’t have any feelings of illness and are not sick. It is not a sexually transmitted disease, so you don’t have to worry about your husband or partner getting it. The risk to your baby comes at birth.  

Effects on the Baby

     98-99% of all babies born to infected mothers will not become infected, if treated. Of those who become infected few will have any problems with the treatment for the infection. There are two types of infections: early and late.

     Early infections tend to occur usually within the first six hours after birth, and most by the seventh day of life. This infection can cause inflammation of the baby’s lungs, spinal cord or brain. About 15% of these babies will die from the infection.

     The other infection, late infection, occur after the first seven days of life. Half of these late infections are not from the mother but from other sources of infection, such as contact with other carriers of GBS, including hospital personnel. Meningitis is the main risk from late infection, which has long term problems associated with the baby’s nervous system. However, babies with late infections are less likely to die than those with early infections.

 Risk Factors & Testing

      During birth as the baby passes through the vagina it comes into contact with the bacteria, making it more likely for the baby to get Group B Strep. To prevent this from happening women who test positive or who have had a previous baby with Group B Strep will be given IV antibiotics during labor. If you were not tested at the end of your pregnancy and you go into labor you will be treated if you have any of the following symptoms of a Group B Strep infection:

•  Water is broken greater than 18 hours
• You run a fever of 100.4 degrees or higher
• You are in labor prior to 37 weeks

The Centers for Disease Control (CDC) guidelines are summarized as follows:

• Every woman should be tested between weeks 35-37 of gestation with a simple vaginal and rectal swab. This is obtained at your OB visit at 36 weeks.
• If she tests positive she should be treated with antibiotics in labor.
• If a woman has tested negative within five weeks of labor, she does not need to be treated in labor, even if she develops risk factors.
• If a woman has an unknown GBS status in labor, she should only be treated if she develops risk factors.
• A woman should be treated in labor if she has ever had a previous baby born with GBS or if she has tested positive at any time during her current pregnancy.

 Common Questions about GBS

GBS is a naturally occurring bacterium in the body of both men and women.

Can I still breast-feed if I have GBS?

Yes you can. A colonized mother will not pass the bacteria on to her child.

Is there a vaccine?

     Not yet, although they are working on it. So, someday there may be a vaccine. The Federal Government is currently funding some studies.  

Would a cesarean prevent transmission to the baby?

     No. There is not even a need to treat with antibiotics unless your water has broken in this case, or unless you need antibiotics for another reason. There have even been documented cases of babies born by cesarean who have developed infection through the amniotic sac, which was not ruptured until the surgery under way and birth occurred within seconds of rupture.

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DUE DATES

   Due dates by very early ultrasound are the most accurate… later U/S are not.

     Remember that we are measuring a flat picture of a three dimensional baby, and then estimating how far along the pregnancy is by the size of the leg bone or of a line drawn across the head.  These dates are educated- guesses, based on measurements, not to mention that babies of the same age can be very different sizes… and look like their parents!
   By the time you can see the sex of the baby on ultrasound (around 20 weeks) the measurements are only accurate to about two weeks before or after the due date. In other words–if the baby measures 20 weeks size, he could really be anywhere from 18 to 22 weeks. In the third trimester, ultrasound dates are give or take three weeks! 

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INDUCTION OF LABOR:

MEDICAL & NON-MEDICAL

    In other OB practices, more and more births are being scheduled ‘a little early’ for non-medical reasons. Experts are learning that this can cause problems for both mom and baby. If possible, it’s best to stay pregnant at least 39 weeks.

   There are lots of important things happening to your baby’s brain and lungs in the last few weeks of pregnancy… they are still growing.

     Remember, this is not your birth… it’s your baby’s birth!

   Quoted from March of Dimes research 10/2008

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  POST DATES TESTING

   If you are pregnant one week past your predicted due date, you will be seen for your next OB appointment at the FAMILY BIRTH CENTER at Legacy Salmon Creek Hospital for testing.                                                                     

    This test is called a Non Stress Test (NST), and uses a fetal monitor. The monitor has two belts that go around the mother’s waist: one registers any contractions she may have, the other tracks the baby’s heart rate. The NST is not uncomfortable and takes at least 20 minutes, and, sometimes, up to an hour.  If the baby’s heart beat goes faster with a contraction or when the baby moves, this tells us the baby is OK. This test will be repeated again at 10 days past your due date.                         

     The second test, that will be done at the same appointment, is an Amniotic Fluid Index (AFI), an ultrasound that looks at the amount of water around the baby in your uterus. This can also tell us if your baby is OK.

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 INDUCTION OF LABOR: SUGGESTIONS after 39 weeks

Remember: this is not your birth… this is your baby’s birth!

1) DO make love…semen has prostaglandins!

2) DO nipple stimulation

3) DON’T walk to try to start labor!! It won’t work and it will exhaust you.

4) DON’T take Castor Oil unless your midwife says your cervix is ready.

5) Ask us for the APPROVED, SAFE blue and black cohosh recipe… can start it at 39 weeks.

REST, EAT AND DRINK HEALTHY.  

Call US with questions… sleep while you can. It’s what you’ll miss the most after the baby is born!