GBS & QMH delivery

LdeJ

Registered User
I have recently found out that I am a Group B Strep carrier and will be delivering at the Queen Mary. I am looking for advice from anyone who has experienced a natural delivery at QMH who has had GBS. What are their procedures during labour and do they take baby away when born for monitoring and therefore elimiating the possibility for baby to be kept at your bedside?

Any advice on this issue would be appreciated.

Thank you
 
I don't know about group B strep - but my baby was born last week at Queen Mary and she was born 38 hrs after my waters broke and they took her to the Special Care ward for monitoring. From what I saw there, it seemed like they were very "cautious" with things like that and kept the babies under observation for the first 24 hrs pretty commonly... I was really upset about my baby being there because I wanted to exclusively breastfeed, but they already gave her formula as soon as she got up there - even though I fed her right after she was delivered!! But everything was ok in the end and she didn't have any infection and was allowed back with me the next day - but it was really stressful for me. I wish they'd just monitored her more in the ward with me - but I understand that they want to be extra cautious and safe and everything. And they ARE one of the safest hospitals in Hong Kong for you and your baby... but a little less "accommodating" to your desires, I think...
 
I have to agree vir Nicole, I also delivered at QMH and my baby was also taken to Special care for monitoring, where she then stayed for a week! You just have to prepare yourself that they ARE VERY CAUTIOUS and will rather keep the baby in the Special Care Ward for monitoring if they deem it necessary. I just made an arrangement with the nurses there to come in for breastfeeding - not the best arrangement for the first week of a newborn's life, but baby and I survived.
 
I had a natural delivery 4 months ago at QMH and was positive GBS.

After my waters broke I was given IV medication. My labour was slow to progress and they were very keen move things along after the waters broke. I ended up having to be induced.

After delivery baby was taken to the special care nursery for observation for 24 hours. After babe is given the all clear you can have her at your bed.

Yes they were very thorough and careful. I found they were too quick to suggest supplementing with formula and I was just too weak and unsure to protest much. You must be very assertive and speak your mind at all times.

Feel free to PM me if you have any more concerns
 
I also have been diagnosed with Strep B and am delivering at QMH any day now. Does the baby absolutely have to go to Neonatal dept?
Last time i gave birth there they put my daughter in Neonatal because there had been meconium in my waters ( which I expect baby was quite distressed after a failed 48 hour induction), and then they wanted to scan her and keep her under observation because of an enlarged fontanelle.
Anyway I have a terrible recollection of my 2 post c-section days at QMH before they discharged me, but not having my baby near, dragging myself like a 150 year old woman up to breastfeed every 3 hours, walking at a 90 degree angle holding on to the walls for dear life... Giving in to letting them use formula right after delivery "you need to rest, we'll use a cup" ( yeah right!).
So I am quite bitter, I realise that my experience is not the worst and that it was in bubba's interest but I really would like to have a better start to my life with my boy to be... are they being overly cautious and if my son were to catch my strep B would he not benefit from being on my skin, feeding colostrum on demand for the first few days of his life rather than alone in a plastic box with his mum not necessarily there when he needs to feed?
 
personally, i think that if there is any risk that the baby could be infected, it would be in both of your best interests to have the hospital be cautious!

to me, the most important thing was the health and safety of my babies. if that meant that they had to be upstairs in the special care ward (which they both were for 24 hours), so be it. in the long run, we have the rest of their lives. yes, of course it would be nicer to have them with me for that time.... but their health is/was more important than my wishes/desires.

and yes, i let them use formula for the first 24 hours... i then went on to successfully breastfeed both of them. and yes, they did use a cup. i saw them do it with other babies, too. they then asked if i wanted to learn how to do by cup just in case. i figured why not? did i use it? a couple of times....
 
Safety for the baby is most important. I delivered at Matilda and my nan**** ended up at QMH for 10days 4of which were critical and from the beginning the used drip and formula. I went three times daily to deliver expressed milk so being in the same building is a little inconvenience. When baby came out I breast fed without a problem, but was appreciative that ,y baby would use a bottle which meant other people could feed baby my expressed milk via a bottle and I got a couple hours to myself once in awhile.
 
Sorry i think my ranting about my last delivery was misleading. I completely understand that the baby's safety is most important. My main concern isn't establishing breast feeding, or what is more convenient or pleasant for me, but considering they leave them in the box to sleep aside from a few tests scattered throughout the day, I am asking whether the baby wouldn't be better off with me benefitting at leisure from all the antibodies in my colostrum and from breath regulation from closeness with his mother.
 
i think it entirely depends on the risk and how quickly symptoms can develop. a new mother might not recognise any symptoms/problems for what they are.

i would much rather have 1-2 nurses/every couple of babies, where emergency care is readily available, god forbid it was needed.

i'm sorry.... like i said, yes, of course, i would rather have had my kids next to me.... but i wasn't thinking about me. i was thinking about what could be done for the babies when they were in special care. i was thinking, at least up there, they have nurses dedicated just to their care and looking out for any problems. it's not like that first 24 will affect them for the rest of their lives (unless of course, something does go wrong and it isn't caught---that could most certainly affect them forever).

so, yes, while it would be nice to have had my kids near me.... am i bitter that they weren't? not at all! they are healthy and happy 5 & 7 year olds now.

and just so you know, i had two deliveries from hell.... not the fault of the hospital or staff...it was my health issues getting in the way.
 
Is it standard practice in all public hospitals to put newborns in special care units for the first 24 hours or is it just if they see something wrong? Obviously if something is concerning the drs I'm ok with my baby being taken away, but I would be very strongly opposed to him being taken away 'just in case'. As PP said being close to a besotted mum for feeding on demand etc has to be infinitely preferable (for a healthy baby) to being locked away in a nursery monitored by over stretched nurses.
 
no, it isn't standard practice. they only do it if there is a possible issue. both of my kids had issues when they were born.
 
i delivered my son by emergency c-section. i had pre-eclampsia and was left on a drip in the delivery suite for the entire night so that i would have a midwife/nurse to care for me. my BP was through the roof. i think he was put upstairs to make sure that my condition hadn't had too much effect on him. i delivered him around 3pm. they brought him to me about 9pm and took him back upstairs about 10pm. they moved me to the ward about lunch time the next day and brought him down to me to stay then.

with my girl, i had similar issues, but i delivered under general anesthesia (so was totally out of it for delivery)... i didn't recover from that for about 24 hours. her apgar responses were slowed because of the GA. her thyroid was having some problems and she was jaundiced. so they kept here there for just over 24 hours.

it really is for the safety of the babies.

sometimes, i feel like they can't win.... if they thought there might be a problem and didn't take action, they would be accused of neglect and mal-practice... if they take the babies upstairs, they get slammed for being overly-cautious.
 
the are extremely cautious which in terms of the babies health is good. for me nothing is too careful when it is my babies health at stake...though my son was in NICU for 3 weeks with what started out as a simple problem (can't remember the term where babies have to be put under the light cause they're too yellow) and they didn't let him come out because ofthe detection of a low fever, possible signs of meningitis (turned out false), bad kidney and wanting to some medical scan on him (which we decided not to get done cause it was too invasive)...the test was not scheduled till 2 months after the release from hospital since there was a waitlist (and in the meantime we seeked the advice of our pedi. who worked at QMH Nicu for many years and was a kidney specialist - Dr Richard CHiu) and he said no need. anyhow, i know it wasn't a good experience but us as a family but knowing how thorough they are was reassuring in the aftermath.
 
When I registered at Tsan yuk for the Queen Mary Hospital I received a little book with lots of pamphlets in it. One of them was their policy on breastfeeding and other things happening within the first few hours after birth.

I don't have it here at the moment, but it said something like the following

1. Breastfeeding is encouraged and mothers should try to breastfeed within 1 hour
2. In-rooming is encouraged
3. Body contact straight after birth is encouraged

So I think they are just very cautious in case there is a problem, but otherwise they seem to be pro breastfeeding.
 
Although it might not seem as if much is happening in the NICU, the staff do very regular observations on the newborns and there is a slew of high tech equipment and personell nearby should a little wee one crash (and this can happen quickly because the newborns have zero to no reserve). Yes its inconvenient to mums and yes with more $$$$$ in the system they could have it so that mums and babies could stay together whilst these obs are being done BUT in a cash strapped, resources/manpower strapped system I think the Queen Mary does really, really well.
Agree with Carang, the hospital just can't win, damned if they don't take the precautions and criticised if they do.....
 
I've got plenty of experience with QMH NICU and honestly I think they do go to the almost damaging point of overly cautious. My daughter was in NICU for 4 months - other babies in the US who were MORE severe than my daughter were out of NICU and home within 2 weeks. There was no change in my daughter's condition between 2 weeks of age and 4 months of age - and the doctors told me she was there pretty much "just in case". When she was in NICU between 2 weeks old and 4 months old, there was nothing that they did there that we could not have done at home. Of course if she took a turn for the worse, we couldn't give her the emergency care that would have been necessary, but she never once needed that.

Also, my daughter's surgery to mend her cleft palate was also delayed more significantly than it should have been. It was finally repaired when she was 22 months old, although in other countries, kids who have similar conditions have their cleft repaired closer to 15 months (slightly delayed from the average 12 months old). Due to the long delay, we are now (at 26 months old) dealing with more significant speech delays than if the cleft had been repaired sooner. (That wasn't a NICU decision, it was a plastic surgery decision).

I'm not saying that they should not take necessary precautions, but over here they take far more precautions than is necessary in my opinion/experience - and there are frequently negative consequences which I feel outweigh the benefits of that gap between "regular-cautious" and "over-cautious".

Ultimately, I would prefer my doctors to be a bit more cautious than average - however the extremes that I've experienced in the system over here are crazy. That said, my situation is not a regular case... but I have seen a common theme occur over and over...
 
Taking a newborn baby from a GBS positive mother "for observation" makes no sense. The chances of a GBS positive mother passing the infection to her baby during birth are:

- 0.5% without IV antibiotics in labour
- 0.025% with IV antibiotics in labour

The risk is extremely low as you can see from these CDC statistics!

There are many other infections a newborn baby is more susceptible to and more likely to contract (e.g. respiratory infection, gastroenteritis, non-GBS meningitis etc.) and by taking the baby away from his mother, his chances are even higher of contracting one of these. A newborn baby in constant skin contact with his mother and receiving her colostrum has better oxygen saturation, a stronger immune system and better stats overall.

So in short, taking a baby from his mother for the 0.5 - 0.025% risk of contracting GBS, is putting the newborn at a very real risk of more likely and more common other infections?
 
Ok so back from QMH: was admitted with 1 minute contractions every 5 minutes for an hour. About 9 hours later my cervix had only dilated by 2cm, baby's heartbeat was "not good" with each contraction and induction was not an option as i had had a previous c-section. Dr said he couldn't see the point in waiting doubted my cervix would open much more so had a c- section about an hour later.
As expected they took baby up for 24 hour observation because of the GBS and because baby was a bit apneic at birth though was immediately stabilized. Was denied my request for immediate skin to skin contacts after birth and for delayed cord clamping.

Was also denied to be taken up in a wheelchair to breast feed baby every 3 hours and had to wait until visiting hours the next day. Was told they would have to supplement or baby would need a drip. Might have been able to see him sooner but Dr decided I wasn't passing enough urine, which I tried to explain was normal as I hadn't been drinking since long before the surgery and don't want to drink too much when I go the go ahead as I was afraid to overload my system. Baby was released after 23 hours observation. We were discharged 44 hours after the operation. Not my ideal birth story but glad to be home with baby.
 
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