Born: July 12, 2015. Age harmed: 7 Hours. Pregnancy: 38 Weeks (c-section). Mother tested? yes, negative for GBS.
Let me start by saying I had fantastic prenatal care from 6 weeks of pregnancy! I was being seen in the ob department of the clinic I am a nurse in. Ultrasounds and labs from day 1--more spoiled than any pregnant nurse should be! If I had an elderly patient on the scale that teetered a bit I had three coworkers there ready to catch them because by all means my sweet baby and I could not be in danger! I had the most fantastic ob doctor who just so happened to be one of the owners of the clinic so that relieved the stress of being worried about your boss not understanding! He would listen and explain things to me throughout my pregnancy and made me feel like I wasn't actually doing it alone. I felt pretty comfortable--I even had a placental bleed and remained calm!
During the second trimester things changed a bit. I had issues as Eli grew! I would pass out when he cut off my blood flow. I once woke up to a couple mid-levels, a mid wife, and a few nurses starting an IV with a Doppler on my tummy. All I could hear was somebody saying is all she will want to know is if he is okay. And he was! My doctor and I had a talk and as always he eased my mind. My little boy was perfect but they were going to send me to maternal fetal medicine to get clearance to deliver in our small rural hospital. After all I did not want to deliver anywhere else. I was told the hypotension issues were less common than hypertension but as long as I was monitored well and positions changed they didn't see a reason that things couldn't go as planned!
Well, before I knew it 36 weeks was here. My doctor was getting one of his trips out of the way. His other would be in two weeks because, of course, he couldn't take off during the week I was due! He promised! One of our precious midwives did my GBS testing, I am going to be honest. I never had researched it much... I just knew it was detrimental to have and if the test was positive there was a prophylaxis protocol in place! So I didn't need to know much more right?? I was no doubt a compliant ob patient, you told me to do it... I was on it! Well, I got the negative results back--I was good to go! I had my RhoGAM (Rh immunoglobin)-- little boy just had to bake a little longer and we could get on with our forever. Getting down to crunch time my house became available 4th of July weekend! Thank goodness Eli and I live in the volunteer state and folks jumped in to move a soon to be single mommy into the beautiful home she had worked so hard for to give her new son! I had an ultrasound and appointment on July 9th. My due date was the 28th so in my world I had eternity to finish everything...
The day before my appointment was the first time in my pregnancy I had called into work because I was terribly sick. I chalked it up to moving in the heat a few days earlier! So at my ultrasound the next day I was joking with the tech as always... I've known her for years. She usually would turn the screen pretty quick for me and I knew he was okay. I could feel him move and had listened to him on the Doppler earlier.... she was very quiet but digging in my belly. She nonchalantly asked if I had settled in the house. I laughed and said, "No, thank goodness. I have two more weeks and I hadn't even bought my pajamas or packed our bags!!" She looked terrified. I made her turn the screen around and what I found is that she was measuring very little fluid and couldn't find a pocket! From that moment on for the next two weeks it was like I was looking in on someone else's life.
I was admitted to the hospital to start immediate induction and I clearly remember as the admitting nurses were going through there checklist allergies- tree nuts abo- A RH factor- negative willing to accept transfusion- yes group b strep- NEGATIVE! Not a second thought.... Well, luck would have it that my induction didn't go like most. I suffered through the horrid pit contractions that were not considered active labor for three days! I was in tears on the 11th. My Dr who had stuck with me came in to tell me he had to leave for his trip but if I wanted to be sectioned they could wait and he would do it! Truth is I was selfish. I did not want the healing time or the scarring and I knew I couldn't really afford two extra weeks off work so I told him I wanted to wait until I had no choice. So we broke my water hoping that would kick start it but also knowing we started a countdown... After a few hours I opted to finally do an epidural and honestly I was more excited to be cathed so I did not have to try to walk to the bathroom because I was so weak. Throughout that day I did not have much progress and when they came in close to 11:00 that night to start a back up IV because they knew there would be a baby the next day--just did not know the delivery mode!!
They attempted 37 times. My bp bottomed and my epidural was revoked! Things looked pretty dang hopeless at that point!! Well at 4:30 that morning I decided that it was mind over matter and believe it or not I finally started to progress! On July 12, 2015 @7:53 within an hour of them having to prepare me for a c-section, my little boy finally made his appearance and boy was he perfect! They promised he would be perfect and he was!!! They laid him on my chest and all the bad went away. It was going to be good for him and I from here on out! His color and cry was beautiful! 6lbs 14oz 19 inches long has never looked more perfect! They took him to the nursery his newborn assessment was good and he had a good apgar score. They cleaned him up nicely and brought him to me! About two hours had passed. I was going to breast feed so I decided to give that a try. He had a little difficulty latching but I chalked it up to him being groggy from the mess left over from the epidural the night before. He felt a little cold so I asked the nurse to put him in the warmer and I would shower before we had visitors. So the day went on. In between guests I would attempt to feed but he absolutely wouldn't latch. I called the nurse in desperation and asked her if that was that not supposed to come naturally. She did a couple things and had a blank look on her face and said he needed to go in the nursery. A year or so later I was told by this nurse that in twenty some odd years of working in L&D she hadn't ever had a baby to feel like that and in her mind she feared he was dying.
As she was walking out I felt something was very wrong. I told her that at that point breast feeding was not so much my priority just please get him to eat. Everyone had left and she came back in and she told me she really felt something wasn't right so she had got an order for a CBC and his WBC had come back at 20,000 and the on call was on his way in. When the on call arrived he allowed me to go in the nursery. (My son was the only baby there and all the attending work at the clinic I work at). At this point they've started an IV and had an o2 hood on him. While he was stable we opened the blinds so the family could see him. I was trying to reassure everyone this was nothing! I was watching his o2 saturation drop despite the constant flow. Again I hear GBS negative and think NOTHING!!! Well about that time the attending says I'm not really sure what to do. We usually have well babies! I immediately went into medical mode instead of mom mode! Before becoming a nurse I worked in a lab so I thought to ask about the CBC... I told the doctor I would prefer that they get a venous stick because when he consulted with a NICU I did not want it postponed because that's what they would want. We decided it was best to do a blood culture a metabolic profile and blood gasses as well! I opted for them to consult Lebonheur in Memphis TN due to family ties and the fact if he were to be transferred the parents could stay in the private room with the child. Well as the labs came back it showed sepsis and metabolic ketoacidosis for starters. We wouldn't know the culture results for a few days.
Lebonheur advised to give him a dose of gent and amp. After an hour or so the grunting started to improve as did his breathing but that was temporary. Lebonheur was supposed to have a bus in route but when they called results from the repeat labs they stopped the bus and send the pediflight crew. Then I helplessly watched my baby being strapped in a box in order to be put on the chopper... My discharge papers were being started. That was the quickest trip to Memphis I had ever made. My sister got me there in about a hour and 15 minutes opposed to the two hour or so it usually takes. It did not really hit me until I seen the giant Lebonheur Heart in the sky and a helicopter flying over and it probably wasn't his but I lost it.... we sat in the waiting room for about three hours. I was desperate! I was hurting and tired and I just wanted to know something. I just needed to see him. Finally somebody came out and asked if I was his mother and I refrained from saying, "Does anyone else look like they gave birth today?!!" She proceeded to ask this question: Were you tested for group b strep? And my response was yes yes yes! And she asked the results and I'm afraid I yelled negative and I started to look at his father and his grandparents and my sisters and started to feel so guilty... I started to really feel like I had done something to hurt him or they were going to think that I had done something! If I heard GROUP B STREP one more time I would scream!
After an hour they let his father and I go to to the back where I was informed while in flight my son went into full respiratory distress and they had been working to stabilize him. He was extremely critical and would be touch and go for the night. If he made it through the night, when they received results from the spinal tap and other test they would develop a plan. So it was time for everyone to leave even his dad had to go home and sleep in his bed. So I set up camp next to his bed, I did a lot of praying and pleading but oh was that a beautiful sunrise when my baby was still breathing and you can bet this mommy was waiting for the doctors t show up! Meningitis was confirmed. It would be two weeks of gent and amp. He was put on dopamine and had to have morphine at one point he had a picc line and several iv's. He was NPO for the first week and lost 1.5 pounds. I had to send some body to shop for smaller diapers and clothes but I didn't care because my baby was going to LIVE! Oh and remember that blood culture, well we got those results on the third day in.... wouldn't you know group b strep.... it was rare that I had it and tested negative but his early onset was even more rare. After being released we had to follow up with audiology every three months to check for damage to his hearing organ now we do it every 6 months until he is three. As terrible as this is we were no doubt blessed... and I can't stress enough to girls about being proactive in your prenatal care... if this can happen to me when I went by the book just think how much easier it would be if you aren't compliant. When our ob patients complain about the swab I tell them they are doing it because they love their baby! I can only hope that technology can only improve to help eliminate situations like mine. There is no doubt Group B Strep had a huge impact on my son and me. — Daisy West, USA
To learn more about Why Membranes Should NOT Be Stripped, click HERE.
To learn more about the Signs & Symptoms of GBS Infection, click HERE.
To learn more about Recurrent GBS Infections, click HERE.
To learn more about How to Help Protect Your Baby from Group B Strep (GBS), click HERE.