There’s that great quote from the writer Elizabeth Stone…
Making the decision to have a child – it is momentous. It is to decide forever to have your heart go walking around outside your body.
…it makes me catch my breathe because it resonates so strongly with me. That’s exactly what it feels like – a vital, beating heart running around you in circles that makes you ache when it aches.
It’s interesting though, I never think of the quote when times are good and I’m watching my son reaping all the joys of life and revelling in new experiences. It only comes to mind when something bad happens and I feel like I’m watching helplessly, knowing that try as hard as I might, there will always be some things in life that I can’t protect him from. Those unknowns that just appear on the horizon without warning. All I can do then is love him and let him know he is loved and safe, as safe as I can possibly make him.
I unexpectedly found myself a guest of one of our fine Dublin hospitals last month. Something that should have just taken an afternoon manifested itself into an unplanned four night stay. Nothing serious but mildly unpleasant and, most importantly, all over now.
In any other circumstances, my short visit would have just been a minor blip in an otherwise routine life work balance which would have returned to normal as quickly as it had occured. But this time, a little 22 month old boy’s mama disappeared into thin air for four long days without so much as a by your leave or a kiss goodbye.
We thought everything was fine though. He hung out with his dada and they had great fun messing around the place. He asked for me a few times but seemed happy enough that I was somewhere else. Then a Skype phonecall, that I thought went well from my side, ended in tears and a long night of settling to bed for Dad.
After getting special permission for a normally forbidden visit, he toddled in to see me the following afternoon. We had lovely cuddles and he sat tightly on my knee for about ten minutes but then the curiosity of his surroundings got the better of him and we decided it might be best they head off before they were escorted out! But there were no tears and a big bye bye kiss and a hug.
The night I was discharged, I got some serious silent treatment. When I arrived in the door, I got a look and then he proceeded to chat away to his grandparents and his dada but looked right through me. Of course I completely understood this, I’d be fairly miffed myself.
But the next day, when he realised I was home for good, everything changed. We had a lovely relaxing bedtime where the three of us hung out singing songs and having chats on our bed to wind things down. I was still quite weak so T was going to put him down for the night.
That’s not how it worked out though. Each time one of us softly suggested giving mama a kiss goodnight, he jumped out of his skin across the bed at me and clung to my chest with a little whimper, saying “mama?”.
Oh then how my heart ached and the silent tears flowed.
And I was angry with myself because I didn’t want him to see that I was upset too. I wanted to be strong for him but I couldn’t hold it in. I don’t think that he noticed, but it does make me worry for when he’s older and more aware of these things. I have no memories of my own parents being upset or vulnerable when I was a child. I only have memories of strength, confidence and support. I’m sure this wasn’t actually the reality but I think is it reassuring for children to not feel they have to “mind” their parents and that being with mum and dad means you’re safe and everything is okay.
I put him to bed that night and it took hours. For the first time that night, he woke several times, crying hysterically and shouting out “mammy gone! mammy gone!”
It’s been like that ever since, well not so many night wakes but at least one with the screaming and calling out. Although it is improving slightly. Even during the day, if I make a move to leave a room or if his Dad wants to take him downstairs for breakfast: “mammy gone? mammy gone?”
The thing is, we know its separation anxiety and we know we can link it to the simple fact that I disappeared suddenly. I went on a business trip for four nights when he was 17 months old and it wasn’t a problem. Okay, I got a half hour of silent treatment and then some angry kicking and screaming when I got home but that was it out of his system then. The difference is he was prepared for my leaving. I spoke about it often before I left and we had regular Skype calls at the same time every night I was away. He might’t have understood literally but he certainly understood on some level.
This has been going on for much longer.
We’ve been giving him lots and lots of attention and I’m taking extra care to ensure he knows where I’m going, when I’m going and when he can expect to see me again. We’re reassuring, try to build up his confidence and his trust.
It’s feels so awful that I created this situation for him. My poor baba.
I also think it might just have happened at a particular time in his development when it would have such an impact, but I don’t know.
Last night for the first time, we got “Daddy gone! Daddy gone!” It wasn’t very nice for my husband to hear but at least it seems change, and hopefully improvement, is underway.
In the grand scheme of things it’s just a very small thing. But sometimes the small things are distressing, for everyone involved.
Remember those sunny, fun-filled days when you were a kid? You could spend hours running around and playing games without a care in the world and with seemingly boundless energy. Remember when you used to play helicopters with your friends and everyone would spin and spin and spin for unnatural lengths of time until you fell down in heaps of giggles? Ah, those were the days.
Have you tried that recently – spinning around in circles? Do it.
See how long you last.
I’m going to guess five – six max – revolutions until you start to feel dizzy, you get a pain in your left brain and you think you’re going to puke. Ditto for running around in circles in the garden. Instant nauseousness.
It would appear it’s a kid thing only. A pathetically adult high centre of gravity maybe? Who knows.
Group B Strep is a totally new one on me. I only learned about it recently when it came up in a couple of online pregnancy conversations I was involved in and I realised I needed to learn more.
Referred to as Group B Streptococcus, Group B Strep or GBS, it is a normally occurring bacterium that up to a third of all men and women carry in their intestines without symptoms and roughly a quarter of women of childbearing age carry in their vagina at any one time. It is an organism that lives on another without harming it. For most women there are no symptoms of carrying group B strep bacteria.
However, where Group Strep B can become problematic is when the bacteria can pass from a labouring woman to her baby. It is the most common cause of life-threatening infections (sepsis, meningitis, pneumonia) in newborn babies. 90% of early onset Group B Strep infection is preventable by treating mothers with IV antibiotics in labour.
What are the chances of my baby developing a Group B Strep infection?
I don’t have any data for Ireland but the following data from the Group B Strep Support charity in the UK are estimates of the chances a baby in Britain will become infected with Group B Strep if no preventative measures are taken and no other risk factors are present:
1 in 1,000* where the woman is not known to be a carrier of GBS;
1 in 400 where the woman is carrying GBS during the pregnancy;
1 in 300 where the woman is carrying GBS at delivery; and
1 in 100 where the woman has had a previous baby infected with GBS.
*This is a broadly accepted estimate of the number of GBS infections in newborn babies that would occur if no preventative intravenous antibiotics in labour are given and this estimate has been used throughout this document. Recent UK research suggested this may be a serious underestimate of the incidence of GBS infection in newborns, which could be as high as 3.6 per 1,000.
The data is a good indicator for Ireland because the UK adopt the same treatment approach as us.
This is most likely reason that I had never heard of Group B Strep before – it is not routinely tested for in Ireland or in the UK, so it doesn’t come up in antenatal care or literature. Irish and UK hospitals adopt a risk factor approach to treating Group B Strep so IV antibiotics during labour will be recommended if:
You carry Group B Strep in your body
You’ve had a previous baby infected with Group B Strep
Your waters have released for more than 18 hours
Your labour starts before 37 weeks
You have a temperature in labour
Your baby’s heart rate is high throughout labour
It is worth noting that 40% of babies that develop Group B Strep have no risk factors. Another additional risk to bear in mind is that many Irish maternity hospitals routinely break a labouring woman’s waters. This carries potential risks to the baby if a mother is carrying Group B Strep but has not been tested. If you have listed that you’d prefer not to have artificial rupture of membranes (ARM) in your birth preferences, it could be worth mentioning the risk factor of passing on an undiagnosed Group B Strep to your newborn if you come up against resistance.
Other countries including the US and Australia test routinely in late pregnancy for Group B Strep.
How do I know if I have Group B Strep during pregnancy?
A vaginal or rectal swab can be taken during pregnancy. The best time for this to be taken is in late pregnancy between 35 – 37 weeks. A positive swab result for Group B Strep means that a woman is colonised with Group B Strep at the time the swab was taken, not that she or her baby will become ill.
What happens if I test positive for Group B Strep in later pregnancy?
Group B Strep colonisation is normal and does not require a women being treated with antibiotics. Preventing Group B Strep infection in newborn babies is the important part, so the time when antibiotics are effective against infection is when they are given intravenously to a pregnant woman whose baby is at raised risk of developing Group B Strep as soon as possible once her labour has started.
Research shows that the risk factor approach to preventing Group B Strep infection in newborn babies, as currently adopted in Ireland and the UK, could prevent up to 6 out of every potential 10 cases. Research has also shown that adopting the US and Australian model, whereby low-risk women are sensitive tested routinely in later pregnancy, combined with offering antibiotics in labour to women at high-risk could prevent over 8 out of every potential 10 cases.
Can I ask to be tested or can I do a home test kit if I’d like to?
If you’d like to, have a chat with your midwife or consultant at your next appointment about testing for Group B Strep so you can make an informed decision about IV antibiotics in labour. If testing is not available you can purchase a private test you can do at home but do check with your caregiver before purchasing the test if they will accept the results of a privately done test because they’re not cheap! Some women under the private care of a consultant do get tested however the test is processed in the hospital’s public lab so all mothers should have access to this test.
But I don’t want to be on antibiotics during labour
Once all the medical facts are presented to you along with the pros and cons of treatment, it is totally up to you to make an informed decision about whether to accept treatment or not. Not every pregnant mother who finds out she is carrying Group B Strep will want intravenous antibiotics in labour. You may decide not to have them unless there are other additional risk factors. It is worth noting that only a small percentage of babies born to mothers carrying Group B Strep at delivery will actually develop Group B Strep infection. You have all of the information, it’s up to you to decide what you think is best for you and your baby. If you do decide against antibiotics in labour, doctors recommend that it would be prudent for the baby to be observed by trained staff for at least 24 hours.
Signs of Group B Strep infection to look out for after your baby is born
If your baby is unwell due to early onset GBS it is likely to show up in the first 12 – 24 hours.
Ongoing grunting of your baby.
Not feeding well
High or low temperature
High or low heart rate
If you have any worries about your baby’s wellbeing speak to a midwife on the postnatal ward.
There’s a lot of information there and it’s a huge amount to digest particularly if you’ve never heard of it before. Please don’t worry, it’s just something that it’s worth being informed about so that you’re prepared. I know I initially thought that it sounded like just one more unnecessary intervention but then I heard from a few Irish mothers who had passed Group B Strep on to their babies and I quickly realised that if I tested positive, given the choice, I would much much prefer for me to be on IV antibiotics for 20 minutes a dose rather than have my tiny new baby on an IV and away from me when he arrived, rather than in my arms where he should be. As with all medical decisions, it’s very much a personal choice.
Weigh it up, see what you think. I know the first thing that will pop into people’s heads is the impact of the antibiotics versus infection risk but read up and make a judgement call. All the power is in your hands once you’ve all the information you need.
There is a huge amount of information on the Group B Strep Support website with a fantastic FAQ section including questions that address home birth, water birth, breastfeeding, natural alternatives, sweeps, ARM, inductions and cow’s milk intolerances to name but a few.