(above: 4 happy healthy babies, GBS status “unknown” at birth)

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I work with many pregnant mothers, and GBS is one of those topics that consistently comes up with women who are close to giving birth.  Through the women I work with, I have learned about what “informed consent” looks like, at the Dr. Everett Chalmers Hospital, here in Fredericton, my city:

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When a woman in Fredericton is pregnant, she is scheduled to receive the GBS (group b streptococcus) test during her last weeks of pregnancy.   GBS is a normal part of human flora, and is present in the bodies of between 10-40% of all people.  The test isn’t mandatory.  But women in Fredericton will find that most often, rather than being offered the test, or asked if they want to receive the test, they are simply scheduled for the test—it’s routine!  It’s protocol.  But supposedly, like every procedure, one has a choice as to whether to undergo the test or not.  Women are people after all, are we not?  Informed consent.

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When a woman declines the test the doctor or nurse may ask again.  Sure, “informed consent”, but that doesn’t mean the doc can’t press the issue! They have your best interests at heart, after all.  They may gently inform the woman of the risks of GBS.  They may inform the woman of the risks of GBS again. They may ask the woman if she is comfortable compromising the life of her unborn child?  When the woman declines the test for a third or sixth time, the doctor or nurse may shake their heads knowingly, dismayed at the obvious stupidity of this woman.  Then they may indulgently inform the woman that “it’s up to you”, but that if she does not submit to the GBS test, she will be treated as though she is automatically GBS positive.

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When the woman asks what this means, she will be told that an IV drip of antibiotics during her birth process will be mandatory.  “Mandatory?” The woman asks.  “Well, highly recommended”, the doctor may concede.  Or he may simply say “Yes, Mandatory.” And when the woman then says “No, I will not be receiving an IV drip of antibiotics”, the doctor will patiently explain that “while it’s your choice to take the IV or not, if you choose not to, your baby will automatically be required to spend the first four hours of its life in an incubator at the NICU for observation”.  And if the woman states that this is unacceptable, she will hear from the doctor, “I’m sorry.  It’s policy.  And it’s really for your baby’s safety.  You wouldn’t want your child to die, would you?”

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I should say that I don’t actually know, for a *fact*, whether or not the NICU visit and “observation” is actually mandatory (in the case of women who decline the antibiotic drip), but I do know for a fact that several women, many women, (most women?) at least in Fredericton, are told that indeed it is.

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This is “choice”.  These are “options”.  This is “informed consent” here in Fredericton, at the DECH.

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Now many of you may be thinking that this doctor probably has a good point.  What kind of mother *would* want to take this sort of risk with something as serious as GBS, and possible infection, and meningitis?

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In an upcoming post, I’ll be unpacking some of the myths and misconceptions around GBS.  I’ll be discussing hospital policies, touching on some interesting scientific research, and looking at what is done about GBS in other countries, GBS when planning a home birth or unassisted birth, as well as the risks of antibiotics during the birth process.  I’ll also discuss my own choices when it comes to GBS, for my babies (I have *never* been tested for GBS, and I will never be tested—and I’ll explain why).

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(If you haven’t yet received my little guidebook for ecstatic birth, download your free copy here.)