There are some scenarios that arise in labour that mean that you will be offered intravenous (IV) antibiotics in labour. These are given more to prevent infection for your baby than for yourself.
Like every intervention in pregnancy, birth, and postpartum, it is your choice whether you accept IV antibiotics in labour.
If you have had group B streptococcus bacteria found in your urine during your pregnancy, if you previously had a baby affected by group B strep infection, if your waters have broken 18 hours or more (sometimes 24 hours or more, depending on your hospital), or if you are in preterm labour (before 37 weeks), then you will be offered IV antibiotics in active labour. You will also be offered antibiotics if you spike a fever over 38 degrees during labour, although you may be offered a different set of antibiotics if you have a fever.
The antibiotic given is usually benzylpenicillin, unless you are allergic to penicillin, in which case a different antibiotic will be chosen, usually cephazolin or vancomycin depending on how strong your allergy is. You may be offered a ‘loading dose’, which is an initial higher dose to raise the levels of medication in your blood quickly, followed by maintenance doses every 4-12 hours depending on the antibiotic.
The benefits to having IV antibiotics in labour are that it protects your baby from potential infections that can occur if you have risk factors for group B strep such as prematurity, waters broken for a long time, GBS in your urine, or maternal fever.
The risks include allergic reactions, slower microbiome establishment for pēpi and disruption to your microbiome. You baby may also still contract some infections that are not treated with the antibiotic you receive, and there is potential for them to contract infections that are resistant to the antibiotic you were given.
If you choose not to have antibiotics in labour, it will be recommended that your pēpi is monitored closely after birth to watch for signs of infection.
It is possible to have IV antibiotics in labour at a primary unit, and your midwife may support IV antibiotics in the community for home birth if this is what you want.