I know this is an old thread but I wanted to post my experience.
I choose to decline the antibiotics with my second. I have very fast labours, 7, 4 and 2 hours. If the antibiotics are given for less than 2 hours then you are treated the same as if no antibiotics were given. I am also pencillin resistant with an unknown risk factor for anaphylaxsis so I'm likely to be offered vandomycin because they no longer use clindamycin.
To administer vandomycin IV you have to have a slow drip for an hour, unlike the penicillin or cephalosporins which only have to be administered intermittently. I would be restricted during labour which is not something I am prepared to do as it will likely affect the risk of interventions which can increase the risk of infection (any vaginal exams etc can increase the risk as it can push the bacteria further up.
There is evidence that a water birth may decrease the risk of infection.
I tested negative at 36 weeks with my third. I do suggest they reconsider testing you. the gold standard test for at least the UK and Canada is a test between 35 and 37 weeks due to the fact it comes and goes as this is the most reliable method bar testing you in labour which is in most cases not possible.
I know in the UK it is the woman's choice whether or not to have IAP as well as where they birth. Even though sometimes they forget, they can only advise and cannot tell you whether or not you are going to have them because it ties into consent law. They are not allowed to deny you care based on refused consent as this would not be informed consent but consent by duress.
Its often worth researching for yourself. Informed consent is rarely properly given in my experience. I've been given the benefits of the antibiotics and the risks of not having the antibiotics but this is only half of the story. They are supposed to go into the risks of having the antibiotics as well. Often I've found that they just assume you will have them and can't comprehend why you might not. Some of the things I look into include side affects of the antibiotic some common ones being abdominal pain, diarrhoea, etc , risks of IAP (risk of non GBS antibiotic resistant infection, anaphylaxsis).
With my second pregnancy I had a home water birth then transferred to hospital for obs for 24 hours with the provision that if signs of GBS were found, the baby would have IV antibiotics.
With my third I just had a homebirth. Antibiotics save lives but the rate we use them is causing more risks due to antibiotic resistant strains emerging and there is also evidence that there are studies suggesting a link between antibiotics in the first year of life and asthma. There is also the emerging research on the infant gut biome and the affect of antibiotics. The gut biome is a very interesting area of research and although some studies suggest breastfeeding can negate a lot of this due to the link between the biome and breastfeeding, it should still be a factor. There is also some research emerging into the link between the biome and development of the infant.
Whether or not to have IAP should always be between a mother and her healthcare provider but I definitely think every woman who is GBS+ would do herself a favour by looking at all of the research before coming to a decision.
