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February 10, 2001
Let me preface this by saying I love my midwives. They listen to me, and are never condescending. I have great respect for them, and am comfortable with them.
When the midwife explained my infection to me, it made sense, but it doesn't seem to anymore. She said that the antibiotics (Keflex, 1500 mg a day) I was taking destroyed the natural balance of bacteria in my body. (That I know.) And that I have bacterial vaginosis. She did take a sample and look at it under a microscope, so it wasn't just a blind guess. I've been prescribed metronidazole, which *is not* okay with breastfeeding. Grr. I haven't started taking it. I emailed then asking if they knew I couldn't take it while nursing, but they won't be in until Monday. Midwife Mary may have put in my chart that I'd agreed to wean Jake, but now that I'm not in pre term labor, there's no way I'm going to wean. And no one told me I shouldn't take this drug while nursing, or asked me if I was still nursing. If I had been one of those people who don't read the info, I would never have known.
About the drug:
http://my.webmd.com/content/asset/uspdi.202365
And I have big objections to strong systemic medications, like this is. It was a strong systemic medication that got me here in the first place. And I had not taken meds since I was a child (other than vitamins, and the occasional migraine pill).
Btw, I was taking acidophilus and bifidus. (sigh)
[later February 10]
This is the email I wrote to my midwives after writing a shocked one about metronidazole. (And I do hope they won’t mind my posting it here.) It contains links to really good info about metronidazole, bacterial vaginosis, and an alternate drug that is safe for both pregnancy and breastfeeding. I hope this is helpful. I include it here only because it summarizes my feelings very well and contains good information.
Btw, no one knows how bacterial vaginosis is caused, but it sounds plausible that taking strong antibiotics could do it.
And BV is common among pregnant women.
******************
I was unnecessarily harsh in my last email, and I sincerely apologize.
I do continue to have some serious concerns:
It was not explained to me the seriousness of bacterial vaginosis. I assumed it was about as threatening as a common yeast infection. I did not know that it could pose big risks for pregnant women, including preterm birth.
I thought that the diagnosis of BV meant I was not in preterm labor, and otherwise fit and healthy. Thus my decision to continue breastfeeding my son. I firmly believe that the stress of weaning him suddenly would be far worse for me than the possibility of causing contractions. Every time I told him no, and tried to explain why, he would beg and I would break down and sob. I am under a great deal of stress now, as well as being very lonely. I'm not willing to wean. I have not had one contraction, or one more episode of bleeding. I do not believe I am in any danger. And I don't think you believe I am in any danger, or you would be having me come back sooner than the end of February.
However, upon researching BV, I've learned that this infection can threaten my pregnancy.
From WebMD:
http://my.webmd.com/content/article/3724.519
Excerpt:
"*Pregnant women with BV more often have babies who are born early or with low birth weight.
*The bacteria that cause BV can sometimes infect the uterus (womb) and fallopian tubes (egg canals). This type of infection is called pelvic inflammatory disease (PID). PID can cause infertility or damage the fallopian tubes enough to increase the future risk of entopic pregnancy and infertility. Entopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube.
*BV can increase a woman's susceptibility to HIV infection if she is exposed to the virus.
*Having BV increases the chances that an HIV-infected woman can pass HIV to her sex partner.
*BV can increase a woman's susceptibility to other STDs, such as chlamydia and gonorrhea."
I understand the necessity of treating this infection as soon as possible, and had forgotten that no one checks the email over the weekend. I had imagined someone calling me today, instead of Monday. (feeling sheepish)
WebMD recommends either metronidazole or clindamycin to treat BV, and both are safe for pregnant women. However clindamycin is safe for breastfeeding women, whereas metronidazole is not.
Clindamycin: http://my.webmd.com/content/asset/uspdi.202145
Metronidazole: http://my.webmd.com/content/asset/uspdi.202365
Clindamycin is available in vaginal form, (http://my.webmd.com/content/asset/uspdi.202700) which I am perfectly willing to use.
Metronidazole also comes in vaginal form (http://my.webmd.com/content/asset/uspdi.202704), however it is still not recommended for breastfeeding women.
I have serious reservations when it comes to strong systemic medications. It was Keflex that got me here in the first place. (I saw the need for the antibiotic.) I haven't taken medication like this since I was a child. I vastly prefer holistic ways of healing, although I do know that those ways sometimes simply won't cut it, and modern medicines play an essential role.
My preference is the vaginal clindamycin, but I am willing to take the oral form. However, I will not be weaning my son to take a drug that has not been tested in pregnancy at all, like the metronidazole.
I would also like to know more about how my diagnosis of BV was made. According to the article (referenced above) from WebMD about BV, I am missing almost all of the symptoms. It does say that some women have no symptoms at all. And it says this is common for women who have a new sexual partner, or many sexual partners. I have no sexual partner, and haven't since September (and he was certainly not a new partner, being the father of my first child). I understand this does not rule BV out. (I'm just hoping I could have something not so scary...)
My point in this long email is to ask that my prescription be changed because I am breastfeeding, and clindamycin appears to be the safer drug for both breastfeeding and pregnancy.
And to apologize for the extreme rudeness and snottiness of my last message. None of you deserved such a tone, and I deeply wish I could take it back.
Thank you.
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