One of the first things I learned in nursing school was how to spot the distinctive condition that is Clostridium difficile bacterial infection (C. diff).
If you haven't had the fortune of learning how to spot C. diff (Hint: It involves a smell like no other), I would say you should keep it that way. But if you're suffering from C. diff during your pregnancy, or are concerned about your risk, here's what you need to know.
What Is C. Diff?
C. diff, Clostridium difficile, is a type of aggressive bacteria that causes extreme diarrhea and a distinct, putrid smell.
C. diff is a very dangerous bacteria. Serious complications from C. diff can include:
- toxic megacolon
- kidney failure
- electrolyte imbalance
- low blood pressure
- bowel perforation
Why Do People Get C. Diff?
One of the most common reasons a person acquires C. diff is, surprisingly, a hospital stay.
C. diff is a bacteria that is often found in hospitals because it is a "super bacteria." It thrives in the overly sterile environment of hospitals. Without a lot of the "lesser" bacteria, or even good types of bacteria to inhibit its growth, C. diff can have full room to flourish and grow.
The overuse of antibiotics in hospitals can kill off many competing types of bacteria and allow C. diff to take over the hospital environment, or a patient's body.
People who have surgery and extended hospital stays are at risk for C. diff. But the bacteria are more frequently found in "community settings” outside of the hospital.
This could be because more people get C. diff in the hospital and then go out into the community, or because of increased antibiotic use in the public. Some strains of C. diff have been found in both healthy babies and adults. But more commonly, the bacteria cause severe diarrhea and/or colitis.
Pregnancy and C. Diff
Pregnant women run the risk of being exposed to C. diff during their hospital stay.
There is a greater risk with a cesarean delivery than a vaginal one. That’s because a cesarean includes the surgery itself, a longer hospital stay, and treatment with prophylactic antibiotics. These antibiotics are given preventively to ward off infection. (Oh, the irony!)
Amy Burkey, a New York-based chiropractor, detailed her story about C. diff in a blog post. She developed the condition after she delivered her daughter by cesarean. Her daughter was fine, but after being discharged from the hospital, Burkey was not.
“We came home from the hospital on Thursday," Burkey wrote. "On Monday I awoke with a fever, diarrhea, and a profound sense of dread. I remember thinking that I was going to die. I felt like I had the flu, but different. I was experiencing a shocking amount of very watery diarrhea. I didn’t even notice the smell at first."
Burkey expressed frustration that more patients aren't informed of their risk of developing C. diff after their hospital stays, and about the lack of treatment available.
The current recommended treatment is — you guessed it — more antibiotics. We now know more about the importance of good bacteria in keeping us healthy, so her frustration is understandable.
What Can I Do to Prevent C. Diff?
If you are pregnant and plan to give birth in a hospital, be aware of your risk of acquiring C. diff. This is especially true if you will be having a cesarean delivery.
You won't automatically get C. diff if you give birth in a hospital, of course. But recognizing the symptoms after you return home can help your doctor make a quick diagnosis.
During your pregnancy, also be cautious about using antibiotics unless absolutely necessary. Be sure to have an open and honest conversation with your doctor. Overuse can put you at an increased risk for C. diff.
If you do develop C. diff during pregnancy and/or in the postpartum period, treatment options will depend on the severity of your condition. But treatment will likely include rehydration, electrolyte replacement, and antibiotics.
Currently, doctors don’t have enough evidence to recommend probiotics, either as treatment for C. diff or to take as prevention. But more research is being done and these recommendations might change in the future.
Chaunie Brusie, BSN, is a registered nurse with experience in labor and delivery, critical care, and long-term care nursing. She lives in Michigan with her husband and four young children, and is the author of the book “Tiny Blue Lines.”