Low Amniotic Fluid....induction likely « Back to Group Discussions

[mama.nesta]

So, yesterday I started off my day with acupuncture with 'induction specialist'  in my area...I was optimistic because I had some serious pressure in my cervix/vagina .  I then went to the midwife , hopefully for a membrane sweep.  Unfortunately she could not do the sweep because my cervix was still completely closed:(

So frustrated..then I go for my NST and ultrasound because of my history of low fluid ( which ended with a long induction and eventual c-section with my first) ...and, it's low.  Not super-duper low, but below the cut-off.  I am told to call people and arrange for folks to come because I will probably have to be induced.  I am crushed and start to make calls and figure out  as they do the NST.  Thank God the NST is reassuring and I convince the midwives to let me go home for the night and return in the morning for another round of testing and most likely an induction.  Last night i hooked up the breast pump and  DTD and that started some small contractions but the baby was definitely not meeting the 10 per hour kick-count goals so I kind of freaked myself out there.  I guess I am unsure of what to do in some ways.  With my cervix not ripe I have limited faith in piticin..there is a chance I could get a foley balloon inserted if I dilate a bit. I have been down the road of a long, painful induction that ended in a c-section and 'I am considering just opting for a c-section if my cervix is still closed this morning when I go in...any advice?    

[buko]

Drink lots and lots of water!  And please take a look at this, in case it's in any way helpful for your situation:

http://www.scienceandsensibility.org/?p=5294

[CamoShades]

How would they be inducing you? Just curious, given the fact that you are a VBAC.

Low fluid is one of my big fears, because I had it with my first (supposedly below 4) and she was breech, so I had a c-section. With my second, I was to start twice-weekly NSTs and fluid checks at 41w3d, but DD2 came on her own on that day (a Monday). Now I do not necessarily worry about the fact that I have low fluid, but I worry about what the doctors want to do about it (intervention). I can tell you that I would not consent to an automatic c-section; I would make them try other things first (foley bulb, even breaking my water, my OB said she would do low-dose pit if I was dilated some, which is new from three years ago when i had my first VBAC). This time I will be 41w on a Tuesday, so I am worried I won't get all the time I need to go into labor on my own becore the interventions start.

If I were you, I would head back for a second round of acupuncture. And I would at least give castor oil a shot if it looks like your last resort. That is exactly what I will be doing if I find myself in your situation. Good luck to you!

[Dakota1235]

I'm so sorry that you're having to deal with this. Having just had a long painful induction ending in a csection for pre-eclampsia, I would say this. Make sure that you agree with the reason for induction. You can always drink a ton of water and ask them to recheck the fluid levels before they do anything else. If it's still low then you decide what to do. Remember that each baby and pregnancy is different.

I made them re-do the 24 hr urine (we did a 12 hr) and some labs on the off chance that they were just anomalies. In my case the labs and urine level got worse, BUT it really made me feel ok about the reason we started the induction.

Best of luck to you and take care.

[mama.nesta]

Thanks to the ladies that replied!  I drank and drank and drank and my levels went up enough to give me a few more days.  I have to go get checked again tomorrow and am trying to drink and lie on my left side and have some electrolytes.  I am feeling more and more like I will try the induction and see where it goes if it comes to that point.  I have been DTD, using the breast pump, using EPO like crazy but if the cervix won't ripen I am not sure that the induction will take.  I know every pregnancy and birth is different but I just go back to the trauma from my first experience.  Thanks again for some advice

[kellybeth]

Originally Posted by mama.nesta 

Thanks to the ladies that replied!  I drank and drank and drank and my levels went up enough to give me a few more days.  I have to go get checked again tomorrow and am trying to drink and lie on my left side and have some electrolytes.  I am feeling more and more like I will try the induction and see where it goes if it comes to that point.  I have been DTD, using the breast pump, using EPO like crazy but if the cervix won't ripen I am not sure that the induction will take.  I know every pregnancy and birth is different but I just go back to the trauma from my first experience.  Thanks again for some advice

thinking of you--

[cortinacolorado]

So glad you have a few more days to work with now. Good luck...keep the faith! You're little one is coming. :)

[odinsmama]

Glad to hear this news!  Hope things start on their own for you

[CookAMH]

Hold off as long as you can! If I were in your shoes, I could see myself mentally prepared for an induction once the possibility arose, but I'd try hard to tell myself to hold off as long as possible since levels came back up. I'm glad to hear that worked! The article posted above was really interesting to me, as I had often wondered about the diagnosis. My doula actually manages that website. She's awesome.

[mama.nesta]

Going for another round of tests today and if they are good I think I can keep them at bay until more tests on Friday.  Send me full fluid vibes!

[MaybeJ]

Crossing my fingers for you!!

[Dakota1235]

Fingers crossed for you!

[mama.nesta]

Another NST and AFI passed!  Another few days to hope that this boy gets ready fast.  I am now also pretty calm with the whole thing as the ultrasound tech today did two readings.  The first one she said my level was 7.1 but "felt like I was low" so did it again and got a 5.2...wtf?  Totally subjective...baby boy is good, I am good, we are waiting!  The midwives are being pretty patient but it is a hospital so they also are trying to prepare me if they want to induce at some point.  Thanks for the support! 

[buko]

Awesome, mama.nesta!  Come on, baby!

[CookAMH]

That's fantastic!

Did you get to read the article posted?  I was intrigued by the two methods to assess....are you able to tell which method they're using to assess fluid? I'd be interested to have them use both and see what the differences are. The deep pocket method per the article is a more reliable way to check levels.

[mama.nesta]

I did read the article and they are definitely using the first measure. Unfortunately, today it was low again and they want to schedule a c section for Saturday. My cervix is still closed, not effaced, an baby's head is still not engaged so the likelihood o an induction working is slim to none...I am taking what they are saying as it comes and def thinking of the article and some words from midwives but also know that if my levels are low and I have been drinking like crazy they would probably be super low otherwise...I am not sure what to do....I have testing everyday from now until Saturday when my c is scheduled but I can always change that....I am crushed and second guessing my body...why won't he come out already.?

[CamoShades]

Honestly, if I were in your position, I'd be doing everything I could to naturally induce labor. I was getting really close to that point during my last pregnancy. There is nothing you can do to up your fluid levels at this point, and a medical induction is seemingly out of the question. I wouldn't "go down" (and by that I only mean consenting to a c-section/getting your baby out, which may be the best thing for him/her soon) without fighting my body! I wouldn't, however, fight the doctors and their recommendation anymore at this point. Try acupuncture, castor oil, pumping, etc. My doula had an herbal induction protocol sheet she gave me during my last pregnancy. I could see if I can find it (I came across it recently, and I know I kept it), or it might be this one: http://www.gentlebirth.org/archives/herbalInduction.html. And if nothing works, I would definitely ask to be rechecked again immediately before the section to see if there is any progress and any way of inducing (foley bulb, low-dose pitocin, AROM). Personally, that is how I would handle it.

Best of luck to you, Mama!

[buko]

I really, REALLY want to emphasize that I am not a health care professional, etc., but my concern is this (from the article above):

There is no evidence that isolated oligohydramnios at term is a risk factor for poor outcomes.

So, I suppose it's possible that you have some unknown other really problematic issue that could also be leading to the oligo, but the above would give me pause if I were in your position.  Again, that's just me-- and I don't know that I would refuse or postpone the C/S in your position, but IDK.  I kind of wonder (again, IANAD-- pure speculation), if you just don't "make less fluid" than average as a pregnant woman and it's not necessarily a problem.  How far along are you now?  How far along were you with your first?  How did the placenta look for your first at delivery?  How much fluid did you actually have at delivery?  What was the outcome for your baby then?  If all was fine with your first baby, IDK...

But, hugs, regardless! 

[mama.nesta]

Originally Posted by CamoShades 

Honestly, if I were in your position, I'd be doing everything I could to naturally induce labor. I was getting really close to that point during my last pregnancy. There is nothing you can do to up your fluid levels at this point, and a medical induction is seemingly out of the question. I wouldn't "go down" (and by that I only mean consenting to a c-section/getting your baby out, which may be the best thing for him/her soon) without fighting my body! I wouldn't, however, fight the doctors and their recommendation anymore at this point. Try acupuncture, castor oil, pumping, etc. My doula had an herbal induction protocol sheet she gave me during my last pregnancy. I could see if I can find it (I came across it recently, and I know I kept it), or it might be this one: http://www.gentlebirth.org/archives/herbalInduction.html. And if nothing works, I would definitely ask to be rechecked again immediately before the section to see if there is any progress and any way of inducing (foley bulb, low-dose pitocin, AROM). Personally, that is how I would handle it.

Best of luck to you, Mama!

Thanks Mama,

 If the BBP looks good tomorrow morning I am going to the health food store to get the herbs and will try tomorrow then a fourth acupuncture induction Friday morning.  I pumped a little while ago and am having some contractions so that is a bit encouraging...I would like to pump again and see if it sticks but honestly I am so tired I think I better just wait til the morning.  Thanks again for your help...sending you baby releasing energy so that your bundle comes soon!  

[kat216]

I have no advice but wanted to wish you best of luck. Stay strong mama!