Polyhydramnios (too much fluid) and homebirth

[nfpmom]

I posted this to the VBAC forum but would like some more perspective. Esp. if there are any HB MWs reading this...
I am 35 weeks currently, pg with #2. 1st baby was a C-section for posterior positioning/ failure to wait/ etc etc...
Planning HBAC with a CPM.

At 20 weeks I was diagnosed with placenta previa. This resolved itself into an anterior placenta about midway up the front of my uterus at 30 weeks. At 30 weeks when they checked on the placenta, they noticed a high normal amount of fluid. At 33 weeks I had a huge jump in fundal height and was measuring 40 cm. I was sent to a perinatologist to check for fetal abnormalities and everything was fine but I was diagnosed with polyhydramnios (too much fluid). My Amniotic Fluid Index is 31 cm.

Side effects of too much fluid are increased risk of cord prolapse, placenta abruption, and postpartum hemmorhage, as well as the very small off-chance that there is something wrong with the baby that is causing too much fluid.
I am at least 30 minutes from the nearest maternity hospital in the event of an emergency- if traffic is good.

Am I being totally blind here? Should I honestly still be considering HBAC? Given the recent developments with the amniotic fluid and the fact that my alternative plan is not that bad (birth at a hospital with a 7% CS rate and a CNM with a >80% VBAC success rate) (although still a hospital) I am wondering if I am not thinking clearly and putting the desire for "the experience" ahead of rationality.

Thoughts?

[JanetF]

Someone just asked me about this today and I have a huge collection of stuff on it now. I'll email it to you.
Hugs, this must be so stressful!

[wednesday]

My SIL had a similar issue in her second pregnancy. Her amniotic fluid suddenly increased a huge amount. She had an ultrasound which wasn't very conclusive. She went from planning a home birth to having a hospital birth instead, and it turned out to be a good thing because her baby needed resuscitation and significant medical attention right at birth. She did have a vaginal birth though. I don't mean to scare you, my niece is 4 now and she's an amazing kid! But she is a case where it was good to have the medical environment right at hand.

[Attached Mamma]

I'm not a midwife, but my first pregnancy resulted in polyhydramnios and resulted in about 5 ultrasounds to measure fluid amount and determine if there was anything wrong. The specialist I saw did make me feel alot better than my ob did about having too much fluid (the only reason she gave me was that the baby's esophagus wasn't developing properly and he might not be swallowing). He said that it may signal a birth defect, but that over 90% of the cases just resolve on their own, which mine did in the 8th month (the fluid was back to normal).

[moma justice]

hi!
i am in metro atlanta too and if you ever want to get together and talk, that would be great!
i live near little 5

but
about the fluid
i had too much too
and i saw midwives the whole time and they seemed to not be too concerned i never did go to a specialist but they often had me checked by their backup dr/obgyn (to cover mal practice stuff i think more than their real concern) and i had more ultra sounds than i would have liked.
these were midwives through a hospital in athens, they did not do homebirths, but i used them for care until my birth and had a midwife friend come down from asheville to deliver me, they were my version of a back up.

and it made my end of pregnancy and birth much harder than i would have liked

first off i was heavy and huge and it was late aug and we had no air conditioning so i felt pretty HOT

and because i had so much fluid my dd never "egaged" until i had already been in labor for days (you know the stages of engagement that start the birht countdown at 2 weeks before birth, well mine never happened) she had so much room to move about and the extra fuild did not allow the force of lack of room to force her into engagement

then also b/c of all the fluid, she was able to move around more than she should at 39 weeks, 40 weeks, 41, weeks and even 42 weeks.

she was turning transverse, posterior, and breech and back again up until i was litterly pushing her out of my vagina (the back up dr through the hospital midwives actualy turned her for me manualy when she turned breech the first time at 39 weeks...that was wild)

my midwife had never heard of such an active baby during labor, but it is b/c most babies don't have the kind of elbow room my womb was providing due to the extra fluid

so b/c i was never engaged til the end adn b/c she had room to flip positions till the VERY end (i mean when her head was in the birth canal she FINALY flipped to the right position)

due to all that i was in labor for 5 days and b/c i had been in labor for so long and she was still in the worng position it took over 5 hours to push her out.
it was long and hard and i was very tired
the labor was not hard till the last day, but i was so tired from the previous days of not sleeping much or eating due to labor, so that made it harder to handle...that and the posterior position REALLY hurt my tailbone

BUT all is well that ends well, i still sang and prayed and took walks, and showers, and laughed adn made jokes....my journey into motehrhood was just harder than i expected, i really had to patient and surender to the birth process. all part of my journey.
b/c i still had my beautiful spiritual low stress homebirth totally all natural
and had a very healthy baby born into my arms....
the whoel time the midwife was checking the heart tones and everyone felt confident that the baby was fine, i think the only real concern was my energy level at the end, but i DID push her out.

we did take her to a chiropractor for a spinal alignment b/c of her difficult and twisty birth, but that was the extent of our medical issues due to the extra fluid, and i woul dtake any little baby to a chiropracter anyway

so that is my story and i would love to talk to you via phone, pm, or in person, if you wan tsome support or even just anothe rperson to talk it out with.

my over all advice is to talk to the baby and listen to your heart
what does your dh adn midwife think? their mood and comfort levels are important during the birth

oh and my midwife and i talked about WHY i might have had so much extra fluid in the first place, we are big believers in the physical being very connected to the spiritual and the mental aspects of of a person's condition and labor.
and we think that i had so much extra fluid b/c i was so determined to keep, nourish , adn protect my unborn baby.
i have had miscariages for years and when i go tpreg with dd i felt it was different, but my past exp with birth loss made me very obsessed with protecting and nourishing my unborn child...and when you think about it the role of amniotic fluid IS to protect and nourish the baby, we think that i just had a lot b/c of that...

so may be this would be a good time to look at your fears about this birth etc and see if that is connecting with your extra fluid.

are you scared or looking for a way out of the homebirth?
is you midwife or dh into doing any of prebirth spiritual counseling with you?

like i said, pm me if you want to talk more and i am here for you
good luck momma
sarah

[sarahwebb]

I'd do a lot of research and pray/soul search very hard. Educate yourself on the risks and how you would feel if something went wrong. Since polyhydramios can be an indicator of birth defects, you need to be really clear about how you and your partner will feel if you go with the homebirth and your baby has a problem that might have been handled better at a hospital.

Best of luck to you. You have a difficult decision.

Love,
Sarah