polyhydramnios and homebirth......advice

[girlsmamma2]

Hi everyone! I"m preggers with my third child and planning our second homebirth. i just posted the other day about having an ultrasound because my midwives say i have extra fluid.

so i had one done, baby is fine, although the tech wasn't as thorough as i'd have liked because she was snotty and annoyed we hadn't done the GTT and also were with midwives. But all in all, baby looks fine, so i dont think it's an issue with the baby. saw her swallow, fluid in stomach etc. no other markers. So the issue seems to be lotsa fluid, bigger baby and possible GD. i think i might have done this to myself as i still have horrible morning sickness and was eating loads of chocolate and sugar as that is all i could keep down. i feel horrible about it. however, i've since gone cold turkey on all that crap eating and taking Natrum Mur to get the fluid under control.

But i'm soooo worried about this. i've only briefly gotten to speak with my midwives since the u/s i hope to talk to them more today. they seem to think they can get the fluid under control. but what if they can't? is it possible to have a homebirth with polyhyrdramnios? Tech said my fluid is in the 95th percentile. I'm 29 weeks 3 days. i think that's pretty high but i'm also near the end i guess.

I'm so upset as i feel in such a tough spot. if it's truly gd then i worry about the baby afterwards. and i don't want to be in a position where i have to find a caregiver even later in pregnancy if i can't get the fluid down. baby is majorly floating now and likes the transverse position..ug.

any advice? am i risking out of another dream homebirth? i HATED going back into that ob's office for the u/s. i delivered my first dd with them and it's such a negative atmosphere. i just hated it. I am so sick about this and getting very little sleep. help?

[turtlewomyn]

Cutting out sugar should help. I am not experienced in natural/homebirth (yet) but I ended up with a c-section in October. The lame reason was a big baby and extra fluid (I chose a medwife in a doctors practice, big mistake). My fluid level was 25 in a 40w u/s. Someone on here told me to cut out sugar, and I did. I ended up with another u/s before the section (we tried to fight it and put it off a week) because the NST wasn't working at my fluid levels were down to 21 after a couple days of cutting out the sugar. I think if I would have continued to cut out sugar, and waited longer it would have come down enough for dd to engage and come out on her own. For some reason I think that drinking Red Raspberry Leaf tea is supposed to help as well.

Good luck.

[girlsmamma2]

really? that is interesting. my afi ws 23.53 and 95th percentile. so i think i am just under what qualifies as poly. as long as the baby is ok, the midwives seem to think i can turn it around. but it's just so hard to know what to do because if i can't, they don't have a dr back up and it will be an emergency situation at a hospital where i come in knowing no one. not that having a doc would make it better i guess. and also if did dual care, they would want blood tests, a vaginal, gtt, strep b, so many things i can't even count.

i'm leaning towards making a follow up appt with the doc to discuss the u/s and all the "bad" he'll tell me about it. but i know i'll open a can of worms as hb will definately come up and i can see him flipping out right now. i just dont know if i want to go there, but if i could make an appt say next week, then get to the next midwife appt in 3 weeks, check on the fluid to see if there is any progress then i would have a doc in the wings, but to him i'd still be deciding but i'd know more about my progress with the diet and homeopathic.

i/m rambling! thanks for your help!

[homemademomma]

i am 25 weeks and also in the 95th percintile. i am worried, but not sure why. i was originally going to decline the glucose test, but now i am not so sure. my understanding is that poly itself isnt an issue- it is what could be causing it. often times it is nothing, but it could be gd or other things.

[chumani]

Hello ladies,

I had polyhydramnios w/my 4th baby. Polyhydranmios may mean something wrong with the babes esophageal or urinary tract systems. The u/s techs should have checked that out. Here is a link to a chart so you know what the numbers are.

http://hostingprod.com/@fetalanomalies.org/Fluid.html

At 40 weeks my AFI was 29, VERY high. He was born at 41weeks at home w/ no problems (the midwife got soaked when my water broke).

Best wishes, listen to your body and baby.
Sarah

[homemademomma]

bump

[girlsmamma2]

that is an interesting chart. That sure is great to know you still had a homebirth with that much water. i expect mine to break towards the beginning as it has with the last two.

I"m still not sure if i will make a dr appt to kind of keep them on the back burner incase i have preterm labor. But i know they will pressure the gtt etc. i wouldn't take it now, as i'm doing in my diet what i'd do if i had a positive gtt, so what is the point. I wouldn't want to drink exactly what I've now been avoiding for the last week or so. I was eating lots of chocolate and have since gone cold turkey on that stuff, so i would never injest that glucola, especially now.

and our u/s didn't show any issues with the baby, we saw her swallowing etc and fluid in her tummy. But i also don't think this tech was very thorough, certainly not like the other u/s's i've had. they would linger in one place for a while checking things out to the point I'd try and get them to move the wand. this one didn't do that and later went around in circles over and over. she was snotty and rude and questioning where i was getting care, if i had my sugars checked. she knew from my chart but wanted to hear me say it or something. a real bad attitude. luckily i'm not as naive as i used to be so i told her as much as i wanted her to know and shut her up after that. boy she was rude. i can't beleive they treat people like that. she ended up saying "I'm sorry, i don't mean to push anything on you (yeah right) it's just when you are in the medical field...." blah blah blah. I felt like saying "when you're in the medical field you must give substandard care to those who don't abide by your wishes!". anyways...rambling.

thanks for the input everyone. feeling better and more confident everyday.

[hippiemom]

I had polyhydramnios as well with my third, was seeing a lay midwife for my care and planning my 2nd homebirth. I measured 47 weeks at term, was huge, the baby was big, and I was carrying a third more fluid volume than normal. I was verrrrry uncomfortable. I had a 2 hour post prandial test and my numbers were borderline high. Not sure if it was GD, maybe GD tendencies. Our family grows big babies too, many women in my family had 'em.

So, in the end I decided to go to the hospital with my GP (NOT an OB)instead of doing homebirth. I had gone into labor twice and stalled out b/c the baby would not engage properly in all that fluid. This was quite distressing to me, and I worried night and day about cord prolapse, bleeding heavily after the birth, etc. I went in and had my water gently broken, just a tiny pinhole while my GP kept his hand in place the whole time water ran out, to ensure against the prolapse I feared. After that I slept, walked, ate, played "yahtzee" with my husband, etc. By the evening labor started spontaneously, and after just 2.5 hours (completely medication free) I birthed my 10lb, 2 oz son sitting up on the bed into my own two hands. It was wonderful! I too had had an adverse experience in the hospital for my first child and it was hard going back after the fabulous homebirth of my second, but I found it to be a better experience as a seasoned, knowledgeable mama rather than a first timer... You know what to ask for, what to refuse, and can be more assertive for sure! I did bleed heavily after the birth since I had been so distended, and was greatful to the nurses who took care of me, got the blood to stop (again, med free) and sat with me through the night to make sure all was well, which it turned out to be. I left the next am with my baby boy, no weird hospital procedures had been done to him (I signed all waivers happily) and I was glad for the support I received, glad I went in. My boy is a kindergartener now and I have never regretted my decision, a learning experience for the hard core homebirth-or-nothing young mama that I was... That is just me, had to write as you sound so much like I was at the time. I hope you are well and can feel reassured, the worry is the worst part.

[girlsmamma2]

well jesh hippiemom, we do sound quite similar. I too have been worrying about that not engaging thing since baby has been transverse for so long. Also the cord prolapse thing. i think it's great you had a wonderful experience. I will definately use your words if i decide (or have to) go that route. i would have to use an ob as our hospitals around here are pretty traditional and the only way i could get a midwife would be to use a hospital that is an hour away (which in this sitation an emergency is what the concern is as you know).

the ob i'd realistically use, as we dr hopped before decding on #2 dd's homebirth, is the same one as with first dd. that could have been a super bad experience if i hadn't stayed home for all but an hour of the labor. i guess i could do that again if my water doesn't break but i think the problem i'm having the most trouble with is all these answers are left until the end. and if suddenly my midwives can't do the homebirth, i'm left out there with no contacts, far along and no where to turn. i go between worrysome thoughts about the hospital and everything that is there and the way i was treated and being away from my first two dd's. to worrying about hb and the consequences if something goes wrong. i mean i just dont know and am totally conflicted at this point. i guess i could i always go into the ob and tell him straight up what i need. but the practice has 6 docs so even if on the off chance one doc will go along with it, i know the others and they won't. very hardcore mainstream doc office. ug.

thanks for your input, as everyone elses. sometimes it helps just to air everyone experiences to help settle my own in my head you know?

[hippiemom]

Oh I sympathize and remember soooo well all of the fear I had, sorry honey. It brings me back just reading it. I am not a fan of induction on any level really, but I was technically "scheduled" to go in and have my water broken at the hosp on the advice of my family doc (who delivers babies too) at a time when he was on call for 24 hours and would likely be there for the birth, so that was an advantage. Would you have this option if you discussed it with the OB you are comfortable with? I knew I was ready b/c I had gone into labor 2 other times, but the baby floated back up in all that water. All of my midwifery books said that poly was a contraindication to homebirth (to the degree that I had it), and in my heart I was not comfortable with delivering at home, that was the kicker. As a 3rd time mama I knew I could handle induced labor if necessary, labor pain did not scare me. In the end I did not need drugs, went into labor on my own after the water had been broken about 11 hours, that's all it took. i just know as an experienced, proactive, informed mother I was better about going in, I knew what I wanted and I got it, with little resistance actually, as I said, the nurses and my doc were great. Good luck to you, I will think of you!

[homemademomma]

so what is actually considered poly? i am in the 95th percentile- is that just high normal ,or is it poly? i am not measuring big at all. also i read that poly that comes on around 20-25 weeks is more likely to mean a problem with baby than poly that comes near the end of pg. has anyone else heard that?

also, are ultrasounds as off on measuring amniotic fluid as they are on measuring weight? should i not worry about poly if my measurements are fine?

ugh i wish i had never gotten that u/s. i got it so that i would not worry as much as i did with my last baby, but now i am worrying even more! i really just want to forget this whole thing and go up/uc.

[girlsmamma2]

Thanks hippiemom, it sounds like you had a good alternative and i think that is the difference. mY alternative is so traditional. I'm thinking of dual care and just calling whoever i need at the end but the will rail me with pressure for tests i don't want, strep b at the very very least. i just keep going back and forth. i wish i had a good handle on if i'm making any progress with the fluid. last time i thought i was better and when i had my midwife appt i was measuring more. i think the two things that worry me the most are cord prolapse and malposition. it really upsets me to because i went from being a very low risk mom to one that is considered high risk for one problem. although my midwives don't consider me that at this point. i think that is the real shock to me. i may make an appt with the ob on the premise to discuss the u/s but i think if i even mention homebirth they will not want my business anyways. i don't know. not like he doesn't already know. i have mentioned midwives and no ultrasound, but not hb.

and homemademomma, from what i have read, poly is an afi above a certain cm depending on gestational age, 30 weeks for me. or one pocket or quadrant that measures on the scan above 8 cm. I was told by my midwives that measuring fluid is an art not a science, to your question about accuracy. My dh is an engineer so he explained this to me and i agree. they could be off, but i think when you are up there, you are up there. yes, there is a difference b/w an afi of 25 and 40 but my worry is that i'll grow to get there or it'll bump up right at the end.

[hippiemom]

Fundal measurement is quite telling IMO, ultrasound aside. I had the US just to make sure I had only one baby in there at the time. I fully expected twins, i was sooooo big from about 6 months on I measured weeks ahead of what was "normal". As for the midwife, mine at the time was surprisingly blase about it, and would have done the home delivery. At that point I had to take it into my own hands as I felt stongly as the baby's mother that it was a risk. I was not (and still am not) sure why I had the poly, in my heart I felt the baby was ok, but I was worried about the complications in L&D that can go along with it. I was also thinking that with such a stretched out uterus it might be less likely to clamp down as well as in my other births, and in that respect I was correct. It was the only side effect of poly that I experienced; had I birthed at home I would have been transported for that... had two young daughters at the time, worried about them, their fear if I had an emergency, the worry became just not worth it.
If you want to read up, Varney's and also Anne Frye's Understanding Diagnostic Tests in the Childbearing Year (so excellent) talk about the testing involved with poly, ultrasound, etc. Like I said, watch fundal height, and how it feels to your midwife's hands, that is very telling. Is the uterus tight, can she feel a vibration of fluid that makes the babe hard to palpate? Are heart tones harder to pick up? This was the case with me, ultrasound aside.. I want to reiterate here that my son was totally FINE, healthy normal, great! Sounds like your girl will be too, but you must also take care of yourself.. I am sorry if you don't have a more enlightened choice for care, but you do have time to do some consultation appt's with OB's, some interviews, etc. You can also find yourself a great DOULA! Yes I would go with a practice that is nearby. Good luck mama, keep us posted, will send you good vibes...

[girlsmamma2]

yep, measuring at 28 weeks 33. but i measured big last time. to me, even looking at the pics, there is no denying it, much as i'd like to! around 24 weekd my midwife felt that revirbiration (sp?) that you are talking about. But could feel baby fine. i too thought it was twins. then at 28 weeks bigger measurements. so we'll see what happens this time. my next appt is April 6. See, with my two girls i think it would be very hard for them to have me at the hospital from the get go. my youngest i'm most concerned about as coming home with a new baby i think would really affect her. but that is nothing if the concern is more dire, i know.

anyways....just wanna get this outa my head for a couple of hours! just a couple! it seems my every thought nowadays. partly because i'm always thinking about what i'm eating and i hate that. not a person who thinks about food a lot and it's annoying! did you take a homepathic, natrum mur? i'm taking that but thinking i may up the dosage. i'm taking lower dosage more often but i heard 200 c's makes a bigger difference.

[hippiemom]

I didn't take anything... by the time we got to the point where we were concerned about it I was literally about 2 weeks before my due date. I had gone into labor once and stalled.... that happened once more, then on the day before I was due I went to the doc for a check in and agreed to come back the following morning and have the water broken. So the time before I made the decision to go in and actually did it was about 14 hours.

For my girls, yes it was hard to let me go overnight (they were 4 and 7).. But I left them with their Grammie whom they adore and takes very good care of them, promised to call them whenever the baby was born (they were asleep in my big bed with their cousin but I called anyway).. they drew me pictures to bring in and hang on the wall! They also came in once and visited before labor started. They came back the next morning early to meet their brother and I was home later that morning, so the time away was minimal. Of course if you have your heart set on your kids seeing the birth, that is a different consideration. I knew I didn't want them there...

Yes get out and do something nice for yourself, try to relax, the worry is exhausting, I hope you get some peace and clarity mama!

[TurboClaudia]

sending you peaceful vibes, girlsmamma2

just wanted to let you know there are some good suggestions about "bringing baby home" when there are older siblings and you are concerned about them adjusting to a new little one. i don't remember the exact details, but something like having daddy hold baby outside the house while mama goes to get the older siblings, brings them outside to introduce them to baby, and then everyone goes into the house together. kind of reminds me of introducing a new pet to existing pets but it makes complete sense to me.

i know your concerns are about your and your baby's well-being right now, but i just wanted to throw that out there if birthing in the hospital becomes more likely an option.

thinking of you... update when you can...

~claudia

[girlsmamma2]

Ug. I forgot all about that since we have been so planning on both girls being a part of it from the beginning. my 3 year old is very interested and I've made her a part of every prenatal, getting up on the table with me. the midwives have commented how interested she is. I had her up on the table for the u/s (as i ignored the tech's hints to get her down) . She loves to watch house of babies together, we sit down and watch it together and i tell her what is going to happen (like mamma is NOT one of those women who quietly push...i'm a screamer honey!!!! ). I think i could explain to her what would happen if i went to a hospital. But i think my coming home with a new baby for my youngest, 18 months, will totally confuse her. Being gone and new baby. oh i can't imagine. I think a big part of my girls being so close is that i didn't have to leave for my second one and dd was there beside us and lying in bed with us as the midwives looked my second dd over from the minute she came out. And now, even more, when i show her the pictures it sinks in even more how she was a part of it. I think it made a huge difference in how they relate that i didn't have to devastate her by leaving for a couple days. She had never been away from us before.

i will say getting out helps. Today we had our music class the girls and i go to then went to lunch after and shopped. it's better than those days i stay home and scour the interenet with research hoping i can find it SOMEWHERE that says this is all ok, kwim? so i'm making it a point to get out everyday now.

thanks for all your good thoughts ladies. maybe somehow by some miracle it will all work out, although just typing that seems impossible. i think this will be my last time around. I don't think i could go thru this stress again. That is the one thing i don't like about hb. You are always in jeapardy of losing what is so very important if just one thing goes awry. at least those women who blindly go to the hospital don't know what they are missing! But those of us who want hb and believe it is right in their soul have to go thru a grieving if it is taken away that no one else can understand, except fellow hb'ers.

thanks again.

[hippiemom]

Oh honey, we take that risk just having a baby, anywhere, just loving a baby... It is all worth it, but yes I hear what you are saying. I think HB'ers are more aware of the fact that all parents are ultimately responsible for their choices with their children, that is parenting, from conception on... The most important choices tend to be the hard ones. We do our best, follow your heart and your love for your child, put that together with the knowledge you have, and make your choice. That is the best anyone can do.

I was 18 months old when my mom brought my sister home to me. (after a 5 day stay in the hospital!). I don't remember it, but do remember playing with her in her baby seat, and feeling like mom brought her home for *me*, my most precious gift. Still feel that way about her and we are old(ish) ladies now! However you handle it, the kids will be fine. It is not the same as an involved HB if you go to the hospital, true, but even the 3 year old will be ok with it if you are ok with it, if you reassure her, etc. And sometimes you have to put yourself first and just explain to them that that is the way it is. You are their mother, they trust you. They won't hold it against you.

[girlsmamma2]

Yea, i know. I guess I'll just take everything I know and sort it all out and see where the chips land. It's so hard. I think my three year old would understand and that is a good point, if i end up having to go to the hospital, I can present the new baby as a , "look what I brought home for you, a new sibling". I'm just going to put all my energy into combating this fluid best I can and also having some sort of a back up plan, if that is possible. Even if it's what to do in case of an emergency.

funny how when you are dealing with issues like this, handling the pain of natural labor or a big baby seem like "bring it on!!!!"

[hippiemom]

Your three year old can stay home and bake a birthday cake for the new babe with a loved one, draw "Welcome Home" pictures, etc. Go shopping for a new baby toy, can be made to feel very important. We did all of this with my then 3 yr old when her sister was born...

But in my heart I do hope your situation will turn around and you can have the HB if that is what you want. Overall you sound very informed, and no matter where you end up you can have the birth that you want

Have a good relaxing day, beautiful weather here in New England, hope it is springy wherever you are.. Will keep you in my birth prayers! :