low amniotic fluid- being induced on Friday :-(

[emilysometimes]

I'm at 41 +3 and on Friday I wasn't dilated at all. I had a biophysical profile yesterday and although little Mimi's heart rate and movement are fine, my amniotic fluid level is VERY low. My m/w says there is too much chance of fetal distress, so she has turned me over to a doctor - who is REALLY nice and seems to be willing to work with me as far as avoiding medication and unnecessary interventions. I was VERY upset about this yesterday, and I'm still not happy about it, but I feel a little better. I was kind of disappointed that my m/w said "sorry to lose you" and that's about it. I thought she would be at the hospital, but apparently I was mistaken. My husband is going to call her tomorrow to check, and also to see if we get any kind of refund, since we have paid her for delivering our baby and she's not going to do that now.

Does anyone else have experience with a situation like this? I know I should have thought to ask her what would happen in this situation at the very beginning, but I just didn't consider the possibility that my daughter would want to hang out for 42 weeks or more. I haven't had a single contraction, but when the dr checked me today, I was at 3 cm and 75% effaced- so apparently the EPO is working.

I'm feeling pretty down and a bit depressed that I won't be getting my completely natural water birth, but I'm happy to know that my baby is okay and that I'll be meeting her before too long.

I hope everyone else is having a better week!

[kalisage]

Just wanted to offer you some and :

[smeisnotapirate]

[Shanana]

I swear I've read that fluid levels go up and down. I would try posting over on the I'm Pregnant forum and/or the Birth Professionals area to see if you can get more info on that.

As for your mw, I'm sorry about how she handled things. It sounds like she didn't handle this as well as she could have and you are feeling very disappointed . I take it she was a DEM and not a CNM? And that's why she won't be at the hospital? It seems like she could still come for labor support, etc. Anyway, I would expect you should get at least SOME kind of refund. I know my mw's fee changes, for example, if you switch to her late in the pregnancy so she doesn't have to do many pre-natals. So it seems it should work the other way too.

Good luck, mama. Again, I'm sorry about this .

[amyaebi]

I know that in my mw's contract she retains the fee if she transfers care after 38 weeks, but she is right there with you at appointments and in the hospital for delivery, so she is still giving her time and expertise. Seems like if your midwife won't be around anymore she owes you some money, as being on call and being at the birth are the majority of most mw's fees.

So sorry!

Amy

[Molck]

sorry you're having to transfer care at the last minute. My MW's policy is that if I transfer to hospital, she'll stay by my side as my doula. Perhaps this is something you could request?

[cj'smommy]

[MarchWillow]

I looked back thru my paperwork and my mw also says she will go with to hospital and still also come see baby after birth to establish bfing and such, then of course the 6 week postpartum. It doesn't say anything about her fees changing though.

I'm sorry you are having to change plans last minute, that does suck. But the good news is, there are hospitals and good doc's like the one you got that are there, specifically for situations like yours. And your baby will be delivered safely-that's what counts mama! Just think, this time next week, you will be cuddling a little bundle of love!!! ELV's to you-I hope you have the best hospital birth you can have and that your doc is just awesome when you are going thru labor!

Don't forget to share some pics with us :P You know how we love squishy baby pics hehe.

[saimeiyu]

Hey, found this through the new posts list.

I just wanted to tell you, before going through w/ the induction, take a bath, drink lots of water, and check the AFI again. It's *notoriously* inaccurate. I had 4 different readings that were more than 3 cm apart- in the same 1/2 hour! ( 2 cm, then 7.5, then 6.9, then 3 cm) by different techs. The one that had the most experience came up w/ the 7.5 cm.

Also, the studies done on using AFI for neonatal outcomes unanimously show that low AFI with a reactive/positve NST means exactly... nothing. So as long as your baby has a good heart rate and good activity during the NST, you do NOT have to consent to an induction to "save" your baby.

This is from an article in the Journal of Family Practice:

http://findarticles.com/p/articles/m...54/ai_n8704997

Of note:

In a case-control study by Conway, 183 low-risk, term parturients with oligohydramnios were matched to 183 women of similar gestational age and parity who presented in spontaneous labor. The patients with isolated oligohydramnios were induced and showed an increased cesarean delivery rate. The increased rate of cesarean delivery was not due to nonreassuring fetal surveillance and was attributed to the induction process (LOE: 2). (25)

An analysis of woman diagnosed with isolated oligohydramnios (AFI <5) at any gestational age in the multicenter prospective RADIUS trial demonstrated similar perinatal outcomes and fetal growth compared with pregnancies with a normal amniotic fluid (LOE: 2). (30)

The only randomized clinical trial of labor induction vs expectant management for term isolated oligohydramnios showed similar outcomes in each group. But this study was small (n=61) and has only been published as an abstract. (31)

And additionally:

True oligohydramnios can be difficult to confirm due to the questionable accuracy of amniotic fluid measurement by ultrasound. There is controversy, for example, about whether (and how) to include pockets of amniotic fluid containing umbilical cord. (15) The AFI was introduced in 1987 (2) to replace the 2 cm "pocket technique" of fluid assessment, and studies continue to question to what extent the AFI reflects actual amniotic fluid volume.

AFI measurements may vary with the amount of pressure applied to the abdomen and with fetal position or movement. (16)

Serial measurements taken by the same ultrasound operator have been shown to differ from the true volume by 1 cm, or 10.8%; serial measurements taken by multiple operators have differed by as much as 2 cm, or 15.4%. (17,18)

And finally:

As adverse fetal outcomes have not been demonstrated in women with isolated term oligohydramnios, there is no rationale for routinely inducing labor based on an isolated finding of a so called "borderline" amniotic fluid index in the 5-to-8 range. In this situation it is appropriate to perform the initial assessment described above and may be reasonable to repeat the amniotic fluid index in 3 to 4 days to determine if true oligohydramnios has developed.

Sorry to butt in on you like this, but I just wanted you to know!
The article itself is kind of long, but it is a good read!

Hopefully you will spontaneously go into labor and have your baby soon! Good luck.

[emilysometimes]

Thank you all so much for the vibes, the info, and the encouragement! I'm going to call my m/w (who is a CNM) tomorrow and ask her if she intends to be there or if we'll get a refund. If I feel weepy tomorrow, I'll let my husband do it- he has been awesome and has already offered to do that for me. I'm going to read that article about the AFI/fluid levels and ask about being re-tested. The only thing that worries me about that is that they say 5 is low, and I'm at 1.5.

I have a doula that I absolutely love and am VERY grateful to have.
I will keep you all posted and hopefully I will be posting some pics before long!


Thanks again to all of you- it's great to know there are other mamas out there pulling for me.