Expert Advice

Labor Induction Due to Low Amniotic Fluid Levels

Important on our list of potentially outdated maternity practices is labor induction due to low amniotic fluid. We know so much more today than we did twenty years ago about what determines a safe birth. This frequent practice is worth looking at more closely as you formulate your birth plan.

“Oligohydramnios” (ol-lee-go-high-dram-i-nose) is the medical term for having less than the expected amount of amniotic fluid. Labor induction due to low amniotic fluid levels is very common. It’s often suggested to you when you are near or past term (37-42 weeks +) or in the summer when you are more likely to be dehydrated.

Some care providers may want to induce you (trigger labor with the help of pharmaceuticals) because they are concerned that a birth defect is causing low levels of amniotic fluid.Low fluid levels could be restricting your baby’s growth. They may also worry the placenta is not working properly.  These concerns are, of course, very reasonable.

 

THE PROBLEM IS, TOO MANY UNNECESSARY INDUCTIONS ARE PERFORMED ON HEALTHY WOMEN CARRYING HEALTHY BABIES.

As it turns out, they don’t have any risk at all. Too many inductions happen on a Thursday (ensuring birth before the weekend). These inductions result in potentially harmful, unnecessary health outcomes for mothers-to-be.

Once a woman is diagnosed with low amniotic fluid, she’s more likely to have undesired interventions.  Procedures like AROM (Artificial Rupture of Membranes), Pitocin (synthetic Oxytocin), and a Cesarean section (C-section) are common. Studies show that, for low-risk women and babies, avoidable birth complications are often caused by such interventions[i].

 

RESEARCH TELLS US WIDE DIFFERENCES IN AMNIOTIC FLUID LEVELS ARE COMMON.[ii]

Research also shows that this type of standard intervention – induction of labor because of low amniotic fluid in low-risk, healthy women – does not improve baby’s health or safety[iv],[v]. The fact is, labor induction because of low amniotic fluid isn’t necessary for most healthy women. Instead of helping, it can cause you to have a major surgery that could negatively affect your health and future births.

Your amniotic fluid quantity is typically measured by ultrasound. But many practitioners agree ultrasound is not a very accurate method[iii]. It’s simply the best non-invasive measurement method available.

 

WHAT SHOULD YOU DO?

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First thing, find the right maternity care provider as soon as you know you’re pregnant. This person will ideally work from an evidence-based approach. They share your viewpoints about the difference between a low risk and high risk birth. You can have an aligned conversation about your desires, and will ultimately outline this together in your birth plan.

Next, do your research and understand what the range is for normal amniotic fluid levels at term. Ask your practitioner what they think of low amniotic fluid at term. What do they consider safe boundaries for amniotic fluid levels? When will your healthcare provider want to induce you? How do they tell if a baby’s fluid levels are low because the baby/placenta is compromised, or because mom simply needs to drink more water?

Amniotic fluid is constantly replenishing.

Simply drinking liquids will increase amniotic fluid levels within two hours. As long as you and baby are healthy and low risk, there could be room for a wait-and-see attitude. Instead of inducing labor right away, consider scheduling additional ultrasounds to get a more comprehensive picture of health.

Let your care provider know you are willing to eat right, reduce your stress, and drink plenty of water to avoid being induced.

Medical practices change all the time. It may be time to change common protocols around  labor induction due to low amniotic fluid levels, too! Learn all you can and work with your care provider to make the decision that is best for you.

As always, give your care provider a copy of your birth plan in advance and bring a second birth plan with you in your hospital bag to the hospital or birthing center, if you are not planning a home birth.

 

[i] http://www.jfponline.com/home/article/isolated-oligohydramnios-at-term-is-induction-indicated/2a0a8ccfda9d73e4cfd3946abeccc918.html?tx_ttnews%5BsViewPointer%5D=1
[ii] http://www.ncbi.nlm.nih.gov/pubmed/9199840
[iii] http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/content/tags/amniotic-fluid-volume/amniotic-fluid-volume-when-and-how-take-action?page=full
[iv] contempomararyobgyn.modernmedicine.com/contemporary-obgyn/content/tags/amniotic-fluid-volume/amniotic-fluid-volume-when-and-how-take-action?page=full
[v] http://www.ncbi.nlm.nih.gov/pubmed/17437223

 

To learn more about labor induction choices to include in your birth plan, download our free Birth Plan eBook now. After three years of research, collaboration with more than 100 childbirth experts and resource centers from Healthy Child Healthy World to the American Association of Neonatal Nurses, the Best Ever Baby Birth Plan Guide is available for a free download.

This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and GraceFull Birthing founder, midwife Elizabeth Bachner.  These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.

 

Published: August 19, 2015| Reviewed by: Kim Walls, Natural Products Expert, Elizabeth Bachner, LM, CPM, L.Ac., Midwife | Last reviewed: August, 2015

Kim WallsLabor Induction Due to Low Amniotic Fluid Levels

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