"I'm 2 weeks and 3 days past my 'due date'!"

So what?!

Gandhi and Wainer

Agreed

Too Little Amniotic Fluid: Another Cesarean Averted

Around the same time that the couple who had been told that they had too much amniotic fluid and a huge baby - and so they would have to be induced and quite probably have a cesarean section - came to see me, another couple came to me for a consult as well. This couple was told that they would have to have a third cesarean because the ultrasound had shown that their baby had Intrauterine Growth Retardation and that there was too little amniotic fluid. I will say it again: ultrasounds are notoriously inaccurate for dating babies, predicting the weight of babies, and for determining the amount of amniotic fluid. It was a Thursday night, and I asked the mom if I could feel her belly. I asked her if anyone had palpated her and she said no. After playing with her baby, I told her that her baby wasn't huge, but then, we wouldn't expect her to have a huge baby - she herself was just five feet one and her husband is five-eight. Her other babies had been small, but healthy and fine. I told her that the baby's head felt like a perfect size, not too small, and that more important, if we measured her and her she was growing from visit to visit, that would give us an indication that the baby was doing well.

The couple called me the next night and hired me over the phone. They decided they wanted to have a HBA2C. We made a plan to get together on Monday, as I was going to be at a graduation party out of state that weekend. The woman had been told that there was no way to increase amniotic fluid -- and I begged to differ. I gave her some suggestions, although I told her that the fluid level felt just fine to me - I did suspect oligohydramnios (low fluid level), not in the least.

The following day, this couple birthed their baby so quickly that only one midwife was able to make it to the birth - and she was heading up the stairs to their bedroom as the baby's head emerged. The baby was five pounds four ounces (exactly what I myself weighed as a baby, by the way!) - healthy, pink, perfect, lusty and adorable. This family is so happy - they cannot believe that they were hours away from yet another cesarean.

Too Much Amniotic Fluid?

This wonderful couple came to me two days after their "due date" which had been calculated by an ultrasound - we all know that ultrasounds are notoriously inaccurate for dating babies. This was their first baby and they had been scheduled for an induction the following day and had been threatened, heard the word "cesarean" thrown at them several times because the ultrasound had also "told" them that the baby was over eleven pounds and that the mom had too much amniotic fluid. The couple's doula had told them to set up a consult with me to get a second opinion. They drove almost two hours that late afternoon to meet with me.

When I met Kate, she looked the picture of health - beautiful and pregnant. She did not look as if she was carrying an eleven pound baby, and even if she was ( I have attended several women with babies well over ten pounds, a few over eleven, and one which was twelve pounds six ounces), who cares? The head position and size is what matters, and some larger babies can have the same head circumference as a smaller baby - the only reason they weigh so much is that they are chubby, and the chubby parts squish to come out! I asked Kate's permission to palpate her belly - and when I did, I asked her if anyone else had FELT her baby like this. She said no one had, that all that her doctor did was to put the ultrasound wand on her and listen to the fetal heart tones. I told her that she did have a good sized baby but not an eleven pound one, and that the amniotic fluid level felt perfect - we all know that ultrasounds are notoriously inaccurate at measuring fluid levels.

Kate and Ryan decided then and there to have a home birth with me and eleven days later, they had a beautiful eight pound ten ounce baby boy.