Pregnancy: Week 39 – Low amniotic fluid and an eviction notice!

This is going to be the last update before #ChuaBeeBee makes her appearance! Today, I am 39+3 with no signs of labour. I’m gonna be admitting later at midnight!

I saw my gynae two days ago on Monday to check on CBB. Her head is low but not engaged, and my cervix is not dilated, not even a bit. Her heartbeat is great and growth is good, putting on another 200g since her last check up barely a week ago. BUT…

… her amniotic fluid index (AFI) is low (oligohydramnios), which came as a shock to us and to my doctor because just 6 days ago, her water level was just perfect for us to still wait for things to come naturally.

How is the AFI measured?

My gynae told us that the AFI is measured in 6 quadrants. What he did was place his scanner in 6 parts on my tummy to see how much water (dark areas) there are. He then measures the individual pockets of water in cm using his machine, and the summed-up area is the AFI. Anything below 6cm is not good, and we measured only around 4.5cm, which is low.

Why does the amniotic fluid decrease?

There are a myriad of reasons, including leaking water bag, growth restriction and etc, according to individual baby’s stages and conditions. For us, the most likely reason is that the placenta is now starting to get weak and unable to supply as much nutrients to baby, since we’re already close to 40 weeks. This is normal in late third trimester, said my gynae, but it doesn’t mean it’s ok. The amniotic fluid is the baby’s urine, so when baby ingests less (from a weakened placenta), she outputs less, resulting in less fluid.

What does the amniotic fluid do for baby?

According to babycentre, amniotic fluid’s role is crucial in:

1) Cushioning your baby to protect him from trauma
2) Preventing the umbilical cord from becoming compressed, which would reduce baby’s oxygen
3) Helping to maintain a constant temperature in the womb
4) Protecting against infection
5) Allowing your baby to move around so that muscles and bones develop properly
6) Helping the digestive and respiratory systems develop as your baby swallows and excretes it and “inhales” and “exhales” it from his lungs

What are my options?

My doctor isn’t toooo worried because at close to 40 weeks, baby’s development is complete. He gave us three options: 1) Admit for inducement on Wednesday midnight (technically 12 May 0000h) and see if my cervix dilates 2) Wait to see him on Thursday and we decide then and 3) Opt for C-section

I’m more swayed towards 1 and 3 because I want to get Chua Bee Bee out safe asap. He’s quite pro-natural and hopes we can get her head to engage in two days instead of going for C-sect right away. I raised my eyebrows at him cos really mehhh two days can much changes happen. The thing about opting for inducement is that it could still result in C-section, especially when baby’s head is not engaged and cervix is not even dilated. He told me to “walk more these two days but don’t walk until you faint la” and we can try first. If dilation doesn’t happen and baby is in distress, we can decide on c-sect in the afternoon. Some people will just opt for c-sect but I don’t want to live with a what-if. And that’s my choice.

What are the extra costs involved?

I’m going to be delivering at Mt Alvernia, so there’s no additional cost for an emergency c-section if it happens. I will just be paying the deposit for a natural delivery, and if I end up having a c-section, I pay the balance of a c-section package and of course my gynae’s fees for c-section instead of natural. I don’t have to pay the hospital double (natural + c-sect) nor do I have to pay my gynae double. The cost per pill inserted for inducement is around $60-$80. More info on Mt A maternity packages can be found here. And although c-sect costs are higher, you can also claim more under the Medisave Maternity Package.

Did you have any complications before this?

Not at all! This pregnancy has been great. Apart from being overweight to start with (I started at 72 kg – yes not bluffing), everything’s perfect. Blood pressure 113/81 at last measure. No gestational diabetes. No excess protein. Not GBS positive. Baby has been putting on weight constantly. Lots of fetal movement. Chua Bee Bee’s estimated weight is 3.16 kg as of last scan, but it’s just an estimate after all. Can’t wait to lose all the weight and more!

So… when is Chua Bee Bee coming out?

I’m going to be admitted Wednesday midnight cross over Thursday (12 May).. hopefully Chua Bee Bee cooperates! But even if we have to go for a c-sect, what matters most is that she arrives safe and healthy. I’ve heard people say that our womb is the safest place for our babies and everything should just go “naturally”. If everything else is going great, then yeah, but when there are medical reasons, getting baby out IS SAFER. Please don’t be stubborn and be your own doctor! Actually even if you opt for non-medical reasons to induce/c-sect I don’t believe anyone should judge you. It’s your body, your baby, your choice.

Good luck to me and to all mummies-to-be! A new journey is starting soon and we’re very nervous but excited!

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Catch up on my other pregnancy posts:

Pregnancy: The big reveal!
Pregnancy: The first trimester scans… I saw an empty womb on my first scan
Pregnancy: The second trimester – harmony test and gender reveal!
Pregnancy: The second trimester – 20-week anomaly scan + gestational diabetes scare
Pregnancy: The third trimester 4D scan – I saw Chua Bee Bee’s cute little face!
Pregnancy: Mount Alvernia Hospital – Maternity Tour & Estimated Bill Size 2016
Pregnancy: Bellybuds! Playing music for your baby in the womb
FY2016 Budget: Is the government giving us an extra $3K into the Child Development Account?
Pregnancy: Why I’m choosing GAIA Natural Baby Organic Skincare for #ChuaBeeBee
Pregnancy: Tips for changing your gynae at Week 35
Pregnancy: When you wrist hurts like nobody’s business (All about De Quervain’s Tenosynovitis)
How to bake your own chunky chocolate lactation cookies

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