Midwifery Today Community

 I'm wondering if there's ever a low enough level of fluid to warrant induction.  If there is, what is it?  I know that when I had a level of 3, I was told to induce.  I tried natural methods and they seemed to get things started, but not really kick off.  I then allowed them to do stripping, which did the trick and threw me into active labor.  Once the baby was born we saw that there really was no water, but the baby was fine the whole time.

Measurements of AFI are not that accurate. I would not induce on that indication by itself. There are ways to increase the level- drinking lots of water, stevia (an herb) seems to increase levels and actually may be something to check if mom is showing too much fluid. I don't think there is enough knowledge about fluid levels.

 So, this can be a tricky subject.  Levels of amniotic fluid have been associated with poorer outcomes, this goes for higher and lower levels.  The normal range for an AFI (amniotic fluid index) is 5-25.  For example, high levels can be associated with diabetes and low levels can be associated with placental insufficiency.  That being said...the levels do fluctuate and obtaining the "reading" can be very subjective based on who is doing the measuring and the position of the babe.  I have seen a Mama get a low reading by one provider and then get another reading later in the day that is just fine.  Also, it is important to factor in the "surrounding" information...why are we doing the AFI?...is it for post-dates, decreased fetal movement or some other concern?.....

I don't mean to sound too technical...just giving the facts.  I would not automatically condsider an induction based on one piece of information.  I work in an out of hospital setting and we send our Mama's to get a BPP (BioPhysical Profile) at 41 weeks, part of the BPP is an amniotic fluid level and I deffinitely make sure to tell my Mama's to be nice and hydrated.....

 thanks for your reply.  so basically, towards the end of my last pregnancy I was sent for a BPP and was told that my  fluid levels were at 3.  Being a doula myself and knowing that there is some controversy with fluid levels I called my doula before agreeing to an induction.  She told me that 3 is awfully low (which you seem to imply as well) and I should go in.  Thankfully when I got to the hospital, the monitor indicated that the baby was fine and they were too busy to start an induction so they let me wait.  They offered to do stripping, which I refused at first, but later consented and it worked and I went right into active labor.  Right before second stage, my "water" broke - meaning there were about 3 drops of water on the floor and that was it, so the level was really down to nothing.  Baby was fine.  (though it was definitly my most difficult labor ever - I assume due to the lack of cushioning).  Since then, I've really tried to find out what's real and what's not and what are the risks of have ultra-low levels - cause MY baby was fine - 9 APGARs at 1 and 5 minutes - and this hospital doesn't give 10's so it might have been even better.  he was rather wrinkled and dry though.  Would it have helped at all to drink?

never had the problem myself, and I don't routinely test for it w my clients. I did one birth where the baby had no water, which surprised me. That baby was fine. I think I didn't notice the low fliud level because she was moderately obese, I was confused how much was fat and how much was fluid.

Someone else I just met had that problem w a previous pregnancy. Chronically low amniotic fluid levels caused her baby's limbs to be contractured at birth. His muscles then never formed properly, and he has a rare condition called arthrogryposis.