Is Low Amniotic Fluid (Oligohyrdamnios) a Valid Reason for Induction?

At 40 weeks and 2 days pregnant, at the request of my midwife, I go in for a biophysical profile. After performing the ultrasound, the technician tells me I needed to speak to the doctor. I walk into his office and he informs me that my ultrasound showed low fluid around my baby, and that I would need to be induced. "Today?" I asked. "Yeah, well, I'll need to ask your midwife about it, but I'm sure she'll agree with me that you need to be induced." Being overdue and overly excited to meet my baby, I don't question the doctor's decision. In fact, I am overjoyed to be going into labor that night.

Low amniotic fluid, or oligohydramnios occurs when the fluid which surrounds and protects the fetus is low. About 1% to 5% of pregnant women past their due date will be diagnosed with low amniotic fluid.

Fast forward to the next day, during my pitocin-induced labor. At one point, amidst the painful contractions, I feel a pop and then a gush. I announce to the room that my water has broken, then push the nurse call button on my bed. After my midwife checks me, she shakes her head and I hear her quietly saying something to the nurse about there being plenty of amniotic fluid.

In their paper Isolated oligohydramnios at term: Is induction indicated?, Lawrence Leeman, MD, MPH and David Almond, MD, MS come to several conclusions. They conclude that, for an otherwise healthy pregnancy, oligohydramnios is not harmful to either the mother or the fetus. They also advise health care providers to instruct a woman whose amniotic fluid appears to be low to drink some water. This has been shown to increase the amniotic fluid within a few hours. After 2 to 6 hours, they advise, another ultrasound can be performed to make sure the low fluid is not persistent. They also instruct that a borderline amniotic fluid index (AFI), which is defined as an AFI of between five to eight centimeters, is not an indication for labor induction.

In addition to this, ultrasounds are not as accurate as we'd like to think they are. Women who've had a c-section because their baby was "too big" (only to birth an average-sized 8-pounder) can attest to this. The same goes for measuring the fluid around the baby.

Later, almost 30 hours after the induction was started, I have stalled at 6 centimeters. I am sent to have my baby delivered by c-section.

I wish I had known all this before I was induced for labor that day. It set off a spiral of events that ended in a c-section, me being kept away from my daughter for 24 hours, her being in the NICU for a few days, and a rocky start to breastfeeding.

Consider this if you are at term and are diagnosed as having oligohydramnios during an otherwise healthy pregnancy and your health care provider wants to induce you. Request that you be able to drink some water and be retested in a few hours to make sure that what you're experiencing is truly oligohydramnios.