Understanding Polyhydramnios

“I’m so sorry, Amy. But I’m going to have to rush you out for a caesarean.”

That’s when an alarm sounded in a small Australian hospital, echoing off intentionally subdued blue painted walls. Amy, already a mother of one, was forty weeks pregnant and had just had her water manually broken due to a diagnosis of polyhydramnios at twenty weeks.

Affecting between 1% and 2% of all pregnancies, polyhydramnios is a condition that causes an excess accumulation of amniotic fluid. As you approach the end of your pregnancy, amniotic fluid is supposed to decrease through a process of fetal reabsorption. When you have polyhydramnios – it increases. Causes include gestational diabetes, fetal abnormalities that affect the gastrointestinal tract, excessive weight gain, fetal infections, twin to twin transfusion, blood incompatibilities between mother and baby, and other rare instances. However, many times the cause isn’t clear.

From 20 weeks, Amy and her husband, Dan, knew that she had polyhydramnios. Because it is so uncommon and she hadn’t heard any horror stories, Amy didn’t really let her anxiety or fear run wild. She also magically managed not to Google obsessively or get lost for hours on end in message boards. The only real difference from her first pregnancy was her needing to be monitored every two weeks by scan. (And the added exhaustion of chasing after a toddler.) Without being able to determine a cause, Amy’s doctor was a bit baffled when the scans consistently showed a large baby measuring four weeks ahead and a lot of fluid. However, he was confident that Amy could deliver a healthy baby one way or another, which put Amy at ease.

While too much fluid may not seem like a big deal, the risks of polyhydramnios are preterm labor, premature rupture of membranes, still birth, placental abruption, postpartum hemorrhage, fetal malposition, fetal macrosomia, as well as a 1% chance of a prolapsed umbilical cord. In a prolapse, the umbilical cord drops through the open cervix into the vagina ahead of the baby. The danger of having the umbilical cord prolapse is the exposure to oxygen, which can cause the cord to spasm and cut off oxygen to the baby. It can also break away from the placenta and cause bleeding, which is life threatening to both mother and child.

As Amy approached her due date and with the possibility of a prolapsed cord in mind, Amy’s doctor was adamant that her water not break without being monitored and had her come in for an internal examination. It was decided that she would come back in the next morning at 7:30am to have her water broken manually and to be induced with Syntocin. Upon arrival, Amy was surprisingly relaxed. Her first son, Lawson, had been born naturally at the same hospital and her experience had been wonderful. After the midwife put in an IV for the Syntocin, Amy’s doctor began to break her water. Rather quickly, a cascade of fluid came pouring out. Erring on the side of caution, her doctor checked the position of the baby and cord with an ultrasound machine. Almost immediately, an alarm rang out. Oblivious that it had to do with her, Amy was shocked to find out that she was one of the 1% of people who experience a prolapsed cord due to Polyhydramnios and would need an emergency C-section. Immediately.

Not fully aware of the true danger both she and her baby were in, Amy asked her husband, Dan, if he would call her mom to come to the hospital. She also asked him to call her sister, Katie, because she was going to take photos. Expecting a 12-hour labor, she hadn’t bothered to tell anyone to show up that early in the morning. Amy added he also needed to call her sister, Kristy, who wanted to come because she’d never seen anything be born and wanted to witness it. As she continued to rattle off the to do list, Amy’s midwife instructed her to focus and flip over on all fours and stick her butt in the air because they needed to keep the cord inside of her until they could wheel her to the operating room. To save whatever modesty Amy had left, they draped a sheet over her and swiftly pushed her through two sets of double doors through the Emergency Room waiting room of the small rural hospital and into the O.R. Amy’s head was now down and she was growing silent, finally realizing the gravity of the situation.

Amy’s doctor, three other doctors and several nurses, including her brother in law, Josh, acted quickly and with no time for an epidural, knocked Amy out with anaesthesia. Within half an hour from having her water broken, Amy was awake and told that both she and her baby were doing great. Then she slept for an hour. Once awake again, Dan and Amy cradled their new baby boy – named Jude – after Amy’s late grandmother, Judith. He had been born on Amy’s birthday.

In those first few hours after Jude’s arrival, both the midwife and the doctor asked Amy if she’d like to speak to a therapist about what she had been through. Elated and high from having a healthy newborn in her arms, she said no. It wasn’t until Day 10 that Amy became overwhelmed with emotions about how close she came to not having her baby. Things truly could have been so much worse.

Amy says, of her experience, “I am forever grateful for the incredible team that kept Jude and me safe. Even though it was quite traumatic, I feel blessed to have gotten to experience both a caesarean and a natural birth. I know some mothers who have C-sections feel disappointed, but it still made me feel really strong and powerful. It’s something I wouldn’t change.”

This piece was originally published on The Tot.

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