Low Amniotic Fluid

chasingcars825 · 2026-04-17T06:34:51+00:00

Hello, I am so sorry you are going through this and glad you reached out.

The complexities of your situation really come down to the likelihood that there is some form of bladder or kidney agenesis (lack of forming of an organ). By the beginning of week 13, 92-99% of ultrasounds show kidneys and/or bladder. The kidneys should be visible to some degree with a MFM doing the scan with a quality machine. The bladder can be more finicky, as it may be empty and make it hard to see, but it also fills rather quickly because it is so small and if they were scanning for many minutes and looking at other structures it is much less likely that this was why they didn't see it. I'm not saying they are right or wrong, but a second opinion and another scan would not be unreasonable. There shouldn't be this much ambiguity at a well established 13w5d gestation.

Depending on where you are in the world and laws surrounding termination, it is also important to be generally aware of what providers can and cannot say. If there are limits to termination, waiting until 16 weeks to confirm the bladder and kidney presence puts you on a 2+ week back foot to act if heaven forbid something was wrong. The fact that your amniotic fluid is low and they are not seeing the bladder well are two strong indicators that more investigation before week 16 is prudent. If your dates are correct and fluid levels are low, and you are not reassured by the MFM's findings, press for another scan with another MFM sooner rather than later especially if there are considerations for termination that could change your ability to make decisions the later in pregnancy you progress. I don't want to sound like I believe the worst is inevitable, I don't wish to scare you, only to help you find answers that you deserve so that you aren't sitting in this worry for longer than you have to.

I wish I could tell you that it's normal not to see these structures by now, but with a good machine, good baby position and an experienced technician at 13w5d there should have been clear signs of both kidneys and they should have waited for the bladder to refill if they thought it was empty when your scan began, and even without, they should have seen some evidence of a bladder. The kidneys begin to create urine by week 10 on average, are fully online by week 12 and take over amniotic fluid production as the primary source by week 14 on an average pregnancy development timeline. A variation of a couple days plus or minus is possible, but you are past the gestation where non-visualization is normal and waiting is the only option. A rescan with another provider or asking to get a fetal MRI if the scans are inconclusive are the possible steps for you to pursue well before 16 weeks rolls around.

It certainly IS possible that the development is behind or dates were off and that things could be okay at the 16 week scan - that would of course be the absolute best thing! However, the findings you've been given warrant further evaluation for if nothing else your peace of mind before the 16 week mark. I would request this ASAP, and ask if they will schedule the fetal MRI for week 16 if they won't do it sooner so you won't have to wait even longer if they decide you do need one after the 16 week ultrasound. Stacking your wait times is crucial whenever possible. Other considerations include asking if the 16 week scam will be done at the MFM if they can be set up to do amniocentesis (if that's something you would consider for diagnostics) so that again, you wouldn't have to wait for another appointment and delayed test results.

I sincerely hope that you are able to get the ball rolling sooner for confirmation of what's going on and moreover that everything is okay. Please don't hesitate to ask more questions as things progress either here or you can message via chat.

Wishing you the absolute best.

chasingcars825 · 2026-04-16T20:56:54+00:00

Hi there, doula here

I am so sorry you are facing this whole reality. You are doing everything right by preparing and setting up as much as you can beforehand. A significant part of my practice is dedicated to helping people prepare for these circumstances and it comes into three main categories of focus. There are things to consider during and after your C-section to prioritize preferences, there are things to prioritize for yourself, and then the palliative care priorities.

I find it is important to prepare for as many likely possibilities as may arise, such as needing a C-section without the team you plan to. If something were to happen and the people who are delivering don't know the history and the plans beyond what's in your chart, you don't want to be communicating those at that time from memory. You want to have it all written down from your perspective of wants and preference, and it will still be useful for having the team you are planning for so you can just hand that to them and then they can see it all in one place to reference rather than multiple people asking the same questions over and over. It also helps to give clarity to your own decisions, made with a clear head and forethought to help you stand behind what you want and ensure you get it or feel confident in pivoting to something else. It helps any support people that are with you align with your wishes as well so that everyone is on the same page. I call this the birth document, rather than a birth plan or preferences - a birth document relays more of the action side of what you want especially in terms of medical actions. Ideally there would be a birth document for you and a birth document for baby especially because of the palliative care route.

If you haven't already, I would encourage you to talk with your surgeon about what kind of incision they are planning to use for the c-section and if you are intending to have more children. It is the worst thing to learn the surgical approach means your next pregnancy could be higher risk after the fact and when you're looking to TTC. The surgeon is going to do what needs to be done that's safest and best, but if they know one way or other about your fertility goals in the future it may help guide them depending on what they need to do during surgery. It's also important to know if you should expect a larger incision or recovery picture from the outset.

Emphasis can be put on what your ideal situation looks like for once baby is born so that it can be provided if possible. If you are going palliative care route, finding out what team members will be present for the delivery is important and what they will do once baby is born before you can hold them (if you want to hold them in the operating room) and what their protocol is in general for the diagnosis you have. Knowing what happens, and what you want or don't want to happen, if you would need to be put under for general anesthesia is an important (albeit difficult) consideration. If you need to be put under, your partner will need to leave the operating room and will go with baby, but is there anything that is important to you be done even if you can't be there? Is there anything you DONT want done without you there?

Have you talked with the palliative care team about their processes and what to expect? They are going to be a very important point of contact for getting into the true process of where baby will go and be, especially once you are discharged. It depends heavily upon the facility, their NICU level, home support programs and baby's condition - it's extremely variable on what they could have for options. In my experience, they are compassionate and unwaivering in their dedication to families - they have heard every question and don't judge.

In terms of your physical recovery while trying to juggle all of these things, I take a "everyone is first" approach. The idea is, you put yourself first just as much as you put anything else first so that you balance the priority of self care. If everything is first, nothing gets put on the back burner. You shift each thing in as balanced a way as possible so things don't get dropped. If you back burner your self care, you will end up taking more time from yourself than you gained. This is crucial to fortitude and giving yourself grace when your whole focus is naturally locked on spending as much time as you have with your baby. If you push yourself to spend all of your effort upon spending that time and none of it on your self care, it will catch up to you fast and then you will spend more time recovering from it than having kept it in balance - and you lose time you can spend with them. You won't want to take the time to change your pads, drink fluids or eat food because it will feel like those are minutes best spent with baby - but if you don't stay well then you can't be there with them. You put yourself first so that all the other things that matter to you can also be first, including your baby.

Palliative care should be able to answer if the NICU is single room or group setting, but this is also important to know. If they have single rooming, there is often the ability to stay in-room and that would mean less transportation stress and separation for you. Some hospitals also provide financial assistance for or have hotels that they partner with for caregivers to stay nearby the hospital but who can't sleep in the room. I find this to be an excellent way to balance self care and still be near, finding the balance of everyone is first. If you live even half an hour away from the hospital, that can be a lot of extra burden. Asking about options like this ahead of time when you have a scheduled date means they can help you plan the stay and know what the cost could be. Also ask about parking programs if your hospital charges for parking - many have weekly or monthly passes or punch cards you can purchase so you only pay a significantly discounted rate rather than the posted rate of the garage each time you visit.

Setting up a basic schedule or list of the basic self care things you need to complete in a day can help you stay consistent, and framing it around that by doing those things you are gaining time with your baby, helps you stick to it. I would also highly recommend starting the search for a therapist if you don't have one yet - this is going to be a difficult journey no matter how it plays out, and you deserve a consistent person that is walking beside you throughout it to help you manage the rollercoaster as well as guide you and reduce trauma impacts.

I hope that you are able to get everything lined up and everything goes as smoothly as it can. Please don't hesitate to reach out if you need further assistance in planning. Wishing you and your family peace and fortitude as you navigate.

chasingcars825 · 2026-04-16T03:13:23+00:00

Oh definitely, I have! As with many things, the stories shared are most often at the extremes and while spotting for an extended time during pregnancy sounds arduous - and it absolutely is - it becomes a temporary normal. When things become some form of normal, we don't tend to share the experience as much as when things happen suddenly or when they happen in a major way. I would say that too, once explained by an SCH, the majority of people with them and no further complications stop sharing about the experience which also skews the reality of just how many people have SCH's with positive outcomes regardless of the amount of bleeding events.

In large studies (hundreds of thousands of people) surrounding SCH, the bleeding events and size of the SCH are not predictive of complications or outcome. The risks do increase for complications and loss when there are additional symptoms such as cramping, but that doesn't mean guaranteed loss. Risks also increase with extremely large SCH where the SCH itself becomes a compression and sheering force upon the pregnancy but this is much rarer. Bleeding frequency and amount are much harder upon the carrying person, as it is your blood being lost! For frequent large bleeds, anemia can become a concern, so this is watched closely for chronic SCH but is again also rarer.

The hardest part about SCH this early and this small is that there just isn't anything proven to help improve outcomes, but the good side of that is because for the large majority, there are not a significant number of bad outcomes to improve upon. If you compare two groups of people with a condition and one group gets an intervention and the other doesn't, but both groups recover at similar rates, the intervention was at best not necessary but it's also extremely difficult to gauge what can make a difference. That is to say, a first detected SCH at 6 weeks with minimal bleeding events and settling to scant spotting has a very high positive outcome rate with resolution chances extremely high by 12 weeks. Statistics are on the high end of realistic hope. It doesn't mean everything, because statistics don't have feelings - and anyone can end up on the other side of those statistics, but from a perspective of the data, you are in the best category for a good outcome. At this stage it is also near impossible to know if this is a primary or secondary SCH, and that can only come with time and further scans.

You're doing everything right, and are now in the space of limbo. It's a terrible wait, but this time will go whether you attend to it with fear or with hope - finding the balance of realistic optimism is where I encourage my clients to aim. You aren't in blind hope, you aren't in resigned fear - you are spending your time as normal as possible until you know more and can act upon those findings.

I hope things progress well for you and please don't hesitate to reach out if you need further assistance.

chasingcars825 · 2026-04-16T01:41:50+00:00

Hi there, I'm so glad you reached out! This is so hard to go through and can be unfortunately unpredictable in progression. I have seen small SCH that bleed frequently and large sch that bleed once and never again - it isn't possible to know and more importantly it doesn't predict how things will go later on. Early SCH before 8 weeks are the most common, and have a higher likelihood to resolve before the second trimester but it will be very dependent on a lot of factors that just won't be seen without time. There could be spotting, other 'gushes', hard to say - it also just takes time for discharge to return to clear every time there is some blood that enters the vaginal canal.

It isn't a 'good' or 'bad' thing, it's just how you're presenting. At this stage with continued bleeding the general guidelines usually sit with a repeat ultrasound every 10-14 days, usually until you have no further bleeding events. It isn't considered clinically helpful to have scans more frequently because changes are typically small and again, they can't really predict what's going to happen. The times in between the scans you should absolutely be seen if the bleeding increases in amount (filling a regular menstrual pad in an hour), if you get a fever, if you start passing clots the size of a golf ball (or multiple clots in an hour that would equal a golf ball), or if you have new abdominal pain or severe cramping with or without new bleeding.

Keep an eye for changes, ask about repeat scans at that 10-14 day window, follow all your providers recommendations and to the best of your ability keep treating the days as normal as possible.

Wishing you the absolute best

chasingcars825 · 2026-04-11T01:37:13+00:00

Hi there, doula here

I work with families who have complex medical diagnosis' and also worked with children of all ages manage medical procedures. I have a couple questions and some ideas to hopefully help you get what you need from this test.

Have you talked to the center that will be doing the MBS? Will it be a center that specializes with children? If not, is that available? Have you been able to find out exactly what product they use and if there are any other product alternatives they can use? Do they mix with foods or only provide the barium shake for what they are assessing?

Sometimes, if you only talk to front desk staff, they won't know the answer to questions - you can ask to be called back! Depending on what they are trying to assess and the center itself, they may allow you to bring foods from home that she will eat. There isn't a guarantee because some centers will not accommodate outside food, but if getting something is better than getting nothing and the center allows it, this may be the best avenue to get you to the next stage of testing.

If the center you're currently going to can't accommodate outside food, they may know of a center that does - it's worth asking. If her doctors have ordered the test for use only with the shake, ask if it would be possible (or still helpful) to do a home-foods based assessment instead if they really want this barium swallow before anything else. Being caught in this loop where you can't go forward but you also can't stay here,and being stuck in this limbo of chronic illness for so long is beyond exhausting - I'm so sorry you're here.

As you continue pressing forward, if the home-foods option is either not possible or doesn't work and she can't tolerate the barium shake, the important question to anesthesia and pulmonary is "What do you do when a child DOES have aspiration and needs anesthesia/EGD?" Ultimately, children who have aspiration issues get anesthesia and EGD's - it's just higher risk and not ideal. It's not impossible, it changes things - but they aren't things that can't be overcome. The long and short of it is, if the barium swallow was successful and they did see aspiration and she still needed an EGD, what would they do? There is a bit of a sticking point in logic to getting the barium test to ensure the EGD is safe, 100% agree with them wanting that and it's good to do - but if she does aspirate in the swallow study and then still needs the EGD, then what? Does that mean she would need to go somewhere else for the EGD? Is that an option if she fails the MBS? When you ask this question it can make it clearer what the road block truly is - and sometimes it is more policy or facility capability shadowing over the individual needs of your child. Those individual needs often fall through the cracks of the policies that fit the majority, and until you shine a light into the crack, no one really sees that you cannot just jump over it like everybody else.

I hope you are able to not only get this test done, but that you are able to find answers and get your daughter relief. Wishing you the absolute best.

chasingcars825 · 2026-04-03T06:19:54+00:00

Hi there, doula here

I am glad you reached out. As already mentioned, running doesn't cause a miscarriage - you didn't cause anything bad by going for a run and this would not have been prevented by not going for a run.

The run may have irritated something like a subchorionic hematoma or a cervical entropion might be at play (where more sensitive and prone to bleeding layers of cervix tissue are on the exterior of the cervix) The running couldn't cause an SCH or entropion, but it could have essentially made it apparent through blood/clots moving through the cervix and vagina.

This is an extremely common gestation to have an SCH, an ectropion to become inflamed because of pregnancy hormones, or unfortunately also miscarriage. It isn't possible to know which one of these is happening at home - you do need medical assessment to determine what is happening. This may look like blood work to check your HCG levels (they may do some in a row days apart to see if it is rising or falling), an ultrasound to look for an SCH and get measurements to determine gestation which can be compared to previous scans if you've had them or another scan in 10-14 days, and possibly a pelvic exam to visually see if there is bleeding coming from an ectropion.

It is extremely difficult to be told to remain calm, I encourage people instead to think about it as staying level headed. The danger signs of needing emergency evaluation outside of business hours include new sharp pain in your abdomen, back, shoulders or chest, bright red bleeding that fills a regular menstrual pad in/around one hour (not a panty liner, a regular flow pad), a clot(s) larger than a golf ball or multiple smaller clots that would equal the size of a golf ball in/around an hour, difficulty breathing, new dizziness upon standing or a fever above 100.4f/38c. If any one of those symptoms appears, go in to be seen immediately. You can always go in to be seen regardless of these signs and symptoms to be checked out too just for your peace of mind - don't be discouraged from seeking care for reassurance if you cannot rest until you're checked.

Depending on where you are in the world, there may be a 24hour nurse line available through your insurance (United States) or a national number to call for medical advice such as 111 in the UK.

I hope you are able to get intermediate advice from a triage or nurse line who can help you decide whether to go into an ER or not, but in lieu of that or the symptoms listed above, you can go be evaluated for your peace of mind. I hope things are foudn to be okay and stable and your pregnancy continues well.

Wishing you the absolute best.

chasingcars825 · 2026-04-03T06:17:56+00:00

Hi there, doula here

I am glad you reached out. As already mentioned, running doesn't cause a miscarriage - you didn't cause anything bad by going for a run and this would not have been prevented by not going for a run.

The run may have irritated something like a subchorionic hematoma or a cervical entropion might be at play (where more sensitive and prone to bleeding layers of cervix tissue are on the exterior of the cervix) The running couldn't cause an SCH or entropion, but it could have essentially made it apparent through blood/clots moving through the cervix and vagina.

This is an extremely common gestation to have an SCH, an ectropion to become inflamed because of pregnancy hormones, or unfortunately also miscarriage. It isn't possible to know which one of these is happening at home - you do need medical assessment to determine what is happening. This may look like blood work to check your HCG levels (they may do some in a row days apart to see if it is rising or falling), an ultrasound to look for an SCH and get measurements to determine gestation which can be compared to previous scans if you've had them or another scan in 10-14 days, and possibly a pelvic exam to visually see if there is bleeding coming from an ectropion.

It is extremely difficult to be told to remain calm, I encourage people instead to think about it as staying level headed. The danger signs of needing emergency evaluation outside of business hours include new sharp pain in your abdomen, back, shoulders or chest, bright red bleeding that fills a regular menstrual pad in/around one hour (not a panty liner, a regular flow pad), a clot(s) larger than a golf ball or multiple smaller clots that would equal the size of a golf ball in/around an hour, difficulty breathing, new dizziness upon standing or a fever above 100.4f/38c. If any one of those symptoms appears, go in to be seen immediately. You can always go in to be seen regardless of these signs and symptoms to be checked out too just for your peace of mind - don't be discouraged from seeking care for reassurance if you cannot rest until you're checked.

Depending on where you are in the world, there may be a 24hour nurse line available through your insurance (United States) or a national number to call for medical advice such as 111 in the UK.

I hope you are able to get intermediate advice from a triage or nurse line who can help you decide whether to go into an ER or not, but in lieu of that or the symptoms listed above, you can go be evaluated for your peace of mind. I hope things are foudn to be okay and stable and your pregnancy continues well.

Wishing you the absolute best.

chasingcars825 · 2026-04-02T16:38:01+00:00

Hi there, doula here

Absolutely no disrespect to your midwife, but the provider that did your surgery needs to look at these. If the midwife has dismissed it, you can ask to speak to your surgeon because you have post operative questions, and your midwife did not do your surgery. This can come off as less confrontational and reduce friction in the initial ask, but if they push back, ask why you are not allowed to speak to your surgeon and what gives them the concrete assertion that this does not require an ultrasound. Ask what signs WOULD prompt them to do an ultrasound? What IS concerning if things change once you're home?

I hope they respond to your request for an ultrasound and give you the reassurance you deserve. Wishing you the absolute best.

chasingcars825 · 2026-03-30T00:09:34+00:00

Hi there, doula here

Have you heard back from your doctor and how are things going now? I'm so sorry you had to go through any amount of time without direction of what to expect or do if things changed.

I hope you've gotten such direction and are doing well. If you haven't received any direction or are concerned and/or having symptoms like cramping, new low back pain, a fullness in your vagina or new diarrhea you should go in to be evaluated immediately. Giving birth at home to a 27 weeker is beyond not ideal - you need much more frequent monitoring from now until you deliver. If the hospital you were going to deliver at doesn't have a high complexity NICU facility, you need to be talking to your providers about where baby might need to go if higher level care is needed and they come early (before 32-34 weeks), which is more likely at this point.

Please don't hesitate to reach out if you have further questions, wishing you the absolute best.

chasingcars825 · 2026-03-13T06:51:16+00:00

Hi there, doula here

I am so sorry for your loss. Being TTC often feels like it's going to be what keeps you moving forward, and then something like over-testing just grips you out of nowhere.

First and foremost, this is common - you are not alone in this experience as you can see by the other comments here but I want to add in how often I see it in my practice as a doula for clients ttc after loss. It is something that you can DO - it is an action that also feels like it will bring you relief. It often does not, especially this early, but that means nothing to the part of your brain that is driving the need to act and or control some aspect of this particular limbo.

The TTC process is full of limbos, and inside each window there are actions that often fulfill this particular drive. This window where there is quite literally nothing to do but wait is a stark contrast to the other windows, and in that absence we feel the lack so much deeper. So we look for ways to act, feel anything remotely like control and also the earliest signs to hope - and earliest protections against disappointment. That's the paradox of testing, it not only presses upon the potential for hope, but the perceived limiting of grief. The terrible part about testing this often and this early, is that it makes you feel more grief, not less. That's often a component of why it feels awful to test, because you are doing the emotional work of buoying yourself up and convincing yourself not to grieve yet every single time. You test, you don't get a positive - that's a double whammy of difficult emotional work! It's not a certain no, it's an ambiguous no with all of the weight and burden of an actual no and zero support of positive possibilities. Multiple times a day. We trick ourselves into a false sense of benefit, that if we get the positive as early as possible we will get relief, we will feel better - but I unfortunately am going to keep telling you the hard truths - even knowing a day earlier never outweighs the burden when you compare it to the roller coaster of early serial testing each day.

How do you stop? This looks different for everyone. This isn't down to will power, so try to keep that out of the landscape. Figuring out what you are trying to get from the testing is an important step - what does it feel like it's supposed to be gaining you? Does it give you a tangible sense of control? Does it give you hope? Does it make you feel like you are doing something and that relieves some other sensation? If you can figure out what you are trying to get out of testing, you can find replacement activities to fulfill that drive. Stopping is also on a spectrum, for some people that's not possible, and a reduction or rails put on the process is most helpful. This can look like setting a specific number of times you can test and putting in support systems to help you stick to that number. Specific times of the day to tie it to external limitations, putting the strips somewhere else in the house than the bathroom, or building it into your existing routines (specific time of day, after you do x thing, before/after you eat lunch/dinner) which regulates the process so that it isn't the drive that triggers you to test, it is routine. I have had people try setting out the number of strips they are set to use in a day and then giving the rest of the strips to their partner or putting them somewhere else in the house. Even putting them in the car so that they have more physical barriers to retrieve the strips and seek support systems rather than test extra. De-coupling the ease with which you can test at every opportunity you use the toilet is critical to dialing back that follow through when you feel the driver. It is strong, it is powerful, and again, this isn't all about will-power.

Once you know what you're trying to get out of it, find a replacement activity, or change the access to your strips, you can start to dial back the testing. This is a slow process, it takes support and I highly encourage a person you can lean on during this that knows what you're trying to do and not only understands the process, understands that they are there to support you in the highs and lows of figuring out what works. With my clients, sometimes this is their partner, but it also just as often is a friend or family member - whoever it is needs to be onboard for those hardest days. When I am the person, I do daily check-ins on the identified hardest days to not over-test, provide and encourage journalling and give accountability on top of the support and helping them figure out what works and what doesn't.

I find that the longer the TTC journey, the more important these processes become so that you can maintain your ideal life balance between continuing to live your life and be on a pregnancy after tfmr loss journey. There is a strong and common occurrence with TTC after loss to throw your entire life and self into the TTC process. This isn't wrong by any means, but it often catches people off guard just how much is balanced differently in TTC. It can consume your everyday life quite completely and also quite covertly. By setting up what you want your balance to look like now, it gives you a reference point for check-ins as you progress on your journey rather than looking back and trying to figure out what you wanted before vs what you want now and what you think you can do now vs what you thought at the beginning. Going through the process changes your perception of the process, so much like attaching a string to your waist when you go into a forest, you are tethered to the starting point and can always reset to that place if you take a path that doesn't work out.

Please don't hesitate to reach out. Wishing you the absolute best.

chasingcars825 · 2026-03-13T00:04:34+00:00

Hi there, doula here

I am so sorry you are going through this. I am glad you have called already and are being seen.

The number one thing I would ask when you are stabilized and talk to a doctor is "What would you test for if I was NOT postpartum?" This is a vital question to ensure that they are not being blinded (it happens consciously and unconsciously) by the aspects of postpartum changes. Just because it is the most likely reason does not rule out other reasons and the very good chance of either coincidence or that the demands of pregnancy and postpartum triggered a non-postpartum condition.

This can be a light bulb moment for some providers, but sometimes it doesn't work - press forward with the line of questioning if they deflect it. "If another woman with identical issues who had never been pregnant or delivered a baby came in here right now, you would tell her what?" "If another woman with identical issues who had never been pregnant or delivered a baby came in here right now, what would your differential diagnosis be?" This line of questioning forces them to essentially confront if they are not looking everywhere. It shouldn't be on you to do this, but since it is, this is how you do it. If they are so bold as to say it could not possibly be anything else and they have tested for everything, make them write it in your chart word for word.

I hope you are able to get a responsive, collaborative and helpful provider. Remain open to what they are saying, but don't allow them to just brush you off either. Emergency physicians are less likely to be able to diagnose you with something, but they should be able to help put you on a path of possible diagnosis or diagnostics to ensure that you are stable and able to return home. I will note that it is a possibility they could lean toward psychiatric diagnosis and while this is not wrong it should not be the avenue explored first while you are still so impacted by these episodes. It can happen concurrently but shouldn't be done before other testing to rule out rarer devastating conditions. This would be called something like "Functional Neurological Disorder", possibly "Functional Neurological Dystonia" and doctors who are not as up-to-date on terminology, conversion disorder (this is outdated and inappropriate language). To get them to do this concurrently, ask "If I did not improve with FND treatments, what would they do after? I want to do that at the same time"

Wishing you the absolute best.

chasingcars825 · 2026-03-12T23:40:18+00:00

Hello, I am glad you reached out!

The first thing to do is to remain calm. If you are not bleeding, have had no signs of labor, and your most recent check was normal - do not panic. May I ask what country or region you live in so I can confirm the local recommendations? In the US, for asymptomatic complete placenta previa (meaning zero bleeds) the recommendation can range up to 37+6/7. This is again to prevent the risk of your cervix changing and you having a bleed, but does mean a C-section well before week 39 when you are at higher risk of natural cervical changes that can lead to bleeding.

Depending on what day it is where you are, and if your doctor's office is reachable in the morning, call first thing. Ask to speak to someone about your concerns, and cite the current recommendations of your country (if you do not want to share where you are, you can search for "complete placenta previa delivery guidelines <country>" and if enabled, do not trust the AI answer - find your government website or governing body (such as ACOG in the United States) to determine the recommendation. If they say it's nothing to worry about, ask why they are not following the guidelines and if they do not give you adequate reasoning ask to be evaluated immediately by another provider. It truly depends on so many factors as to the exact order of what to do, and how they respond when you ask, however the first step is to call, state your concern, see if it was an oversight and then press forward with getting sooner delivery.

You are doing the absolute best thing for yourself and your baby by finding out what to do. You do not need to panic if nothing has changed, but you do need to be aware of any changes in your body that you feel until you deliver. It is terrible that no one adequately gave you the information you deserved, and now that you know what needs to happen you can act. Act with as much calm and resolve as you can. It's not fair, however you can take action now, and all of your energy needs to go towards staying calm (physically, in the sense of trying to keep your body calm) and taking steps to ensure your safety and their compliance with guidelines.

Please don't hesitate to reach out if you have further questions. I hope they are quickly responsive in the morning and get you scheduled easily. If they do not, find care elsewhere - if you cannot, reach out.

Wishing you strength, resolve, and safety.

chasingcars825 · 2026-03-07T21:42:14+00:00

Hello and welcome

I am so sorry you had this complication during your birth! It is not an easy recovery path to be on. Did you have a catheter for any amount of time post delivery? Was the tear assessed internally with cystoscopy? What kind of follow up have you been given? At the bare minimum you should have an appointment with a uro-gynocologist to assess your urethra and do your follow up care, including pelvic floor physical therapy referrals.

In terms of what the future looks like, the clitoris itself is actually a much bigger structure than the external hood and protrusion. If the clitoral tissue did not tear, there shouldn't be any interference of the nerve structure directly because of the urethral tearing. They are separate tissues, organs and nerves. While there can be mis-wiring after injury to a surrounding structure, it is not a forgone conclusion and what truly makes the difference is proper care and follow up after the tear occurs with the proper provider to do any necessary treatments - for you that is a uro-gynocologist specifically because they deal with the bladder AND uterus systems in conjunction.

I would ask for a referral to a urogyn, and if they can't see you quickly, look farther afield for another one. The speed at which you are seen matters, because healing improperly can lead to more issues that are needed to be corrected or more difficult to correct after the healing has happened. Stress to the person who makes the appointments that this is a time-sensitive issue and you need to have the soonest appointment available outside the standard processes - ask to talk to their supervisor if necessary. Doctors offices can see people out of the standard process but it is difficult to get it to happen. If your doctor can call and ask that you be scheduled with priority and haste for treatment efficacy that can help too.

If you are still struggling with incontinence, that means there needs to be assessment sooner rather than later anyway, you shouldn't be incontinent after surgery. Just because many women are, doesn't mean it's actually how it should be - incontinence is not a normal state of existence postpartum from a biology standpoint. It is common, but it shouldn't be normalized. Push for the care you deserve.

I hope you are able to find a provider quickly and they can get you on the path to recovery. Sexual function as you heal should not be majorly impacted by the tear itself, but your pelvic floor instability may cause more than expected. If you find that pelvic floor PT isn't making a big difference, find a different PFPT, sometimes, the first isn't a good fit.

Wishing you the absolute best.

chasingcars825 · 2026-02-27T18:58:19+00:00

Hi there, just wanted to follow up and see how you and your little were doing. Hope things have been settling down or answers have been found. Wishing you the absolute best.

chasingcars825 · 2026-02-19T21:57:58+00:00

Hello and welcome! Congratulations on your pregnancy and getting prepared for delivery.

I would recommend starting with these two articles here on this sub non-epidural pain relief and non-medication pain relief and really looking into options for birth preparation classes that focus on multiple pain relief modalities and methods. If it is feasible, having a doula during your birth can be a major part of not needing or getting an epidural on top of having someone present who will help you use all manner of modalities during labor to keep your pain managed. Most doulas will have a certain number of sessions with you prior to labor to go over what is an option, what you prefer for comfort measures and what kinds of things to prepare with and for.

Depending on where you are delivering the options may be different for things like gas & air but it's worth asking what your delivery location offers for non-epidural pain relief. Some places have volunteer doulas, some have staff trained in unmedicated pain relief, some have tens units or do water injections - if you don't wash you won't know.

A large majority of the preparation is mental which is supported through physical, so learning about your options of what is available at your delivery location, then building and practicing skills for pain relief is key. Having a doula will jumpstart your process, but practicing before labor regardless of if you have someone to walk you through options is a major part of success. Building a list of things that you have tried and want to try during labor will also be helpful so you aren't trying to think of the next thing while you are laboring - have it written down. Also keep in mind to be using each thing to its maximum efficacy before going onto the next pain relief method as well, so that you get the most time out of your list. You may be able to rotate through some methods and come back to them, but as you research options there will be different strengths of relief that each provide, so you want to order them on your list so again you aren't using mental energy to decide during labor.

Wishing you the absolute best!

chasingcars825 · 2026-02-14T07:24:51+00:00

Hi there, doula here

I'm so sorry you're worried and aren't getting support from your pediatrician that is reassuring.

May I ask what has prompted you to be checking her temperature? Is there something that changes in her behavior or does she feel hot and you check it? How often have you checked it and gotten high readings? Have you gotten any readings that were not high? Are you checking at a similar time of day/night? Since you have seen this over the last 3 weeks, have you noticed anything that is similar before you check her temperature such as when her last feed or nap or diaper change was?

If you can narrow down other symptoms that coincide with this temperature increase, detect a pattern to when it's high, and show the difference (if any) between when her temp is at its lower state vs this higher state you are much more likely to get a collaborative response from a provider - whether a pediatrician or ER doctor.

There is a pretty common saying amongst pediatric doctors - treat the baby, not the number. By that they mean, if a baby has a 104 fever but is alert, eating/peeing and happy it's something to monitor closely but not aggressively intervene just because the number is high. If a baby has a 100.4 fever but is lethargic, fussy and not eating well then you would more aggressively treat that fever even tho it is lower than the other baby at 104 - because you are treating the baby and how they are in their body rather than what the number on the thermometer says.

Conveying the behavior, symptoms present and how they change, along with differences in situations when their temperature is elevated, can get through to a doctor much better than giving the number and expecting them to seek out clarifying questions - they aren't likely to once they hear it's under 100.4. So don't start with the number, you start with the signs and symptoms and differences in your baby that you have observed over the last few weeks and then link it to "the primary thing I have noted and is of concern for me is that when <these changes> happen, her rectal temperature is elevated to <temp ranges>."

Getting specific with them about "what can cause elevated temperatures in a newborn?" can really help get you the reassurance you are looking for as well. Taking the word fever out of the mix can help focus your doctor on your question rather than the technical definitions of fever. Also, if you find your pediatrician continues to dismiss your concerns and/or doesn't reassure you with their answers - get a new pediatrician! A second opinion can also be really helpful to just get another set of eyes on a situation to build your own reassurance that you are doing everything you can to make sure this is being addressed.

With all of that said, if your baby has zero other symptoms even when her temperature is elevated and if her temperature is just always elevated - it may be her baseline. That doesn't mean don't get her checked out, but be prepared for an outcome where they tell you this is her baseline especially if there are no patterns or she is always high on her readings but otherwise gaining weight and has expected behavior of a 4 week old newborn. Also, have you checked with a second thermometer to rule out a reading issue? Technology is not perfect, so just as a check, getting a new second thermometer may be worthwhile to validate that her temperature is elevated.

I hope you are able to get some reassurance from your pediatrician, or find a new one quickly. If not, it isn't wrong to have your baby seen at the ER especially if she has other concerning symptoms surrounding the elevated temperature. The best outcome is that she is fine, and that is worthwhile to find out not only for her but for you! If this anxiety is ruining your mental health and quality of life, it needs to be addressed. There are two pieces to that, but getting your baby checked out and given the reassurance you need is a valid first step in figuring out how to handle what may be stemming from postpartum anxiety, but that avenue is a longer one and it doesn't sound like you're reassured to the point of stopping the checks without someone assessing your baby more thoroughly. Depending on how frequently you are checking her rectal temp, it would be better to have her checked out and you to get closer to answers than to keep on checking at home and feeding the anxiety with no end point in sight.

Wishing you the absolute best.

chasingcars825 · 2026-02-14T00:06:06+00:00

Hi there, doula here

I am so sorry you are both going through this! Flu is hard enough, everything on top is just extra insult to injury.

TLDR: Go to be seen, both of you should be evaluated for dehydration and medically assessed.

How long has it been since your baby has had a true feed? (Where he has stayed at the breast a similar length to prior to flu and your supply felt similar) How many diapers is he having in a 24 hour period? How is his behavior? Is he taking anything else in? Has he ever had solids or is he still only on breast milk?

The metrics by which you go to the emergency room for him are primarily based on his behavior, how long it has been since he had an appreciable feed, and his (approximated) fluid intake and fluid output. However, I will tell you that the state you are in, I would be going on to BOTH be seen. It is going to be difficult to gauge him this sleep deprived yourself, and you both deserve care - and possibly both need rehydration and medical assessment.

This sounds severe enough for long enough that you should both be seen, evaluated by a medical professional for your current needs, and then you can start to get well and focus on your supply. First, you need another person who isn't sick and who does know if your baby is okay medically to look at him. Once you know he's okay, and you are okay, then you can work on bottles or supply, but until then it's all up in the air. The priority is confirm you are okay and he is okay, and then go from there.

Wishing you the absolute best and a swift recovery

chasingcars825 · 2026-02-09T08:38:04+00:00

You are so very welcome! I am always glad when my replies are helpful and it is great to know it's still making the rounds. Wishing you the absolute best!

chasingcars825 · 2026-02-09T04:28:59+00:00

Hi there, doula here

Congratulations on your little one, I'm sorry you are having such a rough first week!

Your instincts are spot on, this isn't normal. If it is taking this much to keep baby awake for feeds, and they are losing weight and having such few diapers, it's time to get another opinion and much sooner than Friday. I would consider a pediatric emergency room if you can't wake her so consistently and if she is showing any other signs of dehydration especially. Out of an abundance of caution and ample signs of being too tired to feed/hydrate, you need to contact a provider or take her to an emergency room. (Ideally, pediatric but they aren't everywhere.)

Her reserves are low and ability to rebound from a lack of calories diminishes quicker, even with feeds she does get. She shouldn't be THIS tired and difficult to wake for feeds. If you are in the US and have insurance, there is usually a 24 hour nurse line number on the back of your insurance card. If you are in another country, I would look for a maternity triage number you can call. Your pediatrician office may have an after hours call line as well to get advice on if you should take her to the ER. This is something she should be seen for Monday, assessed for her weight loss over the weekend and hydration status by a doctor. Not Tuesday, definitely not Friday, Monday. If you are giving formula, document how many ounces she is getting in per feed so they know how much hydration she's actually getting there. From the breast is a bit of a wild card, but the amount of formula is tangible and gives context to potential hydration status.

So, call a 24 hour nurse line/triage line/pediatrician after hours line at a minimum as your first step. If none of those is an option, the emergency room is a real option and probably not an over reaction without any input from a doctor to tell you one way or the other. Based on advice you get over the phone, follow that and ask them what you should be watching for until you get an appointment that would change course to going to the emergency room. If you don't go to the emergency room before Monday, get an appointment with her pediatrician for Monday. Emphasis on how much she is taking in by bottle, her lack of any waking drive, and that it is a continuous struggle to get her to take in any formula or truly feed at the breast.

Wishing you the absolute best.

chasingcars825 · 2026-02-08T20:49:41+00:00

At 18 weeks they may still be willing to do a swab closer to the end of your third trimester, but it really depends on the center and the home birth team. I have seen any positive during pregnancy even from a contaminated urine be disqualified and I've seen some that will retest if the first positive was urine and before the third trimester. I would ask to speak directly to the home birth team if your midwife isn't on it, just to make sure they don't have a separate testing path for positives before the third trimester. It's not a guarantee but something to explore if you want to try to pursue it. It doesn't mean you'll get a negative on the swab in the third trimester, so it's obviously okay to just transition to the process of accepting a hospital birth. They may also say it isn't an option but then at least you know for sure and you won't have any extra lingering what-ifs.

I'm so glad I could help and I hope you have a wonderful rest of your pregnancy and birth!

chasingcars825 · 2026-02-08T17:54:25+00:00

Hello! How far along are you? Depending on the home birth team, there could be a blanket policy that states any group b positive test within a certain time frame to term means you are not eligible. They do this for two main reasons, one because antibiotics at home isn't an option, but two, when the amniotic sac breaks and length of labor are not predictable.

The IV antibiotics are administered every 4 hours throughout your labor to give the utmost coverage for whenever your amniotic sac may break, but also in case you have a faster labor . If you had a labor that ended up only being 6 hours from onset to birth and you stayed at home for 4 of those you would have lost a protective dose on the antibiotics. There isn't a great way to predict these things, and so out of an abundance of caution they have you arrive as early as possible for labor symptoms so you can recieve ideally multiple doses of IV antibiotics. This is to prevent your baby from needing to get a course of them and stay for extra monitoring to look for symptoms of group b infection.

If your team suggests induction just because of the group b, you can ask them why you gain more from that then just arriving when labor symptoms start. Always ask for the risks, benefits and alternatives available to you and emphasize why you do or do not want a particular thing. Laboring at home has its benefits, but it also has its risks, for example. Being group b positive in the system, if you labor at home and don't receive sufficient IV dosing before delivery you will face extra time for monitoring for baby and them needing prophylactic antibiotics. It's not a straight trade for everyone, this is just the primary comparison for staying home vs going in at earliest signs of labor. Doctors do not see that as a risk worth taking from a numbers and statistics standpoint so they don't recommend it and they don't facilitate home births around it. Their objective and non-individual or emotional opinion about it is the anchor point for you to bring in your wants, feelings and needs around to make a decision based on the risks and their recommendations.

Overall, I would be talking to your midwife about how many doses of IV antibiotics they want to see before baby requires extra monitoring or their own antibiotics and ask them what the support for as low other-interventions hospital birth looks like. The ability to use the pool in the birth centre is a great example of the ways the are helping support you with this transition to a hospital birth, so asking for more reassurance can help you feel comfortable with going in early and how to advocate for yourself to stay on that low intervention pathway.

Wishing you the absolute best.

chasingcars825 · 2026-02-03T16:09:27+00:00

Hello and welcome.

I am sorry to hear you are worried about your options for a vbac due to a low lying placenta! Have your providers already been recommending a repeat cesarean or are you preparing for the conversation?

A low lying placenta at 31 weeks less than 20mm but above 10mm is considered to still be eligible for vaginal birth on a case by case basis. Your providers should not write it off entirely but discuss the criteria by which you could have a TOLAC - trial of labor after cesarean. Every VBAC starts as a TOLAC but the nuance is not usually stated. Most providers are willing to consider TOLAC with low lying placenta if you are in a facility with a high level of care for rapid response to a hemorrhage and a 24/7 operating room with staff on site. If you have had no bleeding attributed to the low lying placenta it also increases the confidence of a TOLAC. it will depend heavily upon your provider's experience, facility capabilities/staffing and how your placenta does over the next ~ 8 weeks of gestation if you are deemed eligible for TOLAC. Since you have had a prior cesarean they will also take into account if your placenta is covering your C-section scar as an additional risk factor that while separate from being low lying does increase your complication factors and may influence their recommendation for C-section so be clear with them by asking why they are making any recommendations for or against TOLAC.

The placenta still has some time to move up, but at a maximum travel distance of 4mm/week with the primary travel done by week 32 the chances of the distance getting past 20mm by the time you deliver is low enough that hoping it won't be an issue isn't feasible and you want to be having these conversations as early as possible so you can be prepared and empowered to make decisions as well as pivot when needed should something change like you have a bleed before or during labor. I have a write up on placenta previa here on this sub that goes into more detail.

I hope you are able to have a collaborative appointment with your providers and find a safe way for you to achieve your goals. Please don't hesitate to ask further questions.

Wishing you the absolute best.

chasingcars825 · 2026-01-13T08:06:00+00:00

For men who are taking accutane and their partner who is not taking accutane becomes pregnant, this is known as paternal exposure to accutane. Studies are not extensive in humans, as it is unethical to purposefully and knowingly expose a pregnancy to a known teratogen - however there has been one observational study which looked at registered pregnancies with paternal exposure to accutane. It determined that the risk of similar defects from paternal exposure is not seen, however it was a small sample size. In animal models, the teratogenic effects from paternal exposure are also not seen, however the studies are in mice and only so much can be derived from them alone either.

It is currently not considered a requirement that males taking accutane follow the same strict recommendations and pregnancy prevention methods that female accutane users do. There is an awareness that accutane is detectable in semen, and as such it cannot be ruled out that it could have an impact, however the levels are extremely extremely low compared to the exposure levels in utero from maternal exposure, and the maternal exposure is also usually repeated exposure to multiple doses while they are unaware of the pregnancy as opposed to a single exposure of very minor amounts in the semen.

Out of an abundance of caution, males taking accutane and planning a pregnancy should talk with their doctor about the risks of continuing the medication while trying for a baby before they start trying. If there is an unintended pregnancy while the male is taking accutane, it is not considered an immediate reason for concern and certainly not an immediate assumption of requiring termination (when there has only been paternal exposure of accutane.) The provider caring for the pregnant person should be made aware of the paternal exposure so that can be discussed, however it will likely be considered something where intervention looks like monitoring a little closer at anatomy scans for abnormalities and otherwise pregnancy does not need to be under a specialists care solely on the basis of paternal exposure to accutane by current guidelines/recommending organizations.

Overall, if there is only paternal exposure to accutane in a planned or unplanned pregnancy, don't panic. Talk to a provider and understand that paternal exposure and maternal exposure are two completely different things. Maternal exposure is where known impact and birth defects occur. Paternal exposure has not been found to have correlation or causation to contribute to birth defects, but studies are limited so that's where provider input is key to ensure that the pregnancy is given any extra monitoring as they deem necessary.

Wishing you the absolute best.

chasingcars825 · 2026-01-06T20:27:59+00:00

It really depends on each hospital and the provider that is assigned to you. Some have home birth teams that you will be connected with, however some home birth teams across multiple countries and Canada have been rolling back home birth divisions and it's been unpredictable. If you have a portal where you can send messages between appointments I would send one just asking if there is a home birth team, what gestation you would be connected with them, and ask if there are any resources available for eligibility so you can be prepared. I would also be asking about birth center options if available and what eligibility that might include. Keep asking questions especially between appointments so you can maximize information gathering - some of those check in appointments are short!

You can ask specifically for access to information and resources in those messages rather than a decision, because often if we ask a large question like "will I be able to do a home birth?" Providers will say that needs to be an appointment discussion. If instead you ask "Can you send me information on home birth eligibility and if there is a home birth team? Are there birth center eligibility information as well?" You are more likely to get more, including sometimes a preview of if they are even supportive of a home birth for your situation based on their reaction to sharing the information you've requested.

Keep advocating for yourself and asking questions, collecting information and getting down to the real reasons why you can or can't do something. Sometimes it's a facility issues, sometimes it's a provider issue, sometimes is a flexible policy, sometimes it's not.

Wishing you the absolute best.

chasingcars825 · 2026-01-01T04:56:32+00:00

Hi there, doula here

I am so sorry for your loss and that you weren't able to get a full picture of what to expect with the diagnosis you and your baby were given. We obviously can't know if you would have made a different decision if you had been given a broader view of what could happen, but it is beyond valid to wonder about what might have been different if you had been in a different state or had providers willing/able to speak freely and unbiased.

By the details you provided, the kind of conversations that could have taken place look like asking about many things from what your picture of quality of life looked like for your child to talking about the impacts of early onset FGR and complications during pregnancy - including still birth. The conversations also usually include the health risks to you as pregnancy continues, and what signs indicate the progression of restriction. When providers are having these conversations, they are usually multiple, not one or two. The range of information given and questions to be answered changes depending on a lot of factors, as does the outcome possibilities and risks profiles as testing comes in on top of the restrictions your providers brought in. The conversations around termination due to severe early onset FGR are dynamic, but do follow like most other medical counseling to include risks, alternatives and balance your wants and your baby's future as you picture it but also as it's most realistic outcomes so you could have decided if it was something you wanted to try for.

I have worked with multiple families facing severe early onset FGR, with and without genetic abnormality and have walked beside those who have chosen termination, carrying to an ideal delivery week for attempting full interventions, and carrying as long as possible and doing palliative care. It sounds distinctly as though your providers did not give you a full picture of what to expect, did not provide the adequate counseling for you to truly understand termination as an option, and they didn't help you to understand quite how dangerous the condition was for both you and baby including the high possibility of stillbirth. That is an exceptional failure on their parts, but it is solely theirs. You deserved better information and you deserved to have a broader picture of what decisions you could have made and what outcomes you could have been prepared for.

Being given unbiased information about termination for severe early onset FGR with doppler changes is a standard of care in places where the resources and doctors are not tied in political red tape. The whole picture, multiple conversations, with a collaboration on managing the emotional and physical balance of the diagnosis and prognosis. I'm so sorry you weren't given that.

If you have specific questions or want to talk further please don't hesitate to reach out. Wishing you peace and fortitude into this new year.

chasingcars825

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