Mrs Soundarya came to Vijayam Hospital from Singapore for a routine checkup at around 32 weeks of pregnancy since she wants to have Normal Delivery with us and she wanted to know the merits and risks of  having a normal delivery.  She was thoroughly explained about the process of normal delivery.

Normal delivery:  It is the delivery of the baby from the uterus out through vagina.  Entire process of normal delivery takes an average of 13 hours in women giving birth for the first time, 8 hours in women who have given birth before, though the exact duration varies from woman to woman.

She was explained about three stages of labour, Contractions, pushing, recovery time after normal delivery etc.  For a normal low risk pregnancy, normal delivery is the safest option for women and baby.

Benefits of having normal delivery over C-section:

• Babies born out of normal delivery is found to have lower incidence of respiratory problems
• Less risk of blood loss to the mother
• Normal delivery is the natural process
• Recovery after normal delivery is quick

When C-section is preferable over normal delivery?

• when the baby is in breech position or an emergency to deliver a baby quickly
• when the labour is too prolonged
• when previous repaired 4^th degree tear

After explaining the merits and risks associated with the normal delivery,  we did a scan for her and found out her AFI (Amniotic Fluid Index) is <5.  She was very much worried and wanted to know how much Amniotic Fluid (AF) is needed to have a Normal Delivery.

Role of AF:

During pregnancy, the baby lives in the amniotic sac inside the uterus.  The amniotic sac is filled with amniotic fluid that acts like a cushion for the baby.  When the amniotic fluid index is less than 5 cm, it is called oligohydramnios.  If it is more than 25 cm, it is called polyhydramnios.  But this can be managed and the same has been conveyed to the patient.

Normal AFI levels during pregnancy: 

AFI Volume – 800 ml to 1000 ml at around 34 weeks of gestation.  It can be calculated only by Scan.

Lower AFI does not indicate ceasarean section as long as the baby’s growth is normal.  AFI can  be increased by (i) by drinking 3-4 litres of water per day (ii) sleeping in left lateral position for more than 8 hours (iii) regular follow up with gynecologist (iv) by infusing IV fluids and Amino acid infusion.

By doing all these measures, Soundarya’s AFI increased to around 8 at 38 weeks of gestation and she had a Normal Delivery what she always wanted.