It can feel like there’s so much to think about during pregnancy — eat a balanced diet, take your prenatal vitamin, drink plenty of water, exercise regularly, keep anxiety in check, sleep on your left side, pat your head and rub your belly at the same time. (OK, so we’re not serious about that last one.)

Amniotic fluid is something else you want on your radar, but let’s get serious for a moment. If your levels are putting you or your baby at risk, your doctor will tell you — and advise you on what to do next. It’s important to do what they say.

Amniotic fluid is a very important part of fetal development. It’s the fluid that surrounds your baby while they grow inside your uterus. It’s a workhorse that:

  • cushions your baby (kind of like a shock absorber)
  • allows baby to move
  • helps baby’s body parts develop normally
  • keeps baby’s temperature regulated
  • helps prevent infection

Amniotic fluid also helps keep the umbilical cord floating freely, so that it doesn’t get squished between the baby and the side of your uterus.

Let’s first take a look at how amniotic fluid works and why it may be low. Then we’ll consider what you can do on your own — and what your doctor can do — to help.

Your body starts producing amniotic fluid super early — about 12 days after conception. For the first half of pregnancy, amniotic fluid is made up of water from your body.

During the second half of pregnancy, the amniotic fluid is made from — wait for it — your baby’s urine. As strange as that sounds, it’s a crucial part of how your baby learns to breathe, swallow, filter fluids through their kidneys, and pee.

Because amniotic fluid is so important to your growing baby’s development, low amniotic fluid (oligohydramnios) can be very concerning.

There are several things that can cause low amniotic fluid. These include:

Premature rupture of membranes (PROM). This is when your amniotic sac (or “bag of waters”) breaks or begins leaking before labor actually starts. Call your doctor right away!

Problems with the placenta. The placenta plays the crucial role of bringing nutrients and oxygen to your baby. If the placenta isn’t behaving, or has started to detach from the uterine wall, your baby may not be getting enough nutrients to have good fluid (urine) output.

Birth defects. If a baby has physical problems, especially with the kidneys, they may not make enough urine, which leads to low amniotic fluid.

Health conditions in mom. Maternal complications such as the following can cause low amniotic fluid levels:

That’s why it’s so important to keep those prenatal appointments, even if they’ve been fairly uneventful so far.

Post-term pregnancy. Amniotic fluid naturally starts decreasing after 36 weeks of pregnancy, and is very likely to get too low after 42 weeks of pregnancy. (By that point, though, everyone — and especially you — is probably so eager to meet baby that being induced or otherwise delivering will be more than welcome.)

Medications. Some medications, especially those used to treat high blood pressure, may cause low amniotic fluid.

Remember:

It’s most common to have low amniotic fluid levels in the third trimester. But when low amniotic fluid levels occur in the first six months of pregnancy (the first two trimesters), the complications can be more serious.

We’ll be a broken record here: For this and other reasons, it’s so crucial to make sure you’re getting good prenatal care.

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How can you know for sure if you have low amniotic fluid levels? This will require — you guessed it — a visit to your doctor. They can use an ultrasound to measure if there is enough fluid.

Before 24 weeks or in pregnancy with multiples, amniotic fluid is measured via ultrasound with a method called the “maximum vertical pocket.”

The ultrasound technician will scan your uterus to find and measure the single deepest pocket of amniotic fluid they can. A normal measurement is 2 to 8 centimeters (cm). A finding of less than 2 cm indicates low amniotic fluid at this stage.

After 24 weeks of pregnancy, the most common way to measure amniotic fluid is called the AFI, or amniotic fluid index.

The AFI is measured exactly like the single deepest pocket method, but the ultrasound technician will measure fluid pockets from four different parts of the uterus. These measurements will be added together to get the AFI.

A normal AFI is 5 to 25 cm. An AFI below 5 cm means low amniotic fluid.

Treatment for low amniotic fluid will depend on the cause and how far along you are. Some causes of low amniotic fluid have a simple solution, but others may require more intensive intervention.

1. Drink more fluids

Anytime during your pregnancy, drinking a lot of water can make a huge difference. According to one study, hydration is very helpful for upping amniotic fluid levels in women between 37 and 41 weeks of pregnancy.

While more research is needed, a Cochrane database review also found that simple hydration increased amniotic fluid levels.

The nice thing about this remedy? There’s little to no harm in drinking more water — pregnant or not.

2. Amnioinfusion

An amnioinfusion is when your doctor squirts a saltwater solution (saline) through your cervix and into the amniotic sac. (It may sound uncomfortable, but it’s well worth it if your doctor thinks you need this.)

This can at least temporarily increase the level of amniotic fluid. It’s also done to increase your baby’s visibility on ultrasound, or before delivery if your baby’s heart rate is abnormal.

According to a review from the UNC School of Medicine, amnioinfusion is an effective treatment for improving a baby’s environment if there isn’t enough amniotic fluid.

3. Injection of fluid before delivery using amniocentesis

Amniocentesis involves a thin needle being inserted directly into the amniotic sac through your abdomen.

If you have low amniotic fluid before or during labor, your doctor may give you fluid via amniocentesis before delivering your baby. This can help your baby maintain their mobility and heart rate throughout the delivery, which may also help decrease your chances of a cesarean delivery.

4. IV fluids

Your doctor may recommend IV fluids. This can be especially helpful if you’re dehydrated due to nausea or vomiting, or if you need to hydrate (and therefore increase your amniotic fluid) more quickly.

Basically, this is another way to get those all-important fluids into your body.

5. Treatment of preexisting causes

Since low amniotic fluid may be caused by underlying conditions such as high blood pressure or diabetes, treating these conditions may improve your levels. This may involve taking medication, monitoring your blood sugar, or making more frequent visits to your doctor.

Preexisting causes may create other issues during your pregnancy, too, so managing the cause is a win-win.

6. Bedrest

Bedrest is not as popular of a pregnancy treatment as it used to be — and it’s never been very popular among those who have to go through it. But some doctors will still prescribe it in the case of low amniotic fluid.

Resting in bed or on the couch (except to go to the bathroom or shower) may help improve blood flow to the placenta, which in turn helps increase amniotic fluid. Bedrest is most likely to be advised if you’re in your second or early third trimester and your doctor hopes to wait before delivering your baby.

It’s not easy, but try to relax during this time. Find that perfect Netflix show to binge on and let those around you wait on you hand and foot.

7. Extra monitoring

If you’re less than 36 weeks pregnant, your doctor may recommend watchful waiting. They’ll see you more frequently, and may perform additional tests to make sure your baby is in tip-top shape.

These tests may include a non-stress test, where stickers placed on your belly will monitor for contractions and your baby’s heart rate. Or you may need more frequent biophysical profiles, which are ultrasounds measuring your amniotic fluid level and baby’s movements.

This may sound scary, but there are a couple of bonuses to extra monitoring: One, you get to see your baby more often! And two, your doctor will be able to treat any issues sooner than later.

8. Diet

While a healthy diet (you know the drill: lean protein, whole grains, and plenty of fresh fruits and veggies) is very important throughout pregnancy, there’s little evidence that it affects your amniotic fluid levels.

Some research — only in animals, though — shows a modest negative effect on amniotic fluid levels when mom consumes a high fat diet.

And while there’s been some chatter about stevia (a sweetener) being used to increase amniotic fluid, there’s no research to support this. In fact, the opposite may be true: There are some preliminary studies indicating that consuming artificial sweeteners during pregnancy can increase your baby’s risk for metabolic disorders later in life.

To make matters more complicated, there’s some debate on whether stevia is natural or artificial. Fancy being on the safe side? You may want to just steer clear.

9. Natural remedies

There’s little to no research that natural remedies (besides drinking more water) increase amniotic fluid.

While there are internet sites or videos claiming to have natural solutions, low amniotic fluid is a serious medical condition that can have a severe impact on your baby if not treated properly. It should be treated and monitored by your doctor.

We’re all for doing things naturally when you can — literally. But there’s too much at stake here to chance an unproven fix.

10. Delivery

If you’re 36 weeks or further in your pregnancy, first of all, congratulations! Second of all, your doctor may recommend delivering your baby early. While this may cause mixed emotions in you, the outcomes for babies born in the last month of pregnancy are excellent.

The risks of continuing a pregnancy without enough amniotic fluid, on the other hand, are high. They may include stillbirth, cord compression, or meconium aspiration.

Your doctor will advise you of the benefits and risks of early delivery, but many, many babies are born preterm or early term and have absolutely no adverse effects. You just get to hold your precious bundle that much sooner!

Low amniotic fluid can occur anytime during pregnancy, although it’s most common the closer you get to the finish line. It can have serious effects on your baby’s health and should be treated promptly by a doctor.

Some signs that warrant an immediate call to your doctor include feeling your baby move less than usual or fluid leaking from your vagina.

If you’re at all concerned, it’s always best to give your doctor a call. If you do have low amniotic fluid, there are a number of treatments (including delivery) that can help keep your little one safe and healthy.