Early induction due to predicted baby weight

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'd push back on this and stay firm. Unless your health is impacted, ie your blood pressure is going up, or the baby's health is impacted, there's no need for an induction because of predicted birth weight.

These predictors for birth weight are notoriously wrong. Also, you are much more likely to have to have a c-section if the induction stalls. A c-section, while very common, is major surgery.

This. Doctors like to induce because then They can schedule your delivery instead of otherwise having to come in the middle of night when you go into labor.

I think this is more the case with c-sections. Inductions aren’t that predictable and your doctor might still very well be catching a baby at 2am.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Both of mine were overdue and had extra scans right around the due date. Both were estimated around 9 lbs. The first was just under 8 and the second was 10.5

I remember the estimates get less reliable the closer you are to 40 weeks because of the head position, but I don't know how reliable 36 weeks may be. Probably better than mine a day or so before each was born.

I induced the first at 40w1d and it was not a good experience so I asked to hold out a little longer with the second (expecting to have a similar sized baby). I went into labor overnight right before I was scheduled for an induction at 40w5d. The labor/delivery experience better, however, there were issues for the baby and me due to size.

Doctors told me they would never have me go 40w again if I had more kids. In my case "prediction of big baby" would be based on previously very big baby and measurements.

What was the issue with your induction? Was it just very painful?

Neither the baby nor I tolerated it well. It was intense and painful (which I’m sure describes most labor ) but there were particularly difficult parts. There were issues with the epidural because of the speed. The baby was in distress and needed vacuum extraction and then became jaundiced. None of these things were so awful or risky, I just wanted to try to avoid it the second time.

I should say I have fast labors and that was another reason they said they would recommend against 40 w in the future.

Interesting point about boys above, my 10.5 boy’s shoulders were definitely the problem! I would have been better off with a c section. He had mild shoulder distortia and was fine.

[Anonymous]

Both my babies were average but I got induced at 39 weeks for other reasons and I had a great experience! I highly recommend. My second was half a pound smaller than my first but my recovery went so much better... really minimal swelling and tenderness. I attribute that to her being smaller and easier to push out.

[Anonymous]

I had a 8 lb 3 ozer induced. She tore up my privates big time. My advice, have a C.

[Anonymous]

Generally speaking, if you had two 8.5 pound babies without too much trouble, as a provider I am a lot less worried about baby's size. You can prob handle a good size baby with your 3rd. I would maybe offer a 39w induction for a 36w EFW of 7.5 pounds, but really would not insist on it. As others mentioned, these sonographic estimates are not rocket science. I tend to be pretty close for mine, 3 ounce "error" last baby, but an occasional baby tricks me.

I am more worried about someone who pushed for 4 hours with a 6 pounder and still needed a vaccuum assist.

[Anonymous]

I was induced at 36 weeks for pre-e but also was told at my last appointment that the baby was already “7.5” pounds. She was born weighing 5 pounds 8 oz. So there’s that.

That said, I actually was totally cool with early induction (again for pre-e not estimated gestational size) because I’m a bit of a planner and I knew what the steps for the process would be and when it would happen. I also was totally fine skipping the ninth month of pregnancy during hot weather. It’s heating up in DC, if that’s where you live, so you may prefer that route also.

[Anonymous]

My first was measuring 9lbs at the 38 week ultrasound - I was HUGE so it wasn’t off base. Doctor didn’t push for a c section but recommended one for 39 weeks and I was fully on board. Had baby at 39 weeks and was 10 Lbs- 90th percentile in height, weight, and head circumference. Very easy and calm, no drama, no regrets. But this was 39 weeks so...

[Anonymous]

Anonymous wrote:I’m curious if this is mostly an American thing.

Absolutely.

It's also why we have abhorrent maternal mortality rates.

[Anonymous]

I recently delivered.

The day before I went into labor I had an appointment with my midwife and she became concerned by my lack of fundus (sp?) growth and weight gain. My stomach only measured 31 weeks and I was nearly 40. So I went down to maternal fetal medicine and got a growth ultrasound. The first tech measured the baby at under the 10th percentile. But another tech (lucky for me, because had she not I would have been induced) came in and measured her better? And estimated her to be about 45th percentile. Her estimate was 7lbs and 10oz. She was born the next day and was 7lb 9oz.

[Anonymous]

At 36 weeks, estimated 7 pounds 6 ounces. Induced 38 weeks because of low fluid and baby weighed 8 pounds 14 ounces. I would've been induced at 39 weeks before the low fluid ultrasound. I am AMA (43 y.o.).

[Anonymous]

Evidence isn’t behind induction for a “Big Baby” as a medical reasoning.

https://evidencebasedbirth.com/wp-content/uploads/2018/01/Big-Babies-Handout.pdf

Also the whole “39 is fine” is due to the ARRIVE study which has a lot of issues with it. Also if your baby isn’t ready to be born at 39 weeks you can have a failed induction (rather common) and could end up with a cesection so definitely have a through conversation on how much time they give how they deal with everything.

[Anonymous]

Just had this discussion with my OB about my 3rd baby. 2nd baby was a massive 10lber who had a shoulder dystocia. My 20 week ultrasound showed 70th percentile. My current baby is 40th percentile on it's 20 week ultrasound and that's what we're using. My doctor isn't recommending a c section based on that (and I'm having a girl and girls have less shoulder dystocias), nor an early induction.

Kinda crazy that 20 week ultrasounds are as accurate as you can get in a pregnancy. My fundal height was on target for a 7lber when I was pregnant with my 10lber, so that's not even super accurate. The OB at the hospital when I checked in to deliver my 2nd baby was like "Oh no- this is NOT a 7lb baby!" but that was the first time someone mentioned my baby could be big. I hadn't gained too much weight and my stomach wasn't super large (but my sides did stick out more)

[Anonymous]

OP do you have any previous experience with inductions? Do you have reasons to not trust your doctor?

But then I don't have any particular beliefs about "interventions." If I needed a C-section then so be it. I welcome all the interventions to help me get through labor so I have a different perspective from the "INTERVENTIONS ARE BAD" crowd.

I had 2 inductions, first one at 40 week and second one at 39. Water broke spontaneously the first time but I had no contractions nor dilation so I needed to be put on pitocin. Smooth labor and delivery after I got my epidural. Pushed for 30 mins after I got to 10 cm.

2nd one had to be induced earlier at 39 due to a mild medical issue. I guess I could have been like "NO." But I decided to trust the doctor; also, I doubted that my body could go into labor naturally even if my water broke on its own like before. So I went for a final check at 39 weeks, and learned that I was not dilated at all, nor did I have any contractions or signs of labor. I thought there must be a high chance of a C-Section because it didn't seem like my body was ready. I didn't mind at all. If it happens then it happens. Anyways, long story short, the ripening drug worked like a charm! Labor and delivery went very well after my epidural. Pushed for 2 mins.

Don't know the rate of failed inductions for whatever reasons but needless to say I had great experiences with it both times.