scheduled induction/c for big baby

[Anonymous]

My doc has been closing monitoring the size of my baby which has been increasing in percentile. he says while it is always preferred to have me go on my own, we may need to consider a scheduled date if his size gets too big and it looks like the physics just won't work.

Is it superficial to schedule a delivery because of size? Should I be going naturally to see if it may work and then if it isn't working switch to induction or C? or is it wise to pre-empt a potentially complicated delivery due to size? I don't know how to feel about it...

[Anonymous]

Totally personal. Is your doctor Dr. Newman by any chance? Regardless, it's YOUR decision. I chose a scheduled c-section and had a baby with the biggest head my ped has ever known of. So, in my case, it was a good choice. But sonograms are also notoriously unreliable. I know people who were told their babies were going to be 10 pounds and they turned out to be 6 or 7 pounds. So really, it's more of a personal choice.

[Anonymous]

Listen to the doctors and do what feels right to you based on their recommendations.

[Anonymous]

Your doctor is not practicing evidence-based medicine. Even ACOG does not recommend induction or scheduled c/s for a potentially big baby. There are a couple specific OBs in this area who are known for pressuring women into a scheduled c for a supposed big baby, and I would bet money that you are with one of them.

The truth is that they have NO IDEA how big your baby actually is. Sonograms and fundal height measurements are notoriously wrong at determining fetal weight. They also have NO IDEA how easily your body will accommodate the passage of your baby. Your pelvis actually moves and stretches during labor; the ligaments loosen due to various hormonal changes, and the pressure of the baby bearing down causes the pelvis to open. It is simply impossible to determine, prior to labor, that a baby will not fit through a pelvis. The exceptions to this rule are if you have a true pelvic abnormality (ie, you were in an accident and broke your pelvis when you were younger, or had rickets), OR if your baby has untreated gestational diabetes.

You can trust that your body is not going to grow a baby that is too big for you to birth. Obviously the answer is different if you actually WANT a c/s (and there is nothing wrong with that), but if you are hoping for a vaginal birth, then no, you absolutely should not schedule anything due to the supposed size of the baby.

If you were planning to deliver with the DC Birth Center midwives, for example, they would flatly refuse to schedule you for anything. Of course they, like many other of the local midwifery practices, have a less than 10% cesarean rate (compared to most OBs 40-60%). Amazing how they are able to get all those huge babies out without resorting to induction or surgery.

[Anonymous]

OP, I know of someone who recently had a scheduled c because she was told the baby was getting too big. Baby was 8 lbs - yes, on the biggish side, but not so big (IMO) that major abdominal surgery was warranted. This happens a lot, from what I hear. As PP said, size estimates can be very inaccurate. Good luck to you, whatever you decide to do.

[Anonymous]

Thanks I am in the same situation and this is very helpful. I had no idea that a c-section was not warranted b/c the baby is too big, or that sonos could be wrong. I definitely would not recommend my OB, for this and other reasons about his "bedside manner."

[Anonymous]

I was induced, labored 30 hours, and ended up with a c-section and 9lb6oz baby. Wait the full 42 weeks so that you give yourself every reasonable chance. Incidence of stillbirth increases sixfold after 42 weeks.

[Anonymous]

I had a 9.5 pounder vaginally at 41 weeks. We knew since the 32 week ultrasound that he was probably big -- but that was probably. The estimates are notoriously inaccurate. I was eventually induced, but it wasn't because of baby's size, it was because of low fluid. It was a slow induction that turned out well because of my doctors. I would be very, very wary of an induction based on size, and I would NOT agree to a scheduled c simply for that reason.

[Anonymous]

23:37 not OP but go to Dr. Newman, is there a particular concern with him?

[Anonymous]

OP your baby may very well be big. But unless you have Diabetes there is no reason to change delivery plans based on this. Sonogram measurements can easily be off by up to 2 lbs. That is huge when it comes to a baby. I would be wary of an OB that wants to change delivery plans based on a sono measurement. I think what ends up happening is it starts sounding more and more appealing to us as we get to the end of our pregnancy and we just want it over.

My baby is measuring big and one of the docs hinted he might get too big. But that was pretty much it. If I even hint at having the baby early my OB smiles and says, "You'll be fine." I swear inside that he has no sense of urgency and won't push an induction and then thank goodness one of us has sense. And it's not me

[Anonymous]

my colleague was induced for size (estimate 10 lbs), leading to C section at 39 weeks. her baby was just about 7 lbs. . this is not to say that all inductions or Cs are unnecessary, but be wary. my OB said that the sono and measurement give an estimate, but it can be off by a lb or more either way. In fact, he does not like to induce before 41 weeks (unless necessary for things like pre-eclampsia) because he says those inductions often fail, leading to more interventions and c sections, and generally thinks inducing or scheduling for size is a crap shoot. And he is fairly middle of the road practitioner.

[Anonymous]

Not 23:37, but Dr. Newman was my OB and I had an excellent experience with him. He never suggested I have a c-section despite my long labor, because all was going well. He is extremely good, very experienced, very smart, really knows his stuff. He is not a hand holder, but he is a truly excellent physician and I would thoroughly trust him with any pregnancy.

[Anonymous]

Dr Newman wasn't my doctor, but I saw him when I was making the rounds, meeting all the OBs in the practice. I saw him when I was at 40 weeks, and he said, "At this point, some women are saying 'Get this baby out of me!' and some are saying, 'Let's see what happens.' Which are you?" I told him I was in the latter group, and he said "Fine."

[Anonymous]

Anonymous wrote: 23:37 not OP but go to Dr. Newman, is there a particular concern with him?

No concerns, I like him a lot. He did suggest a c-section because the measurements of my first baby on the US, but in no way forced me into it.

[Anonymous]

OP, is that the only indication for a c-section? If so, I'd be wary unless that's what your really want for other reasons. As mentioned, sonos really aren't reliable. My baby's size was quite overestimated, including his head, and I hear of this a lot. If you are at all interested in a vaginal birth, why not go into labor and see how things progress. I know people who had a hard time getting small babies out, and others with pretty big babies who had a lot less trouble. Seems very individual and the factors are not just the baby's size but your ligaments, pelvic opening (not hip size), etc.