No VBAC due to baby's size?

[Ambivalent Dreams]

I know of no studies that show having a large baby means that a trial of labor for a VBAC should be avoided. Does anyone know otherwise? Do you have links to articles about fetal size and VBAC risks? My OB is getting a bit shady on me and I've got to set this right quick or bail on her. If you have any resources I can use, please share! Thanks.

[LittleLegos]

Have you heard of ICAN? There are ICAN mentors who could help you sort through studies, ect. http://www.ican-online.org/

I think maybe a more helpful thing would be to figure out how the baby's size was determined and if by u/s, that it can be off by quite a bit.

Good luck!!

[AustinMom]

Sorry, I so started a long reply with a few links and then deleted it....

It looks like most OBs are scared of "big" babies because of the chance of shoulder dystocia

But, here is some of them at least
http://www.birthtruth.org/fears.htm
I found the paragraph that stated this "if you force a baby into the pelvis too quickly, the natural loosening and stretching of the pelvis may not occur." was a GREAT point, this is why, again, inductions are not ideal for anyone if they can be avoided. Also shoulder dystocia "though approximately 50% of all shoulder dystocia occurs in babies of "normal" weight." makes you think too.

http://www.aafp.org/afp/2001/0115/p302.html
This one talks about how doing a cs instead of trial of labor has been proven to not be the best option and it is not advised, also, the studies prove that induction to prevent macrosmia leads to more CS. If you click Ctrl F and search for VBAC you go right to the paragraphs about it.

http://www.gentlebirth.org/archives/icanvbac.html
This one, search (Ctrl F) macrosomia. Again, it looks as though Obs are scared of shoulder dystocia, which if you don't have any anti-mobility interventions like epidurals, straps, etc, then you can do the gaskin manuever or other position changes to aid the "unsticking" of the shoulders.

http://www.ican-online.org/vbac/vbac...p-or-hindrance
I love this article. It talks more about how induction to avoid large babies is stupid, and so is doing a cs just because macrosomia is suspected. The studies say to wait for spontaneous labor for best results.

http://www.ncbi.nlm.nih.gov/pubmed/2...?dopt=Abstract
This is ACOG saying, don't do a CS for suspected macrosomia in any mom.

Also, keep in mind, most MW don't deem a 4000g, me, I don't either. I'm 5'10'' with a longer than average (even for my height) torso, so I know I'm going to grow a bigger baby than a woman who is 5'4'' for instance. My son was 9lb 8oz at birth, if I was 5'4'', this would be more of an issue because my body proportions to the size of the baby would be much more off. BUT, I know of a woman who birthed a 10lb baby, at home, a VBAC, and she was 4'11'', so, it's not always that.

Hope these links help!

[AustinMom]

Originally Posted by LittleLegos

Have you heard of ICAN? There are ICAN mentors who could help you sort through studies, ect. http://www.ican-online.org/

I think maybe a more helpful thing would be to figure out how the baby's size was determined and if by u/s, that it can be off by quite a bit.

Good luck!!

Also, according to ACOG, u/s is no more effective in determining baby's size than external palpitations. If your OB is not skilled in this, then they shouldn't be an OB, IMO

[RedOakMomma]

...and beware of size estimations.

When I was pregnant with twins I went past 40 weeks and was given a level-2 ultrasound by a perineonatologist "with the best technology available" to estimate the size of the babies. The boys were born just a few days later and the estimation, which the dr.s treated as fact, was 1.5 pounds OFF! in the case of ds2. With ds1 it was .5 pounds off. No 8.5-pound babies...just one 8-pounder and one 7-pounder.



In our case, the estimations were wildly off because our boys had big heads. Big heads run on both sides of our families, so no surprise there. Did they listen to me, though? Nope. Thankfully my OB didn't freak and he let me do a natural labor anyway.

[melanie_rabbitbarn]

Check out this ACOG Practice Bulletin
http://www.acog.org/acog_districts/dist9/pb054.pdf

Big baby is not a contraindication for VBAC
They say weight greater than 4000 g negatively influences the likelihood of success (but, again, they don't recommend scheduled c-section)
I thought I saw something about recommending c-section if baby was suspected to be over 11lbs, but I can't find that right now.

[Kelly1101]

Originally Posted by Ambivalent Dreams

I know of no studies that show having a large baby means that a trial of labor for a VBAC should be avoided. Does anyone know otherwise? Do you have links to articles about fetal size and VBAC risks? My OB is getting a bit shady on me and I've got to set this right quick or bail on her. If you have any resources I can use, please share! Thanks.

It seems really weird that a big baby would mean that a TRIAL of labor should be avoided. If the baby truly is big, and you haven't had a vaginal birth yet, it MAY mean that you could end up with a second c-section, but even that is very unlikely.