Doc says baby is HUGE - *UPDATE* page 4

[VillageMom6]

At my recent 20 week ultrasound this baby was estimated to be in the 75th percentile for height, the 60th percentile for weight and the 93rd percentile for abdominal circumference, which is supposed to indicate bone size, particularly shoulders.

I've had five vaginal births... all in the 7 pound range but one bigger guy who weighed 8.10. No problems getting my eight pounder out.

At the end of my OB visit, the doctor mentioned that we might want to induce early so that we can be sure the baby isn't "too big" to be born vaginally.

Do. Not. Want.

I was too surprised to say anything at that appointment, but I surely will at my next one. In the meantime, I am rethinking even having him as my care provider.

I'm concerned that his recommendation for an early induction indicates his more medicalized approach to labor and birth. (My previous babies were all born with hospital midwives.)

My last birth ended up with pitocin and an epidural because my water broke and 24 hours later I was not in labor at all. I'd really like to avoid that this time.

I guess I'm looking for stories about successful vaginal births of "big" babies... or cautious stories about big babies who ended up with shoulder dystocia or C-sections. I'm feeling very confused at the moment.

[chattyprincess]

I can go on and on about the inaccuracy of ultrasounds for weight of babies...I will not. start googling for articles regarding the use of ultrasound/sonograms for guessing weights of babies. It is inaccurate and unreliable at the best and a load of hooey at the worst....(this from the lady whos cousin was supposed to have a 10lb baby 1 week ago...she delivered a week late and the baby was BARELY 7lb 1oz....where did the other 3lbs go??? anyone?)

[Sagesgirl]

You don't need stories of successful vaginal birth of big babies--you've done it. The chances of you suddenly having a humongous baby after five babies all in the same general weight range are pretty darned slim.

I think you're absolutely right to be reconsidering this man as a healthcare provider. I'm sure I'm not telling you anything you don't know when I say that ultrasound predictions of a baby's size are notoriously faulty--especially at the extremes. By all means, go to one more appointment and quiz the doctor very closely, and be prepared to walk. (Honestly, my answer to the whole we might want to induce early line would have been "What's this we of which you speak? Do you have a mouse in your pocket?")

[Melly24]

I would run far, far away from him. Ultrasound can be wayyyyyy off with measurements. Who knows how big your bay is going to be at term? Only your body and your baby. Your body is growing a baby you can surely birth.

My DD was estimated to be over 10 pound via ultrasound at 41 weeks. She was just over 9 pound when she was born two days later (via c-section due to the cascade of interventions - not because of her size).

A friend of mine had a normal drug free birth at a birth centre with her over 10 pounder. Find a care provider who isn't afraid of big babies and who trusts the natural pregnancy and birthing process.

[blessedwithboys]

well, bc you asked for stories...i cant give you one of my own, but a close friend of mine has an inspirational story.

this friend is 4'10.5" tall and before having kids was 104lbs. her first baby was born a vag birth at 26 wks, only 2 lbs. 3 yrs later her dd was just under 7 lbs at 38 wks.

2 yrs after that she had her ds2. she went to almost 42 wks, but her mw had confidence in her. her petite frame wasnt even an issue. no one was afraid of CPD. she did say that she had to work a lot harder to push him out than she did with db2 (db1 came out on reflex 3 mos early) i was in the room for her labor, but she cleared the room of everyone but the mw and one nurse when pushingn started, so i only have the mamas recollection to go by. she mentioned that at one point she got out of the hospital bed and used the siderail for somethign to pull against as she squatted down and pushed. after a few cx, she got into the bed again and out popped her 9lb5oz ds!

every single nurse in Ld that night was amazed that someone so tiny could get a 9lber out, but for those of us who believe in birth, it was really not that shocking. it was her 3rd vag birth, and she was free to change positions. of course it had to work.

i would say your risk of iatrogenic prematurity is way higher than the risk of CPD. sounds like you'll be mw shopping , though, so i'm sure you'll be just fine.

[SeattleRain]

I can't speak to stories about induction or ultrasounds or whatever since I'm pregnant with my first, but 20 weeks seems to be WAY to early to start talking about induction. I'd mention to him at the next appointment that you'd really like to avoid induction and that its not really something you'd like to even consider until at least 38 weeks. I don't even see how he can suggest something like induction without knowing how the next 20 weeks of your pregnancy are going to go.

If he seems open to waiting until later on to make that call, then I'd keep him around for the time being. If he gives you flack, I'd drop him. If down the line he sends for an ultrasound to look at the weight and comes back pushing for an induction, I'd get a second opinion and make a decision then.

[klocke]

My Oma had seven children all between 10 & 11 lbs! She is maybe 5 ft. 3 and during her child bearing years was very slender. She had all naturally no problems.

[thefreckledmama]

Your doc scares me. This is your 6th birth-I seriously doubt you'll have any issues, even if you were carrying a baby that was 12lbs.

The fact that he's mentioning an induction at 20 weeks would be a flashing red sign to find another care provider asap.

[Marylizah]

It sounds like you make babies that are all pretty much in the same range. And I agree with the poster who said 20 weeks is WAY too early to be talking induction.

That said... my first was 8lbs at birth, and my second was 10lbs. And he ended up being a c/s, but for reasons unrelated to his size.

My OB had performed an u/s at 32 weeks and told me it looked like I'd be having a big baby, probably about the same as my 1st. She was wrong-- she underestimated.

So. You just never know!

[Grace and Granola]

With my first baby, I measured 4 weeks ahead from about 18 weeks on. And boy, my midwife loved to joke about how big this baby was going to be. But scary for a first time mom. Towards the end we did a u/s and again, they guessed the baby's weight be 8-9# at around 39 weeks and oh my, it's going to be a whopper! I went past due and was talked into induction at 41 weeks. Being my first baby, I was for one thing, scared of having a huge baby and also excited to meet my baby, so it was not hard for them to convince me I needed to be induced. all said and done, I birthed an 8lb 2oz baby with ease. Looking back, I'm pretty upset that they scared me like that over a pretty average sized baby. All that to say that u/s measurements are not all that accurate. With 5 babies, I think it's safe to trust your gut! You are a pro!

[micah_mae_]

My son was 10 lbs 6.5 oz. Drug free, vaginal, water birth. With no tearing. Pulled baby out myself.

[emnic77]

At 20 weeks he's saying this??? Bogus. Completely bogus. I would probably switch providers, that's a pretty big strike against him IMO. Even talking about size/induction at 20 weeks is just totally ludicrous.

For the record, I am 5'4" and with my first, my daughter, at age 21, I weighed 100lbs. My daughter was born at 41 weeks 3 days, 10 lbs 4 oz, and nearly 2 feet long. I am VERY small framed - I can make circle around my wrist with my opposite hand and touch with my pinkie and thumb. She had a giant head, shoulders like a linebacker, and I pushed her out just fine. It took over three hours, but she was also my first baby. (Probably explain why my hips always hurt so much during pregnancy, they expand so much you could probably drive a truck through them.)

A few hours post partum my OB came into the hospital room and told me next time we'd induce at 37 weeks. Needless to say, I didn't go back to her for care. (My second baby has a different dad, and was 7lbs 7oz...didn't feel much different at all, honestly. A couple hours difference pushing time but that's it.)

One more thing (sorry for the multiple edits) - he's saying all this based on ABDOMINAL size which is "supposed to be" an indicator of shoulder size??? So not even "real" numbers, just a supposed formula that is an estimate. Riiiight. Yeah, I would not be returning to his care.

[emma2010]

Don't know why the doc would say something like that at 20 weeks? Doesn't sound like good medical advice to me.

I delivered an almost 9 lbs. baby (8lbs. 15 oz.) vaginally at 39 weeks. He was my first. I was torn a little bit in the front and had an episiotomy (sp?). It took my 4 weeks to heal completely.

[lisko15]

I didn't have time to read all previous posters, but I agree that 20 weeks is WAY too early to talk about inducing!

My first and only birth, my DD, was 9 lbs 8 oz, and was a successful posterior vaginal birth after Pitocin. Not fun but hey, I got her out!

Given the fact you've had 5 successful vaginal births, I wouldn't be too concerned. I don't think you will have a problem birthing a baby even a bit bigger than you already have. Switch providers if he continues talking about induction at such an early time - as that's just weird and crazy.

I know my doc will want to monitor this baby's growth as I get close to my EDD since DD was so big. Especially since I went "over" with DD. But I certainly will not agree to induction at any point before I'm considered quite a bit OVER unless something is the matter with the baby. I'd love to skip Pitocin this time around!!!!

[RedOakMomma]

CHANGE PROVIDERS.

You've had five kids. This was only a 20-week ultrasound. The dr. is crazy to be talking about inducing. Truly...high tail it outta there.

[sweet_tart_vt]

You're on your 6th baby Mama, and have had 5 vaginal births. Trust that you do indeed have a "proven pelvis"! This provider is seriously jumping the gun talking induction at a 20wk anatomny scan. You are right to be questioning their logic and I would seriously do some searching for a supportive non-interventionist MW. Youve got plenty of time to find another provider. U/S are not as fool-proof as docs/OB's make them out to be.

Im due with my 7th babe on 5/16 and have had a range of weights on my LO's from 6lbs even up to an 8lb 14ouncer. I am of average height (five foot 3 1/2) but slim with a tiny frame. (I usually weigh 115-120 when not pregnant, and have never gained more than 20lbs during a pregnancy) and never had a problem with the bigger one even though he was a compound presentation. (nuchal hand and arm).

Trust that your body will grow this baby in the size that is right and as you can grow him/her, you can also birth him/her.

[mischievium]

I agree with others who say that it is premature to discuss induction.

I am in a similar, but different situation. I've been having growth scans done every 4 weeks since 18 weeks due to issues that went undetected in my last pregnancy and this baby has been consistently measuring 3-4 weeks ahead (and, given that we did AI to get pregnant, my conception date is pretty iron clad) and in the 94-99th percentile for size. I know all about the inaccuracies of U/S at estimating fetal weight, but feel a little more confident since the scans have been pretty consistent (and that's with different people doing the U/Ss and different people reading them).

At my 30wk appt. the OB mentioned that they wouldn't recommend a c-section unless the baby was estimated to be 5kg (11 lbs.) or above. He didn't mention induction, though it has been mentioned as an option to me by other providers for different reasons (mostly regarding my prior loss). The other concern would be shoulder dystocia-- which is more of a concern if the abdominal circumference is outpacing the head circumference (which, so far, is not a problem).

So, if your baby continues to measure large and YOU are concerned enough to consider induction, among the details I would be asking about would be the head circumference versus abdominal circumference. But I would also want a second opinion, at the least, and I would heavily consider switching providers to one who has a more optimistic approach towards vaginal birth-- especially for someone who has already had several successful vaginal births.

[mediumcrunch]

Ditto to everyone else. Starting to talk induction for macrosomia (which ACOG does not evey advocate) from a 20 weeks ultrasound is absolutely absurd!!!
Find another provider if you can.

FWIW, my little one measured a bit on the large side at my anatomy scan. OB went out of his way to tell me the measurements meant absolutely nothing at this gestation unless they were wildly off as in off the charts small or off the charts large and in no way meant that this baby would be any bigger than any of the rest of my children.

[khaoskat]

DS1 9 lbs 2 oz; 23 inches - vaginal birth w/ 2nd degree tear
DS2 10 lbs; 22 1/2 inches - vaginal birth unmedicated w/ 3rd degree tear

[Sagesgirl]

Originally Posted by SeattleRain

I can't speak to stories about induction or ultrasounds or whatever since I'm pregnant with my first, but 20 weeks seems to be WAY to early to start talking about induction. I'd mention to him at the next appointment that you'd really like to avoid induction and that its not really something you'd like to even consider until at least 38 weeks. I don't even see how he can suggest something like induction without knowing how the next 20 weeks of your pregnancy are going to go.

If he seems open to waiting until later on to make that call, then I'd keep him around for the time being. If he gives you flack, I'd drop him. If down the line he sends for an ultrasound to look at the weight and comes back pushing for an induction, I'd get a second opinion and make a decision then.

There's no good reason to talk about induction at 38 weeks either, nor would I want to stick around in hopes that a doctor is going to eventually change his mind about such an interventionist procedure.

Waiting a short time might work--but the longer a mother waits to do so, the harder it is.