Why induce if the baby is small?
I'm sure its an unneeded intervention from time to time, but I do believe it can be a valid concern.
And it really would depend on how far along the mother was, and how severe the growth restriction.
Luckily, both families opted to wait for labor, and had fine natural births, healthy moms and babies
Fundal height is not a reliable measurement, by the way. I've seen women who never got past 34 centimeters fundal height, go on to have 8lb babies. I've seen women measuring several cms large, go on to have average size babies (7ish pounds). Many factors influence fundal height measurements--including mom's height and build, amount of amniotic fluid, other... I would trust the manual palpation estimation of someone with experience in guesstimating growth and size of babies this way, FAR more than I would trust fundal height combined with u/s results.
We are in the middle of an induction epidemic, fueled by doc's increasing fear of lawsuits. I am very skeptical of all these 'need to induce' theories currently proliferating.
1. Fluid levels were perfect.
2. Placenta was fine
3. DD passed every BPP and NST with flying colors
That said, she was born at 5 lbs 7 oz. and her head was a little ahead growth wise. HOWEVER - I think that had more to do with genetics. DH's family has always head larger than normal or top of the growth curve heads. DH even got picked on in the Navy because his uniform hats never fit right, even in extra large. They don't LOOK different from anyone else but it's just the way they are. Also, both DH and I were small babies, 6 lbs and under and are not big people to begin with. So I think in MY situation, this was unnecessary and I am NOT going to induce this time with DD2 unless she actually starts failing BPPs or NSTs or something else.
Another factor was this OB practice was VERY intervention heavy (typical with military insurance). They induced EVERY mother by 40 weeks regardless of her situation because they were convinced it wasn't "safe" to go past 40 weeks. They would also C-section at the drop of a hat. NO VBACS at all either.
So yes I DO think IGR can occur and be a real problem for some women but I think it is over-diagnosed and a lot of other factors should be taken into account including the BPPs and NSTs, genetics and family history, and how prone the OB practice is to intervention anyway. FWIW, I also known a couple people who were induced for IGR and they ended up having 7 lb babies, U/S was totally off.
Until yesterday I was seeing midwives with a planned birth center birth. They consulted with my doc (family doc who does OB) and she in turn consulted with an OB whom she believes is fairly low-intervention. The OB said I need to transfer to OB care.
SO . . . I'll be curious to see how this plays out!
But yeah--if they truly aren't growing inside, then they're better out where we know they're getting oxygen and food. Determining what's actually happening is the hard part. I believe that asymmetrical growth is statistically a bigger deal and a bigger red flag than a symmetrically SGA (Small for Gestational Age) baby because a certain number of "SGA" babes are just genetically destined to be small.
CurvyRed, I hope that everything goes well for you and your little one.
The head was right on track for gestational age, the abdomen was a week or 2 behind. It was growing, just lagging behind the head. No signs of brain sparing or anything, blood flow, BPPs, NSTs and ultrasounds showed everything was otherwise normal. Her head pretty much stayed in the >90% percentile until she was two with the rest of her measurements at 50% or so. That has been exactly DH's pattern growth. Both are very normal, healthy intelligent people so it really seems like a genetic thing to me.
My oldest son (not bio) had a huge head too. He was average size when born (7lb4oz) but his head was literally hovered above the charts until he was like a year.
|The other thing I was told is that a baby who is small, but has a consistent growth curve, is less concerning than a baby who starts dropping down the percentiles.|
Somebody on another thread posted a link to an article done in the Netherlands showing that, for babies diagnosed after 36 weeks, monitoring and waiting for labor had comparable outcomes in APGAR scores and NICU admissions compared to induction. Something to discuss when I have my appointment Thursday.
I probably would be skeptical at this point as well--I assume they were talking about women who got regular growth ultrasounds for whatever reason. If you've been doing them regularly from early enough, I would think the curve would be easier to plot and more reliable.
I actually got to see the radiology report today and both umbilical cord blood flow AND blood flow in the brain were outside normal limits. At this point, I'm satisfied that we're outside the norm but it doesn't matter because I officially risk out of the birth center.
I got a referral to an OB that my midwives love (downside is she's at a hospital an hour from home instead of 30 minutes) so we'll see.
I know this is an old thread... So My fundal height last week was at 35 (36 weeks into pregnancy), this week at 33... The midwife wasn't too concerned but recommended an ultrasound next week. She said it might be the way baby is balled up down low. I mean I never get stomach kicks from this baby! By palpating she guesstimated 6lbs (I'm 37w5d today).... What do you all think? From experiences? The biggest baby in my family born at 40 weeks and some change weighed 6lb 6 oz, DS weighed 5lb 10oz at birth (37w2d). I'm not sure whether I should be concerned or not... And for the ultrasound, I don't care about her guesstimated weight, but just to see if placenta, fluids and stuff are normal. the midwife did ask whether I had been leaking, but definitely nope.
Many moms start to lose some amniotic fluid late in pregnancy--I mean, less gets made, not that you're leaking. This is normal for many. If you add to this, a baby who is scrunched down low (possibly engaged or nearly so), then you can get a low fundal height reading. At this stage, especially if the baby's guesstimated weight is 6lbs, I wouldn't worry if it were me. Fundal height is really not an accurate predictor of anything, by itself--especially early on, and very late in pregnancy like you are.