Macrosomia, a good reason to refuse VBAC?

[lovelymomma]

I finally got to read my second c-sec opperative report and on its "pre-op
diagnosis was Macrosomia (excessive weight in newborn) prior c-section and
refusal of labor (which i totally didnt do but whatever) I know this is going to
come up during my consult with my new (VBAC Very friendly OB), is it a good enough of a reason NOT to allow a VBA2C? so at least I know what im looking at? He was 9lbs15oz, pre-eclampsia and GD baby... I also gained 70lbs during the duration of that pregnancy something I'm obviously looking to avoid this time around and at 9wks Im doing well so far with no weight gain at all, but I also know I packed on most of my weight during 2 & 3 tri. If nothing else Im eating better, more active, going to talk to my OB about doing Brewers Diet to help avoid complications, exc.

Anything I can recourse with? For instance, how can we possibly predict this
baby will be that big? My #1 was 8lbs 12oz and only pre-eclampsia (and kidney stones) as complications during that pregnancy...

http://www.babycenter.com/0_labor-co...mia_1152319.bc

[MommatoAandA]

Im not sure and I wanted to offer you some good vibes. I don't think having a large baby guarantees another one.

One thing though, that sticks out to me in that Babycenter article is the average size of a baby at birth being 7 lbs 8 oz. I would love to examine that further, going on, the article examines what makes a baby large, well, what makes a baby SMALL? Why are our babies notoriously 7 lbs in this country? We should study THAT, then we will see that due to interventions and inductions and planned births, this average weight is skewed. Most homebirth babies are usually over 8 lbs. To me, 8 lbs is normal. 9 lbs might be normal. I think fear is to blame for failed birth. This fear we out into pregnant moms. The lack of faith we give our bodies and what they are capable of.

I wanted to tell you, your body will grow a baby it can birth. It will. I hope your OB is truly VBAC friendly. Good luck!

[lovelymomma]

I have to correct myself, both "pre op/post op" csections indicated macrosomia... my first also indicated direct occipitoposterior position (sunny side up). Both the boys were 38wks gestation when they were taken... I believe my first csections position was due to being induced too early (before he was ready) and all the pitocin we got as quickly as we did caused him to be positioned poorly... I appreciate the good vibes and COMPLETELY agree with you about the birth weight. I certainly hope shes as friendly as I have been told.. considering the reports I have read it isnt looking good

[liberal_chick]

I don't think macrosomia is a good reason to refuse a VBAC. In fact, doesn't ACOG have an official position NOT to induce unless baby is suspected to be over 11 pounds? Not to mention there is no real way to know how big the baby is until s/he gets on the outside. I hear lots of "my baby was going to be 10 pounds, so they induced and I had a c-section and baby was 8 pounds" stories.

[kltroy]

Well, I say new pregnancy, new chance. That said, given your history there are some things that you can do to make this one go smoothly and hedge your bets for a successful VBAC. Your MW will probably tell you all of this too (and you know a lot of it). First is that hopefully you are in good health before you got pregnant. Second would be to maintain that good health during your pregnancy. This means keeping weight gain reasonable (20-30 lbs). This will improve your odds for avoiding GD and pre-eclampsia. Also watch your diet - make sure you eat lots of fruits and vegetables and whole grains, since this can help prevent pre-E. More than a big baby, pre-E can kill your chances for a VBAC, since it may require induction if the baby gets in trouble. I've seen some pretty good evidence that keeping pregnancy weight gain to 20-30 lbs keeps babies on average about 1 lb smaller. Of course many women have happily birthed large babies, but I don't think anyone would argue that smaller babies fit a bit easier. Given that pelvis, position, and baby size *all* influence how well baby fits through, keeping baby to a reasonable size can increase your chance of success for your VBAC.

I wish you a healthy pregnancy and a great VBAC!

[MommatoAandA]

DD2 was OP, literally until 1:49 AM on her Birthdate. I turned from all fours position at that time, she rolled as I was turning, and was literally 2 knuckles up from my vaginal opening. She was born at 1:54 Am. I had worried about the OP thing until I was a WRECK. LOL. She is just an easy going baby all together and took her time turning and engaging for that matter.

[akind1]

I think the whole "big baby" thing is relative - an 8 lb baby might be big for one woman, and on the small side for another -

Also, your bones and ligaments move in unpredictable ways during labor, allowing what one might think be a large baby to easily pass.

My grandmother, who had 5 births, said her smallest baby was the hardest labor. Go figure.

I say, avoid the pre-e and induction if you can, and gain a reasonable amount of weight. I tried the brewer's diet and just couldn't stomach that many eggs. Or that much food for most of my pregnancy.

good luck mama!

[eastkygal]

Originally Posted by liberal_chick

I don't think macrosomia is a good reason to refuse a VBAC. In fact, doesn't ACOG have an official position NOT to induce unless baby is suspected to be over 11 pounds? Not to mention there is no real way to know how big the baby is until s/he gets on the outside. I hear lots of "my baby was going to be 10 pounds, so they induced and I had a c-section and baby was 8 pounds" stories.

This is correct. ACOG says over 5000kgs, or 11lbs. It is absolutely no reason to refuse a VBAC. Unless there is some complication with you, rickets, pelvic bones injury, or the baby is large and in a poor position, and GD can be a factor, but not in and of itself... you can't know what size you are capable of birthing without a trial of labor. My great-grandmother gave birth to a 12 pound baby at home - she was about 5'6". My grandmother gave birth to my 9lb. daddy vaginally, she's 5' even. My MIL birthed my husband at 10lbs. 13oz., she's about 5'6". It's all relative and unless there is something else factoring in, there is no reason to think that your body will grow a baby you can't birth.
Watch your diet. Eat real, whole foods. Real Food for Mother and Baby by Nina Planck is excellent. Brewer too. Stay as active as is doable for you. Trust your body.