Induction and 9 pound baby?

[kblackstone444]

I'm 40 weeks and 3 days pregnant.  I'm 2 cm dilated and still just less than 30% effaced and have been for 2 1/2 weeks now.  My baby is estimated to be at least 9 pounds, as of today.  The doctor says my body is not ready, though the baby is certainly big enough and in perfect position.  He hasn't engaged, but he's just above engagement.  I've been having crazy Braxton-Hicks for about 2 weeks now, some quite painful, but not really progressing anything along.  My doctor has agreed to induce me on Thursday.  I'm aware that induction puts me at a higher risk of c-section and/or episiotomy.  I'm terrified of both possibilities and II will be going alone- no labor coach available.I'm also aware that the bigger the baby gets, the higher the risk as well- the doc says she sees me going another week, maybe two.  That would give me a 10+ pound baby, which I simply won't be able to deliver.  I know this for a fact, from knowing my body- I'm not sure I can deliver a 9 pound baby as it is.  Has anyone here delivered a 9+ pound baby that was induced?  If so, how did it turn out?  Please tell me the good as well as the bad- I need to mentally prepare for all possibilities.

[Turquesa]

You're going to get slammed with this response (or a similar one), but lucky me, I get to be the first! 

Ultrasounds are NOTORIOUSLY inaccurate at predicting a baby's weight, so much so that the American College of Obstetricians and Gynecologists has issued a statement against inductions for a suspected big baby. 

As one who has born two ten-pound barbells, I'm curious to know what is it about your body that makes you unable to deliver a large baby?  Do you have a medical diagnosis?  Are you petite?

Also, did you push for the induction or your doctor?  Were there any other reasons mentioned for induction other than suspecting a big baby? 

[Chloe'sMama]

I didn't get induced for the same reason, I had prolonged rupture of membranes... but it was induction anyway.

DD1 was 10 lbs, 5 oz.  it was fine, but my body was ready anyways.  

I had a very petite friend (5 ft 1 or 2 inches and maybe 115 lbs) that delivered a 10 lb, 2 oz baby vaginally at 41+6, no induction.

good luck. 

[AustinMom]

Haven't read the other replies, but I will say this.  TONS of women birth 9-10+ lb babies!  I think I read of a home birth in CA that was a 14+lb baby.  It totally can be done, and I think women are always surprised what their bodies can accomplish when it comes to labor and birth.

Now, of course you know there are horror stories out there, like 4th degree tears and such, and they do happen, usually due to an extending episiotomy, not a natural tear, and usually with moms doing purple pushing, the holding legs back counting to 10, holding breath pushing, or moms who are pushing on their backs.  You can avoid all of those.

Many women birth babies that big and bigger just fine, and many women go in for an induction for the fear of not being able to.  Of all the responses you get, keep in mind, combined they are a small scale study.  Personally, I'd like to guess the outcome more so on a larger group of women to weed out all the flukes that can happen around birth.  So, when it HAS been studied, it's shown that women are more likely to have more success with going into labor naturally when a bigger than average baby is suspected.  Of course, ultrasounds are off by a lot, frequently, and so are guestimations of a CPs hands on mamas belly.  There is no way of knowing how big your baby is till he/she is out and on a scale. 

There is no way of knowing if your body OR YOUR BABY are ready.  Even if they baby weighed more, that is no indicator that his/her lungs or respiratory system are ready to breathe are or tolerate labor.  That's why your body and baby work together to send the signal to your brain to start labor as soon as BOTH are ready. 

It's totally your choice, and I think you should go with what you feel comfortable with.  This birth is going to be about you and your baby.

[Mama2Kayla]

My 9lb 12 oz baby was by far my easiest birth and the only time I didn't tear ;) she was over 2 weeks late

I am 5'3'

Dont' let size scare you into making a decision.. many factors are at play during labor.

eta~ I was not medically induced. She came out on her own(with some encouragment from castor oil!)

[Eyelet]

My first was 10lbs 6oz, my second was 11lbs 1oz.  Both were born totally naturally and over an intact perineum. Most women give birth to large babies without complications.  I don't think fetal size should be the only determining factor for inducing. 

[cappuccinosmom]

Ultrasounds can be wrong.  With my first, they were estimating more than 2 lb above his actual birthweight.  Telling me "severe macrosomia" and he was under 7 lb.

THe next two they were more accurate, those babies were 9 lb 15 oz and 10 lb 8 oz.  Delivered naturally, non-induced, 4 hour labors each.

I don't know your history so I don't know why you are convinced that a 10 lb'er would be impossible to deliver.  Personally, I would not induce, even so, because especially with a big baby, you will be pretty much marked for a section, and inductions don't do a great job of helping to avoid that, because of the nature of the process.  I would wait it out.  I would labor at home, and only go in when labor is well established.  And then whether you deliver naturally or surgically, your baby will have had the benefits of as much time in the womb as he needed, and some of the benefits to his body that labor gives. 

[Tumble Bumbles]

Edited. 

Edited by Tumble Bumbles - 4/10/11 at 5:01pm

[soso-lynn]

What is the assessment that your body will not go into labour based on? Internal exams mean nothing (and even if they did 2cm, 30% effaced is not bad), the size of the baby means nothing, even your due date is quite meaningless. Based on what you are saying, your induction is purely out of convenience. It does remain your choice, but the huge risks that come with inducing are not worth it without a really good reason. It is not only that you are more likely to get a c-section, you are likely to have a baby in distress, breathing problems, breastfeeding problems, bonding problems, postpartum depression and even post-traumatic stress. The list of things that can go wrong as a direct result of being induced (especially as a first birth) is quite long and a lot scarier than waiting for labour.

[MegBoz]

Originally Posted by Turquesa 

You're going to get slammed with this response (or a similar one), but lucky me, I get to be the first! 

Ultrasounds are NOTORIOUSLY inaccurate at predicting a baby's weight, so much so that the American College of Obstetricians and Gynecologists has issued a statement against inductions for a suspected big baby. 

Yup, THIS THIS THIS. Late term US can be off by up to TWO POUNDS!
 

Originally Posted by kblackstone444 
- the doc says she sees me going another week, maybe two.  That would give me a 10+ pound baby, which I simply won't be able to deliver

While it is true that babies get bigger at the end, I've read that the growth rate can taper off around 40W. So say, just for example, maybe baby gains .5# per week from weeks 35 -40, that does NOT mean he will CONTINUE growing at that same rate if you gestation until week 42W.

Besides, I don't think the risks of shoulder dystocia go up much until like 10# + range. And as for difficulty in birthing the baby, the head is the biggest part of the baby - and a 9# baby doesn't even necessarily have a much bigger head than a 7# baby!! The difference in those weights is often fat - not TOTAL overall size - and the fat squishes.

So, again, it could be that the biggest part of the baby you have to push out doesn't even get much larger anyway in a week or 2 as the baby gets a bit heavier.

[kawa kamuri]

Oh my. Good luck, mama. 

[MyFullHouse]

I did deliver an induced 9lb2oz baby, and the labor went fine.

That said, a friend of mine was recently told her baby was over 9lb at 37 weeks.  She was panicking and considering an elective c-section.  Her water broke at 39 weeks, and she (vaginally) delivered a 7lb12oz baby, not the 10lb'er that was "expected"!

[JenRN]

I know this has been said multiple times, but do not trust a late-term ultrasound for the size of your baby! A friend just had a C-section, failed induction at 40w1d because her baby was "over 9 pounds at 37 weeks." She had a 7 pound baby.

I will preface this with the fact that I am a L&D nurse who knows better, and still got scared at the end of not going into labor on my own and having a big baby, so your worries are totally understandable. I started begging my midwives at my 41 week appointment for an induction, so we agreed the best course of action would be to start incredibly slowly and I would go home if things didn't progress.

And that's what I did: 41+1 got one dose of cytotec and went home. 41+2 tried the foley balloon, and then went home. 41+3 I got a full day's worth of pitocin, and only progressed .5 cm. Turned off the pit to sleep at the hospital. 41+4- decided this was it, and restarted the pitocin and agreed to having them break my water.

It was a hard, long labor, and I ended up with an epidural when I stalled at 6cm and DD somehow turned posterior, after originally wanted a natural birth.

After 2.5 hours of pushing, and being threatened with a C/S for making such slow progress (it took me about 7 hours to fully dilate after the epidural), I gave birth to my 9 lb 7 oz daughter with a 15.5 inch head. No tears.

I wish I wouldn't have gotten so freaked out towards the end and would have went into labor on my own. But I had a successful induction and a perfectly healthy, albeit large, baby girl to show for it.

[xelakann]

Hopefully this will make you feel better... I have birth to my daughter 40w + 5d... she was 10lbs and I had no problems birthing her. Fat squishes. We had no idea she was that big and if I had know I may have been freaked too... but it went really well.

[Italiamom]

An ultrasound estimated my son's size at 9 and a half pounds 1 week before he was born.  He ended up being 7lbs, 14 oz.  He did, though, have a HUGE head.  So large, in fact, that one of the first things my midwife said to me was, "you should feel proud.  He's got one of the bigger noggins I've caught..."  I did have a small tear, but nothing major.  And I am a tiny person (5'1, 115lbs)!

Remember, the pelvis is NOT a rigid structre!  The soreness in your hips, and on your pubic bone that you might have had for months now?  Those are your pelvic ligaments relaxing.  It allows a big old baby to pass through (assuming, of course, that you are NOT on your back pushing, do NOT have your legs pulled up to your chest...  Those may be favorite positions for your OB or midwife, but they are NOT favorable to getting a baby through a pelvis.  Avoid an epidural so you can stay off your back. Squat, crouch, hands and knees...

For a visual, I think it's worth noting that this woman was recently in the news for naturally delivering a 9lb, 14oz "little" boy.  If this woman can get that almost 10lb baby through her hips, then by god, so can you!  Look at her!  She couldn't weigh more than 95lbs soaking wet!

Also, remember that weight has LITTLE to do with head and shoulder size.  I have quite a number of friends who delivered babies with smaller heads and shoulders than my son, but who topped him in weight by over a pound.  At a certain point in gestation, the bones don't grow as fast.  If your baby WAS a 9lber (which I doubt), most of that extra weight would be chub, not skull or shoulder size.

I would tell any OB or midwife to BACK OFF until 2 weeks past due.  At 2 weeks, I would demand a series of non-stress tests before ANY discussion of induction can happen.  If your OB/midwife bring up good reasons to induce, then yes, listen and take heart.  But the size of your baby is a completely ridiculous reason to induce, IMO.