36 weeks pregnant with a big baby

[barbararla]

I just moved to High Point NC from Florida. In Florida I was a good candidate for VBAC now in High Point I'm not. I went to a highly recommended doctor Henry Dorn who scared me half to death with all the risks associated with a macrosomic baby. According the ultrasound he did that day, my baby now is 9.7 pounds and will likely be 10 pounds or over at birth. He told me the baby could suffocate on the way out causing multiple disabilities and I could also end up with a nasty tear that will cause me to have trouble with bowel movements. Not only that but the thickness of my old cesarean scar is 2.3 mm and he told me that 3.5 mm is ideal so I also have an added risk of uterine rupture. After his speech I was left sitting there in his ultrasound room speechless and about to cry, and then he says I need to leave because he has other patients that need an ultrasound. I was mortified. I did my research and supposedly he use to back up homebirth midwives. Not anymore. I don't know what really happened. Today I made some calls and emailed some people he use to work with and they don't know either although it has been suggested that it might be an insurance liability issue.

The nearest birthing center that might take me is an hour away. I'm really leaning towards homebirth but I'm terrified of all the risks. This doctor really scared me I was crying the whole night.

The weird thing is that my with my other son, whom was 10.3 pounds when he was delivered by cesarean 4 years ago, I felt him up towards my ribs and I could barely breathe. I know what it's like to carry a big baby. But with this one, I get a headache here and there when he moves too much but I could breathe and I don't feel as big as last time.  Also when he kicks and I feel his foot it's so tiny. I can't believe that he's already over 9 pounds. Although he could be.

I would just like to know what I can do now to facilitate my labor. I read about doing perineal massages. Is there anything else I can do in anticipating to delivering a possibly large baby? What do I do if the head gets stuck halfway out like the doctor said? What are the optimal birthing positions I can use?

[nudnik]

I'm sorry! That doctor sounds horrible.

Most of my babies have been "macrosomic," and I've never had any tear that needed suturing. Also never did perineal massage.

I also don't know that I've ever heard of a head getting stuck halfway out, although shoulder dystocia (stuck shoulder) might be a possibility, most good midwives know plenty of "tricks" for getting a baby unstuck (usually position changes, sometimes also helping free the stuck shoulder).

It might be a good idea to speak to some homebirth midwives and address your concerns. Most of them sound like they're based on scare tactics from that doctor, not on real fears.

[tash11]

I agree with nudnik.

Also my son was "only" 9lbs, but I didn't tear at all (not even skid marks). I recently heard of "internal work" (from the Pink Kit) which is basically advanced peri massage. In short you not only massage the opening, but go inside (with your thumb or if your partner is doing it they use their middle finger) and massage the muscles inside toward the back, especially anything that feels tight.

If baby isn't moving down or if you just feel uncomfortable change position. Different positions work better or worse for different people, but in general laying or your back or sitting on your butt don't work as well (they push your tailbone into the baby's path and it can't move), while squatting or hands and knees are generally better. I can only do it standing up (with support). If you find you "have" to be in a bed try laying on your side, or if they want you to "sit" (like how you see people on tv shows a lot) lean to one side and bend that knee so your weight is basically on your leg/glut/hip instead of your tailbone. I have heard that squatting with one knee on the ground and the other knee bent with the foot on the ground works too. Really there is no wrong position as long as it seems to be working.

If you do opt for a hospital I would suggest that you get another dr., one that isn't used to scare tacticing his way into patients trust and then 'saving' them from all those 'possibilities'. And you might want to look into a doula as well.

[dannic]

Also keep in mind that these weight estimates ARE estimates...they can be off significantly.  I personally know of two mamas who were scared into csecs by their docs with big baby weight estimates...one was 7lbs6oz, the other 8 lbs.  Hardly large.  I agree to talk with some homebirth midwives...if nothing else, it will help you decide; and it may alleviate your concerns.  So sorry that Dr. made you feel so horrid.

[mamaharrison]

This Doctor sounds terrible! I honestly would report him to the Board in your State for the way he treated you. Plenty of women have big babies easily + there is NO way to properly estimate size with U/S Those things can and often ARE off by at least 1lb both ways. This guy was a real jerk to scare you the way he did. Have you contacted ICAN in your new area to ask about truly VBAC friendly providers for your birth?

http://centerforhealthreporting.org/article/blog-myth-big-baby827

A suspected BIg baby is NOT a reason to have an elective surgical birth--there is NO scientific evidence that supports that decision. The Doctor was not using sound medical knowledge in his assessment of you and I would definitely find another provider ASAP and forget everything he said--after you REPORT him so that other women aren't traumatized the way you were by his off base 'care'.

 

[barbararla]

Well I made an appointment with a midwife for a consultation. Supposedly she has experience with large babies just in case. It's really difficult to find a doctor in this are now. Before I left FL I was seeing an amazing OB, Dr. Delisa Skeete, that respected my wishes of birthing naturally. I spoke to several other midwives that recommended Dr. Dorn. He's a member of ican and also contributes on the website http://www.theunnecesarean.com/, even on his Facebook page there's women going on there praising him for being a doctor with a natural approach. After further researching him online I came across this article

http://www.wcnc.com/news/Seven-nurse-midwives-lose-physician-supervision-expecting-moms-left-looking-for-birthing-care-156867525.html

This just happened recently so I don't know what's going on.

Most appointments I can't get until I'm 38 weeks so I'm a little freaked out. I figure I could labor as long as I want at home and then go to the hospital. I'm about 5 minutes away from High point regional.

[mamaharrison]

Originally Posted by barbararla 

Well I made an appointment with a midwife for a consultation. Supposedly she has experience with large babies just in case. It's really difficult to find a doctor in this are now. Before I left FL I was seeing an amazing OB, Dr. Delisa Skeete, that respected my wishes of birthing naturally. I spoke to several other midwives that recommended Dr. Dorn. He's a member of ican and also contributes on the website http://www.theunnecesarean.com/, even on his Facebook page there's women going on there praising him for being a doctor with a natural approach. After further researching him online I came across this article
http://www.wcnc.com/news/Seven-nurse-midwives-lose-physician-supervision-expecting-moms-left-looking-for-birthing-care-156867525.html
This just happened recently so I don't know what's going on.
Most appointments I can't get until I'm 38 weeks so I'm a little freaked out. I figure I could labor as long as I want at home and then go to the hospital. I'm about 5 minutes away from High point regional.

I am sorry you are having such a hard time :( I hope you MW appt goes well.

You are right, you can always labor as long as possible at home adn then go to hospital and refuse the surgery. They cannot MAKE you have a cesarean and why would it be necessary if you were getting ready to push out a baby from your vagina ; ) 

HIRE A DOULA NOW! This can really make a huge difference in these scenarios--to help you comfortably labor at home long enough to just make it to the hospital and to kind of run inteference when you do get there for you {remind you that you why you don't want the cesarean and that you are progressing well without it}. 

We had a VBAC friendly doc here in FL {Pinellas} who was basically run out of town and forced to stop practicing because she was one of the only OBs who actually did VBAC vs. gave a trial of labor which eventually led to repeat sections. It sounds as if this NC OB may be facing something similar--some pressure to stop working with those MWs--when threatened with losing your own license you kinda have little choice but to abandon your support of the 'fringe' group, right? 

Talk to someone at ICAN right away and ask about doulas--sometimes you can even get one for free because they need certification hours ; ) or they are willing to barter or take payments--most doulas are lovely women who want to help! They can really make all the difference in these situations--help keep you focused on YOUR goals and help keep you calm and in the know--just be warned--if you show up to hospital ready to have a baby they will likely FREAK OUT and pull all the 'dead baby' cards on you to get you to consent to surgery and interventions. That would really be my last choice--finding a provider who actually trusts your body and has experience with VBAC is def. the best situation--hire a doula still!

[caedmyn]

Originally Posted by dannic 

Also keep in mind that these weight estimates ARE estimates...they can be off significantly.  I personally know of two mamas who were scared into csecs by their docs with big baby weight estimates...one was 7lbs6oz, the other 8 lbs.  Hardly large.  I agree to talk with some homebirth midwives...if nothing else, it will help you decide; and it may alleviate your concerns.  So sorry that Dr. made you feel so horrid.

That happens here too--one friend's doctor actually moved her due date up by a week because of the "huge baby" she was expecting.  He was born a few days after his original due date, I believe he was 7 lbs 13 oz.  Someone else I know was told that hers was big as well and he was just over 8 lbs.

And, as PPs have said, big babies do not automatically equal hard births or tearing.  I haven't had any big ones myself, but one friend had no trouble with her 10 lb baby, my SIL's 11 pounder was born super fast, and another friend had a nearly 11 pounder born in two pushes, no tearing.

[loveandgarbage]

Oof that doctor sounds like a jerk! I hope the new midwife works out.

I agree with everyone here-- a big baby doesn't not necessarily mean you can't birth naturally. My big guy (almost 12 lbs) did end up in a c-section but that was more his position than anything else (it was also a hospital birth with lots of interventions thrust on me.) I had a successful VBAC two years later with an 8 lb baby.  A few days before I went into labor I had an ultrasound to "check for size" and they were worried because he was "big"-- I don't remember what the estimate weight was. Either way, it didn't matter. As you feel, I *knew* that baby wasn't as big as his brother because I could feel it!