Big babies induction vs C-section - Mothering Forums

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#1 of 21 Old 10-06-2007, 10:59 AM - Thread Starter
 
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I need some advice. I had an U/S today cuz baby is measuring bigger in size for dates. No GDM....just big.Baby is estimated to be 8# 12oz give or take. I’m exactly 38 weeks…. My EDD is 10-22

I had a horrible birth with my 1st DD....7#20z. 24 hour labor, forceps, 4th degree tear and I think my OB is just trying to prevent problems, complications. He's suggesting a possible scheduled C-section if the baby is "too big" and I'm thinking of asking about an induction to try labor. I'm a L and D/peds nursing instructor so believe me, I"m aware of the risks of both.

I see the OB on Tues at 9:30….any advice on what I should do?

Induction and when…and how (cervidil vs Pitocin) or should I just schedule a C-section…I don’t want to go through a Trial of labor and just end up with a C-section anyway….but then again, I am a second time around mom and maybe things will go faster and better this time around… and lots of women deliver big babies...I know the recovery for c-section isn't fun, but I'm willing to do it if necessary.

Please no harrassment...I'm just asking for your stories and advice, pros and cons. Thanks so much in advance. I'm really torn!
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#2 of 21 Old 10-06-2007, 12:01 PM
 
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U/s is not accurate for estimating size. It is not safe to induce or section without medical reason. I would NEVER agree to it simply for "size"

Bad idea.

It's more dangerous for mom and baby.

-Angela
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#3 of 21 Old 10-06-2007, 12:07 PM
 
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ourback up OB estimated a baby at 9 1/2 lb at 37 weeks. mom got a second opinion- same result. she was induced and had a 7lb2oz baby, who ended up needing to be hospitalized for a week for "severe" jaundice and had difficulties bfeeding for the first few weeks. it was very sad
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#4 of 21 Old 10-06-2007, 12:14 PM
 
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I wouldn't schedule a C-section for "big baby" based on ultrasound. Those can really be off. I would even be hesitant to schedule an induction because it could be a slippery slope, especially if your OB already has it in his mind that baby might be "too" big. If YOU are concerned about the baby's size...the most I would do, if I were you, are some natural induction methods.

I'm wondering if some of your apprehension doesn't have to do with your traumatic first birth. I had one with my dd (almost the same birthday as yours!) and when I think about birthing again, I worry about my perineum (I had a really bad tear too) But I figure, I've had two years to heal, dd was only 7#7oz. (although they tried to tell me she was really big so this baby probably won't be much bigger. Because I am laboring and birthing at home and not in a hospital, I can be a bit more laid back about it, I think. I understand your concerns considering you are dealing with an OB and a hospital environment. As I said before, I wouldn't plan an induction or a c/s at this point. Best of luck with your decision, mama
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#5 of 21 Old 10-06-2007, 12:30 PM
 
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I was pressured HARD to induce or schedule a c/s with both my babies because they were measuring big (dd#2 was also breech). They WERE big, too: 10 lbs. 9 oz. for the first (born at 40w6d), and 10 lbs. even for the 2nd (born at 41w). They were both born vaginally, in their own time. I had a tiny tear with #1 and nothing with #2.

Women CAN deliver big babies vaginally, with minimal trauma to their "parts." They do it every day.

Best to you.

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#6 of 21 Old 10-06-2007, 12:50 PM
 
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I think that you should consider "none of the above".

First labors can be really hard -- labors can be long, exhaustion and fear can play a huge part and if you had a forceps delivery it can be hard to believe that a baby could come out easily next time. But the truth is that if a baby fit through your pelvis with forceps, it could fit without them. I'm not saying that they weren't helpful or even necessary for a vaginal birth last time but that their use had more to do with exhaustion or bad positioning of the baby than the baby's size.

The 4th degree tear had everything to do with the forceps. They are exceedingly rare without them.

Induction creates problems of its own -- labor goes best when mother and baby are ready. There are easy inductions but there are also multi-day struggles where the body refuses to respond to attempts to force nature. Then you are in the same situation that you faced in your first labor -- trying to push out a baby after a long struggle.

An elective c-section would bypass any concerns about 4th degree tears, but otherwise is much riskier for mom and baby. I just counted the number of babies whom I've helped this year who were over 9 lbs. If each of the moms I worked with had c-sections for those babies, I would have a c-section rate of about 40% (right now it's about 3%). There have been 5 babies in my practice this year over 10lbs, all born without complications and no tears worse than a second degree.

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#7 of 21 Old 10-06-2007, 01:53 PM
 
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I would agree with the ladies that say do none of the above. I had a terrible first labor and 4th degree tear from an extended episiotomy. He was 9 14. It was a cascade of factors, starting with induction, limited activity, purple pushing on my back, episiotomy.....
My midwife now isn't worried about it at all. Take out the factors that caused it and though you are more likely to have a tear because you've had one before and have scar tissue, you are most likely not to tear badly. Tearing isn't a big baby problem, it's a positioning problem.... I would hold out. I know it's scary after a tear like that, but I would look very critically at induction, and I think a c/s is unecessary. If you let things go on their own your body will be ready to stretch and you'll be fine.
You could also look up 4th degree tears on this site, I remember seeing one with a lot of mamas that have been through them and went on to never even tear again. It made me feel a lot better!
Good luck!
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#8 of 21 Old 10-06-2007, 02:56 PM
 
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Size is such a minuscule part of hard labors (if it is a factor at all), and ultrasound is notorious for getting size wrong. My son was 10lb 6oz, and I had no tears (just a couple small labial splits that healed on their own in a few days). What matters isn't the size of the baby, but the birth environment, and the patience and care of the attendant. If your attendant doesn't trust birth, doesn't trust your body, doesn't trust that we can birth "big" babies, doesn't trust babies to come out when they are ready, it doesn't matter what size your child is, there are likely to be problems (eg your first birth).



You CAN birth your baby. It's completely normal to have fears, and I encourage you to work through them in the time you have left. But that birth and this birth are two very different births - in a metaphorical sense, you are not the same woman as last time, and in a very real sense, your baby is NOT the same baby as last time! It doesn't have to be like that again.
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#9 of 21 Old 10-06-2007, 04:32 PM
 
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Every birth is different and can't be judged on previous births. My SIL's first birth was a dream, the second was horrible and the third was in the middle.

Give yourself and your baby the opportunity to birth naturally. Think of how you would feel if you chose a C-sec first without even trying labor.

Know that you can do this. My son was 10lbs 11oz. I'm so glad my midwives never told me they thought he would be big (actually, they were estimating around 8 lbs but I don't know how they could have been saying that because I was measuring way ahead and I was HUGE - maybe they didn't want to scare me). I know I would have been scared if they had estimated that he would be over 10 lbs. I hope I would have had the strength to listen to my gut - I knew I could do it and that my body wouldn't grow a baby it couldn't birth.

Tell your doc that you won't talk about size again. That you need him to be supportive, that you are going to do this and that if you do need him for any interventions after you labor then you don't want to hear "I told you so." You've hired him to provide you with a service and it ain't lip-service.

Seriously, you can do this. Because you know the risks, then give yourself and your baby the best chance at a positive experience and outcome by laboring and birthing naturally (no inductions).
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#10 of 21 Old 10-06-2007, 04:38 PM
 
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i would not do it- induce or c-section. your baby is not ready to be born yet (since you are not in labor, that is).

i also had a 4th degree tear with my first and went on to deliver my second and third babes with just tiny little tears.

are you worried about your scar tearing? i did not have an issue with that at all.

i think you are much more likely to have problems with your health and your babe's if you either induce or have an elective c-section, especially before you are even 40 weeks.

good luck mama. i know from personal experience (my first labor/delivery) that OB"s can use some serious high pressure tactics to get you agree to what they want.

Chrissy, lucky mama to Noah (9), Lilah (6), Rowan (3) and Laney (1).
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#11 of 21 Old 10-06-2007, 04:42 PM
 
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I answered in your thread in Pregnancy. But I thought of something else--*how* was your last delivery "managed" last time? Did they give you Pit? Keep you attached to monitors and on your back? Did you have an epidural?

IMO and from the stories I have read one of the primary causes of birth trauma is medical intervention when it isn't necessary. A 7 lb baby is highly unlikely to cause trauma all by itself, but even a tiny baby can get "stuck" if a mother is forced to stay motionless and on her back.
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#12 of 21 Old 10-06-2007, 05:01 PM
 
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And even small babies can get stuck when mother is mobile! My DD was only 6 pounds 13 oz and I needed a ventouse which resulted in a 3rd degree tear. So I fully understand your concerns.

I don't believe they can predict wieght by scan either, I had one at 36 weeks where they estimated DD was already over 7lb. She was born 4 weeks later and didn't make it to 7lb!

I personally think you should really try for a natural labour and birth. But I also think that you will KNOW if during labour things aresn't going quite right - I know I did and think I would again - could you not at that stage, if it happens, fall back on c-section. At least you would have tried, and the likelihood is you won't need it.

Maybe having it there as an option if things aren't going well will also make you feel more confident?

Best of luck to you, it's a difficult decision you face

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#13 of 21 Old 10-06-2007, 06:55 PM - Thread Starter
 
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Thank you everyone for your stories and honest replies. Wow! I truly appreciate MDC. I had a midwife with me first and she gave me lots of confidence....things didn't go as planned, and I was just glad baby and I were both fine. That was in RI.

Now we moved to CA, no midwives are covered by my insurance, so I have what I thought was a good OB. I liked him up until he suggested I have an u/s to check the size of the baby since I am "huge"!!! And pretty much said because of the forceps, smallish baby last time, and the 4th degree tear, I MIGHT want to consider induction or C-section to "avoid" problems. And everyone is right....something is just not sitting with me since I'm so not into medical intervention unless absolutely necessary. I'm finding it hard to trust my body and this baby.

I know the risks of both...and because maybe I haven't released the trauma of my first experience, I really am scared to death! But reading your posts made me realize to wait a bit and not let him talk me into anything. I'm hoping this baby decides to come out soon, on his own, and that our experience is a good one! Thanks....on Tuesday I think I will tell him I'd like to see what happens for the next 2 weeks. I may even check out accupuncture....I'm taking EPO, walking alot, etc.
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#14 of 21 Old 10-06-2007, 07:02 PM - Thread Starter
 
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Oh, I forgot to add that I really did have a "natural" birth...no epidural, etc. I did have some IV stadol 2x which did nothing. I moved around as much as I could, but after 22 hours of labor and 3 hours of pushing, honestly, all I wanted to do was lay in bed. Supposedly she was in a good position, face down, etc. I believe my uterus just gave out and became too tired to push anymore so they eased her out with forceps. Water had broken at 2:30 in the am the night before and I delivered her at 6:08 am. Thanks again for sharing!
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#15 of 21 Old 10-06-2007, 07:06 PM
 
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I wouldn't induce or have a c-section because of a "suspected" big baby.

I don't think our bodies are trying to sabotage us with making babies that are too big to birth.

As others have said ultrasounds are not accurate for sizing that far into pregnancy.

Even if it was accurate its not like they are suspecting you are having a 15lb baby, just around 9lbs.

If I did suspect a larger baby I'd do things to facilitate the birth, like laboring upright, not putting a time limit on labor, and pushing in non prone position.

Mom of a 7 yr old, 4 yr old, and 1 yr old. Wow. How did that happen?
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#16 of 21 Old 10-06-2007, 07:31 PM
 
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I'd hire a midwife, stay home, push instinctively, and have my big baby WITH my body intact. I would do whatever I had to to pay for this, because my bodily integrity is worth more than a couple grand.

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#17 of 21 Old 10-06-2007, 07:37 PM
 
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Neither Induction is dangerous c sections are dangerous. I would never consider it based on a u/s estimation of weight.

I would avoid pushing on your back at all costs. I would either do a birth chair, squat or standing supported. In the hospital that may not be allowed tho. If you are stuck on your back your body cant open up as fully as it should.

 
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#18 of 21 Old 10-06-2007, 07:48 PM
 
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I had a bad birth experience with my first. Labor stalled, I went with the pitocin, had the epi, pushed on my back, she got stuck. She was 10lbs.
My second was a home birth, pushed on all fours(I just went with what felt natural)and she weighed 10lbs 10oz. I didn't tear with either of them.

Induction can lead to other interventions, so I say none of the above

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#19 of 21 Old 10-06-2007, 08:12 PM
 
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Quote:
Originally Posted by Abylite View Post
Thank you everyone for your stories and honest replies. Wow! I truly appreciate MDC. I had a midwife with me first and she gave me lots of confidence....things didn't go as planned, and I was just glad baby and I were both fine. That was in RI.

Now we moved to CA, no midwives are covered by my insurance, so I have what I thought was a good OB.
What part of SoCal are you in? Can you check (I know my last three insurance providers have a website index) whether "Dr. Michael Liu" at UCLA Medical Center is covered? If he is, then the only (that I've been able to find) non-Kaiser hospital midwife practice in SoCal is covered. ;-) The UCLA Nurse-Midwives bill under his name. I used them last time, when I had UCLA student insurance (so the ONLY practitioners that were covered were at UCLA), so I knew what to look for this time... but I had a heck of a time finding out what I needed to know to determine if they were in-network for me. I have United Health Care, just FYI.

I've also heard that Debbie Frank, a midwife that works with... Dr. Paul Crane? Oh, I get all the OBs names mixed up... does see patients and do deliveries, billing under Dr. Crane's name (if I've got the right doctor!) She only does hospital deliveries, though, and I think also at UCLA.

I know it's late in the game to be switching providers, but it may be worth looking into.
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#20 of 21 Old 10-06-2007, 08:17 PM
 
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I wouldn't do it. My doc pressured, pressured, pressured me into an induction. I finally caved. I deeply regret that decision. Something like 40 per cent of induced labours end in a C/S.

Mine did.
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#21 of 21 Old 10-06-2007, 09:22 PM
 
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unfortunately my first was a failed induction followed by a forceps attempt and c-section . according to ultrasounds, my baby was about 5 1/2 lbs and they were concerned she wasn't growing anymore. of course, scared to death i agreed to an induction not knowing any better and she ended up being 7 lbs anyway! so me personally, i would not agree to a section or induction based on baby's size.

needless to say my last 3 were born at home, 8 lbs 9 oz, 9 lbs 5 oz and 9 lbs 4 oz.

your body can do it!

Midwifery student , Mama to my 4 amazing kids. treehugger.gif

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