[Pelgie]

Please no rants on how mom's who consent to planned c-sections are bad people. I'm already having a hard time with this.

My baby has been measuring as a "big baby" this whole pregnancy and so I've been doing the non-stress tests and periodic ultrasounds to keep an eye on the amniotic fluid (also high), etc. The baby was 5 1/2 pounds at 32 weeks (per ultrasound) when most babies are 3 1/2-4 pounds. He's continued to be big and they predict will be 9+ for sure and probably 10+.

Doctor told me today (at 35 weeks) that OB statistics show that 25% of babies this big get stuck in birth canal or have related complications because of shoulder size, etc. and that c-section is recommened by OB standards when babies are known to be this big. We will play this by ear as we determine how big the baby really is as we close in on 39-40 weeks.

But now I'm wondering if anyone else is headed for a c-section for this reason or any other reason.

My last baby was only 8 pounds and came out vaginally but only after 21 hours of labor, some help from one of those suction things on his head and a lot of painful tearing on my part that took about 9 months post-birth to stop hurting. I'm slightly scared what a 10 pound baby could be like and whether he'll make it out vaginally or not.

I guess I'd like your thoughts and stories.

 

[alegna]

Not in your group, so forgive the intrusion, but I noticed that you said OB STATS. Perhaps you could get a midwife opinion as midwives regularly assist with larger babies without any trouble at all.

-Angela

 

[Parthenia]

Also not in the group, but just wanted to mention that (and this is total anecdote!) I know personally 2 women who safely vaginally birthed babies over 10 lbs. One was 12 lbs (her second 12 lb baby delivered vaginally). Another woman had a 10 lb + baby without drugs, episiotomies, or tearing. My own younger dd was almost 9 lbs, and I delivered her at home, no tears, and she didn't get stuck.

I agree with the pp. Beware the stats, and consult a MW. Don't let anyone scare you out of a birth without surgery.

 

[MilkOnDemand]

My ob has also been monitoring the size of my baby very closely, but because I'm on 90 units of insulin a day - making mine a high risk pregnancy with increasing risks to the baby. She has a very low rate of c-section, even when dealing with high risk because she does not like to do major abdominal surgery unless she feels it is absolutely neccessary. She also will not induce a *large* baby early, feeling that the best place for baby is in the womb if possible. That said, I have an u/s at 38.5 weeks, if at that time baby is estimated to be over 4500 grams, I'll have a c-section. It will not be scheduled though, it will happen when I go into labor. At 34-35 weeks we were estimated at 7lbs, 4 oz. I have lots and lots of u/s, NST & BPP's....sigh...

I don't think "big baby" alone should be the detirmining factor in deciding to have a c-section. Many big babies are born vaginally every day without complication. There is no way to determine whether a baby will fit without trying.

 

[ewe+lamb]

Hi - I just wanted to add my pennies worth on this one - A good friend of mine had such bad tearing that it took well over a year along with repairing surgery and with her second pregnancy was terrified that the same would happen however, even although #2 was bigger she didn't tear at all. So my experience with a c-section is that I was induced at 39.5 weeks because of GD, needless to say that even although I was getting there - baby engaged, soften cervix etc we ended up with a severely long time on pitocin (2.5 days) with no other drugs, however, what I wanted to say that after the c-section the recovery from the whole experience was exceptionally hard in comparison to folk who didn't labour at all or for not so long, the pitocin encourages very un-natural contractions - I know you'll know all that stuff. Don't know if this is really what you want to hear but it was just my experience and although I really wanted as natural a birth as was possible in our situation it didn't happen and I was devastated, if you do go down the road prepare yourself both mentally and physically - physically the pain goes ... eventually, however, for me and for other women I have talked to about c-sections mentally it takes alot longer, I read The Silent Knife which I borrowed from our LLL library - not sure if it is in print any longer, but it gives you all the points - it maybe better to read now rather than after - it takes quite along time to absorb and consume before going further into the book. Not sure if this will help but whatever you decide make sure that you are prepared for it - we weren't and it really took me a long time to recover from. This time I am determined to try for a natural birth and have prepared myself so much better I have also consulted a homeopath for medicines which will help before and after the birth which you may want a note of - if you do, I'd be pleased to give you the information. I sound abit preachy but I'm not trying to be just don't want you to go through what we did.

 

[OnTheFence]

There is a Cesarean Support Only Thread in Birth and Beyond. My birthplan is the second plan.

I am not having a cesarean for the reasons you posted about it, but just thought I would let you know.

Kim

 

[Max's Mami]

Another thing to think about is that ultra sound is extremely inacurate at determining weight. Some OBs love to use it to *predict* what the baby's weight will be but its just very, very hard to do. It cannot measure body tissue so what they are going on is bone length, etc. which just cant tell weight. They use the length to estimate weight but we all know that every baby is different and just because a baby is long doesnt mean its chubby too.

You totally have to do what is best for you and your family but doing some research on this might help you make a better decision. There are lots of OBs (mine is one) that dont think a big baby is a good reason for a c-section. There are definitely time c-sections are called for and thank goodness its an option in those cases and emergencies but having a big baby isnt medically dangerous - not given the risks that come w/ c-sections.

Unless you have gestational diabetes or some other condition its not very likely that your body will grow a baby that is too big for you to deliver.

Good luck!

 

[Jane]

If I were planning a c-section - I would make two plans - to go into labor first, and to meet with the anesthesiologist ahead of time to discuss what was going into my spinal/epi and the plan for my post-op pain.
I'd also arrange a little more childcare for my older child for the week or two after the c-section. Playdate, day care, preschool, something he would find fun and exciting and part of his routine. Summer day camp might be starting up in your area - that could be a fun option. Even ballet lessons might be good. Of course, someone to drive him there, too.

As an option, you might think about why you think you are growing a baby that is really large. If I thought I was experiencing some glucose intolerance (aka pre-diabetic condition), I would use my pregnancy as a spring board to change my diet and exercise lifestyle. That doesn't have to do with your c-section at all, but it's my two cents.

 

[colobus237]

Having been through a c-section with my first (for breech), I would at least *try* to birth even a Really Big baby before deciding on a c-section.
Do you have diabetes? This can cause babies to grow in a different proportion, with extra-large shoulders/chest. If you don't, if you've just got a big baby, then your big baby is gonna have a big head, and if the head fits then the rest will too except in rare cases. So I would find out whether those stats really apply to you and your baby. If they refer to true diabetic moms and you are not truly diabetic, then they don't.
Also - my midwives find that the average baby in their practice weighs 8.5 lbs, and they have like one c-section a year. I think how birth is managed has a lot to do with outcomes. Bigger babies may need upright pushing positions, full mobility for the mom, and optimal fetal positioning is really important - most doctors don't do or recommend any of that.
If you decide that a planned cesarean is the way you want to go - as I did with Simon due to the breech issue - the one thing I am glad about with that birth is that I did not schedule the surgery but waited to go into labor. That way I knew that the baby was ready, he picked his own birthday, got some of the benefits of labor hormones and contractions, and some of the joy and surprise and specialness was preserved for me.

 

[ChiknGirl]

I've never has a c-section but I have birthed a "large" baby and am expecting one even larger. Anneliese was 9 pounds even at birth and this next one is expected to be somewhere between 9.5 and 10 pounds. Dh was an 11+ pound baby and I'm very glad we aren't expecting one that big.

Everyone is different and everyone has different birthing experiences. I was blessed to be born at home and see my brother born at home. I grew up with an inate trust of women's bodies and thier ability to do what they were made to do. If I didn't have this background I think I would probably be very scared.

I hope you find the information you are seeking and are able to find peace with the decision you make. Wishing you a good birth.

Emily

 

[Mama Coltrane]

Your OB said 25% of babies that big do not come out vaginally, but that means 75% do! I don't know if I would be as worried in your case because you have already had one vaginal birth. It was hard and you tore, but usually the second time pushing ( even with a larger baby ) is way easier.
If you decide on the c birth, I totally understand that too. Planned c births can go very smoothly and not be too traumatic. Do whatever you want to do. Talk to people, talk to your OB some more, talk to the baby even. Whatever happens, wishing you a wonderful birth and a beautiful babe!

 

[nfpmom]

FWIW, I was told that this baby was 6 lbs, 15 oz at 34 weeks, which is greater than 97th percentile... and I am planning a VBAC.
This information has not changed *any* of my VBAC plans. Having gone through a C-section I would do *anything* to avoid another one. YMMV.

Having said that, there are sites that have information on how to have a better c-section experience... things I would do would be to wait to go into labor on my own, because it is better for the baby to experience labor- it prepares their lungs and systems for life on the outside-, I would not have my arms tied down, I would ask that all extraneous conversation be kept to a minimum, at the moment of the birth I would ask that the curtain be lowered so I could actually see my child enter this world. Most of the time, after they pull the baby out they wisk it away for deep-suctioning. I would request that they return the baby to me as soon as possible and allow me to hold the baby on the table, possibly even nurse on the table while they are stiching & stapling my abdomen back together... I would request double-layer sutures because that is the "politically correct" suturing that will probably give you an easier time finding a careprovider if you wish to VBAC next time around.

Good luck with your decision
take care

 

[NordicMamma]

Quote:

Originally Posted by Max's Mami Another thing to think about is that ultra sound is extremely inacurate at determining weight. Some OBs love to use it to *predict* what the baby's weight will be but its just very, very hard to do. It cannot measure body tissue so what they are going on is bone length, etc. which just cant tell weight. They use the length to estimate weight but we all know that every baby is different and just because a baby is long doesnt mean its chubby too. You totally have to do what is best for you and your family but doing some research on this might help you make a better decision. There are lots of OBs (mine is one) that dont think a big baby is a good reason for a c-section. There are definitely time c-sections are called for and thank goodness its an option in those cases and emergencies but having a big baby isnt medically dangerous - not given the risks that come w/ c-sections. Unless you have gestational diabetes or some other condition its not very likely that your body will grow a baby that is too big for you to deliver. Good luck!

I agree with all of this. (Well, I pretty much agree with what ALL the ladies here have said so far.)

I have mentioned this before, but I am living proof that u/s predictions can be very inaccurate. With ds I was told at 33 weeks that not only was he breech but HUGE ('off the charts' at 6 lbs!) and not likely to turn on his own. If by some miracle he did turn I would be induced by my due date because of size. I cried my eyes out and started to think c-section. (Note: I did not have GD.)

Well, he did turn, I went into labour naturally, and ds was born on his due date weighing all of 7 lbs 8 oz!

I still tore like mad (3rd degree into the back passage), but that had nothing to do with size, and everything to do with the fact that he came out all at once, not giving my perineum a chance to stretch.

Where I live (Sweden), having a big baby is not a good reason for a c-section. Especially if you have a 'proven pelvis'. And like a PP said, even if your OB's stats are accurate, 75% sounds like a good percentage to me! Also remember that head circumference and position of the baby are more important than overall size when it comes to giving birth vaginally.

If I were you, I would prepare mentally for a c-section on the chance that it MIGHT happen (personally, I think everyone should at least read up on it), but at least try for a vaginal birth.

Good luck - whatever you choose to do!

 

[CherryBomb]

Any good ultrasound tech will tell you that +/- 20% on the weight guess is standard, and it can be even higher. I've known a couple women who were sectioned or induced because of "enormous" babies who had little 6 pounders. :/ It's just simply not a good indicator of weight. Fundal height really isn't either, because a lot of that can depend on how the baby is laying.

That's not to say that you don't have a large baby, just that there's not really any way to tell for sure. You absolutely can not diagonse shoulder dystocia in utero. A 7 lb baby can get stuck, while an 11 lb baby gets out with no problem. You just don't know until you're in labor.

I think you need to do some research and weigh the risks and decide what's best for you. The decision is yours and you're the one that has to deal with the outcome, but if it were me, I wouldn't consent to a c-section because of a potential large baby.

Oh, and I had a c-section with my first and am having a homebirth this time, so that should tell you how much fun I thought the section was

 

[Pelgie]

Lots of really great advice. Thanks to all of you.

I am going to read up on the c-section to be prepared (my last pregnancy I skipped all the chapters on c-sections in my new mama books figuring I'd have good karma and not need one and it worked out since I didn't need one). So now... I'm dusting off those chapters and at least reading what it is all about.

That being said, I agree that I'm going to try to avoid the c-section unless I can be convinced that the risk for problems is pretty high. I should note that I wasn't seeing my regular OB yesterday because she was on vacation but instead rotated to one of her partners who perhaps has a different view on the matter. I see my regular OB next week and I'll see what she thinks.

I should also add that I don't have GD or blood pressure issues and am perfectly healthy in terms of diet/exercise/sleep/etc. I'm a pesco vegetarian and that seems to be working pretty well for me & the pregnancy.

Lastly, thanks for the views on ultrasound being inaccurate. I've had 3 ultrasounds over the course of this pregnancy and all of consistently shown "big baby" but you are right in that it's hard to know what that means exactly. My uterus has also measured 2-4 weeks ahead of the size it should be at every visit... but part of this may be due to the extra amniotic fluid factor.

 

[Max's Mami]

Quote:

Originally Posted by Pelgie That being said, I agree that I'm going to try to avoid the c-section unless I can be convinced that the risk for problems is pretty high. I should note that I wasn't seeing my regular OB yesterday because she was on vacation but instead rotated to one of her partners who perhaps has a different view on the matter. I see my regular OB next week and I'll see what she thinks. I should also add that I don't have GD or blood pressure issues and am perfectly healthy in terms of diet/exercise/sleep/etc. I'm a pesco vegetarian and that seems to be working pretty well for me & the pregnancy. Lastly, thanks for the views on ultrasound being inaccurate. I've had 3 ultrasounds over the course of this pregnancy and all of consistently shown "big baby" but you are right in that it's hard to know what that means exactly. My uterus has also measured 2-4 weeks ahead of the size it should be at every visit... but part of this may be due to the extra amniotic fluid factor.

I just wanted to say 3 more things -

First, if it wasnt your OB then I would DEFINITELY not go on this OB's opinion. He/she is not the one you have been working w/ throughout your pregnancy and probably will not be the one to deliver you.

Second, if you dont have GD or other issues there is no reason to think that your baby is too large for *you* to deliver. Like a pp said - without gd babies are generally proportional. Usually only in the case of gd or other condition would the shoulders be larger than the head.

And finally, Maxi measured big my entire pregnancy - 2 weeks ahead of EDD both by u/s and by fundal height. He was born 2 weeks late and was 8 lbs. 5 oz - not huge. Which means that both u/s and FH were totally inaccurate. Babies grow at different rates. *They* say that most of the growing is done in the last month but in my case my baby grew big earlier then stayed there.

This time I am measuring big again and my OB says its fine. I am tall, my husband is tall, we will have another big (not huge) baby.

Good luck with whatever you decide but definitely dont let an OB make you think that there is something wrong when there isnt.

 

[nfpmom]

I just wanted to add that I am 37 weeks and measuring 41 weeks and I am carrying too much amniotic fluid too (and I don't have GD or BP issues either). The fluid could be a result of a bigger baby or my friend who is a CNM said that sometimes when you are carrying too much fluid it distorts the image and the baby appears to be bigger than s/he really is. Anyway, its always good to prepare for anything... I did not even look at the CS info first time around because I just knew that it would not happen to me... and it was a huge shock and disappointment to end up with CS.... it took me a year to get over it emotionally... so being prepared is not a bad idea, that said I think you have a good plan to not just jump into the CS either. Recovery is no picnic....
And Cherrybomb, I am planning HBAC this time around as well

take care

 

[darsmama]

's to you

I wanted to let you know that as a first time mom, with no gd or anything -
I was measuring 46cm at 40 weeks and had a 9 pound 6 ounce baby. No tears or anything and I birthed in the water.

You have nothing to fear - you will do what you need to to have a happy birth experiance and have a healthy baby!

 

[orangebird]

Quote:

Originally Posted by alegna Not in your group, so forgive the intrusion, but I noticed that you said OB STATS. Perhaps you could get a midwife opinion as midwives regularly assist with larger babies without any trouble at all. -Angela

I just wanted to point out the same thing. I wouldn't trust anything that says OB stats. Of course 25% of OB's babies get "stuck". I would actually expect the statistic to be even higher. I know you just wanted support and not questioning, but I am really sad because so many of us are frightened by OB tactics. I am very skeptical of your OB's diagnosis. As it is the typical one we hear all the time. The one that ends up being bogus. The one that is edging our c-section rate in this country up close to 30%. Don't get me wrong, if you really need one, or heck, even just want one, you should get one, but I don't like that what the doctor is telling you is what is persuading you. Because I just don't buy his diagnosis. Especially if you are able to move about freely during labor and especially pushing. Which most OB's don't allow and what contributes in a big way to their failure rates. So yeah, if you get an epidural, especially if you get induced, and are laying on your back in stirrups, well, yeah, 25% of those women probably can't push the babies out. No doubt.

I can't wait to see the real size of your baby. Especially if he's right about the size and you have a vaginal delivery. I would also love to see him section out a 8 pound baby, but I don't mean I wish a c-section on you, I would just love for him to be proven wrong either way.

 

[Pelgie]

Well, I see my regular OB this week (36 weeks) and it will be interesting to see what perspective she has. In addition, I have an ultrasound to check on the baby and amniotic fluid levels... so that should be interesting as well. I'll post again at the end of the week to provide an update... and of course will let you know how birth experience turns out whenever that happens to be (due July 11th).

I agree with you the OB interventions tend to snowball into one another and I'm really hoping that I'm able to avoid most if not all of them. This is my 2nd birth and everyone tells me that 2nd births tend to go significantly smoother for most women. Fingers crossed.