[Abylite]

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 (x-posted on pregnancy)

I had a horrible birth with my 1st DD....7#2 0z. 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!

 

[Aeress]

I was induced by breaking my water and some pit. I refused the cervidil because I had heard it didn't work.

Looking back, I wish I hadn't consented to the pit, it caused very hard labor with contracts that were lasting over a minute and were like 2-3 minutes apart for hours. It was a fairly quick labor but since breaking my water did start contractions, I should have let them do there thing. Man it was so hard with keeping under control with those pit induced contrations.

just my thoughts

 

[Vicitoria]

It sounds like your first labor was difficult and you don't want to re-live it. A scheduled c-section my be easier. I'm already overweight so I don't want a c-section simply because what it takes to heal and how much worse my belly with look with all the stretch marks. But, in your position, if I had the physical support to help me recover I would choose the c-section. If it's true that many inductions end up in emergency c-sections I'd skip the middle man and have the surgery under the best of conditions. They say that the sizing is usually off but your first wasn't really overly large and was a hard delivery and this one is bigger it will probably be even harder.

You are a L&D nurse so you know all the options and how true the talk is on this board vs. what you actually see in the hospital. I'd base it on that. Nothing wrong with taking what looks like the easy road with the c-section, the most important thing is a healthy and happy mama and child.

 

[Lukas's Mama]

I've had amazing success with acupuncture for induction. You can google those two together and see how well people do. Also, sometimes second births are easier than first now that your body has a better idea of what's going on and there is always the ultrasound margin of error on weight. You could go through the whole nasty induction/ or c-section and end up with a baby not much larger than your daughter.
I'd definately give the acupuncture a try or two, it only takes a day or so and your labor wouldn't have the drama that pit can cause.

 

[Hippiemommie]

When I was pregnant for DS they told me he would be "at least 10lbs 10oz" at 36 weeks. We had to have the baby by 40 weeks or our midwives would drop us. We tried everything in the book and nothing worked so we had to go to the hospital for induction. It was a really bad experience and I ended up with a c-section. Don't count on those numbers to be right. They were expecting at least a 12lb baby by my date and he was 8lbs 12oz. I've heard of this more times than I can count since my experience. BTW I was measuring 48 weeks when I was 40 weeks along. If I were to choose I would go with induction but try to do it without PIT. Acupuncture is a great choice. Remember, even if you do end up with c-section it is better for you and baby to go into labor first.

 

[naismama]

I think you cross posted... I posted for you in another thread. Meant for it to be this one

 

[Liam's Mum]

Quote:

Originally Posted by Hippiemommie Don't count on those numbers to be right. They were expecting at least a 12lb baby by my date and he was 8lbs 12oz. I've heard of this more times than I can count since my experience.

Ditto this. Besides, the size of your first was not the cause of the bad experience last time, right? So it's entirely possible this labour, regardless of baby's size, will be completely different (also that est. weight doesn't seem bad to me at 38 w -- my first was 9 lbs 3 oz at 40 and a few days.) I guess I'd hesitate to induce or opt for a c based on something that is so inaccurate. Your labour and delivery might, unfortunately, suck even if baby is small, or it might go much smoother this time because every l/d is different and this is your second time. My m/w is not giving me guarantees but has assured me in most cases the 2nd time is easier, so I'm holding on to that

I had a pretty rotten time with my first too, and he was a big baby, and though I've not been given an option of induction or c at this point, I'd hesitate to do either based on weight because I know that I can birth a 9 lb baby, I did it before, and because they simply might be wrong. Of course if it came down to it and I needed to be induced or have a c for my safety or baby's I would, but I'd wait and see what happened first. But if I have to chose, I'd also say try some sort of induction first. You never know, perhaps you'll go early and this is as big as the baby will get anyway.

Just my rambling 2 cents. Good luck!

 

[DoomaYula]

Le sigh.

Possible macrosomia is NOT a good reason for induction OR a scheduled c-s.

 

[LBW]

My first was 10 lbs 14 oz. Labor was fine, but the birth was really traumatic for me. My doc invited everyone in the hospital into the room to watch, he was chatting and showing off while I was supposed to be pushing, and in the end, I tore badly (not quite 4th degree, though). Healing from that tear was awful. I also had so much hip and back pain that I was barely able to pick up my baby for the first month of his life. I was an emotional and physical wreck trying to breastfeed and care for a newborn.

My second baby was born with the help of a midwife. She and I discussed the first birth at great length and decided to induce at 38 weeks because baby #2 was also measuring big. I was experiencing a lot of the same hip and back issues that I had with DS1, and wanted to do what I could to improve my post-birth experience. The induction was not at all pleasant. I had cervidil inserted in the evening, and immediately started having painful, and useless, contractions. I didn't sleep at all that night. The next morning, they started a pit drip, and after a few hours of that, I still wasn't progressing, so they started to talk about sending me home. I think that's what finally got my body going. I delivered a couple of hours later. DS 2 was 9 lbs 14 oz.

I still tore, though not as badly. My hip pain went away almost immediately and I had no back pain after birth. I really do think that having him a couple of weeks early really made a difference. However, I wish I had first pursued more natural induction methods since I didn't respond well to the cervidil or pit.

With DS3, I'm probably just going to wait until I go into labor and deal with the aftermath. He's measuring big, too, but I don't want to have another hospital induction. Good luck making your decision. I know it's a tough one to make.

 

[gottaknit]

Please keep in mind that *most* first labors/births are really hard. The second time around could be completely different. And ditto what everyone else said about size guesstimates. And one more thing... recovery from a c/s is no picnic.

 

[aylaanne]

Im wondering what else happened during your first labor to cause it to be so horrible. Was it your support? Your position? The baby's position? A 7lb baby is not reason alone to cause the complications you mention in your original post. I, personally, wouldn't induce OR elect for a section, I'd start looking for a new provider, someone better able to help me avoid whatever caused the problems with the first baby.

ACOG recommends against induction or c-section based on weight estimates.

 

[Abylite]

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.

 

[Abylite]

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!

 

[gottaknit]

Quote:

Originally Posted by Abylite 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!

I think getting exhausted is really common for first-time mothers, and probably what leads to a lot of c/s. It does seem to be a good case for epidural (not that I'm a big fan of epidurals!). I think when used at the right time (not too early when they can cause labor to slow), they can prevent exhaustion later on during pushing.

I'm glad you're rethinking his suggestion. Your second labor could be really fast. It happens a lot!

 

[Usually Curious]

I agree that US can be way off when it comes to size/weight. As much as TWO POUNDS. I wouldn't base anything on US estimates.

I'm glad you're going to give yourself more time!

 

[HeatherB]

Sounds like you've gotten to a good place in your seeking out advice. I think waiting a couple of weeks to see what baby does makes perfect sense. Even my MW misjudged the size of my baby by palpation - we were all surprised when he was just over 7lbs, when she thought he may have been 7.5lbs at 36wks! I hope you can work through some of the first-time issues and fears surrounding that, and go on to have a smooth and rewarding birth this time!

 

[Banana731]

My c/s was the worst experience of my life physically and psychologically. It makes mothering your infant incredibly difficult. It will only further damage your ability to believe that your body is made(and it is) to give birth to the babies it creates. I wouldn't go that route willingly...

 

[pampered_mom]

Not in your DDC, but saw your thread title and wanted to share my experience from my first. When I was pg with ds the OB became concerned about his size around 36 weeks. I was told that if I didn't go into labor on my own by 38(!) weeks they would do an ultrasound to check his weight. Not surprisingly, the u/s said that ds weight over 10 lbs. After a some coercion and flat out lying by the OB we consented to a primary "elective" c/s. It's amazing now reading my records that she makes it look like I'm the one who chose the c/s all on my own!

The actually surgery itself went ok, but ds was 9lbs even. The u/s was more than 1 lb off. He really would have benefited from a trip through the birth canal, though, and had some difficulties breathing. Ds and I spent the majority of his first day separated. They only brought him to my room to bathe him (and were annoyed to have to do that) and then, because his temperature was low after the bath (duh!) were going to take him back. I was so out of it and was just going to accept that. Luckily my mom was there otherwise I have no idea when they would have brought him back to my room.

Recovery was h*** and breastfeeding was complicated. Ds lost a lot of weight (common in c/s babies) due to all the fluids they had on board prior to the surgery. I actually doubt that ds was actually 9lbs. It took me over six weeks until I felt more like myself and I gave up breastfeeding under the pressure of my ped after 1 week. Ds was fully on formula by the end of three weeks.

I really regret my decision and wish that I had just passed on the c/s. I agreed to the c/s for the same reason as you have given. I didn't want to "go through a trial of labor just to end up with a c/s". But...in hindsight...if I had gone into labor on my own it would have been very beneficial for ds. I had my c/s at 39 wks and truly believe that ds wasn't ready.

Anecdotally, SIL just had an "elective" c/s for the same reason

: and her baby wasn't anywhere near the doc's estimates either (although her's had the added reason of being suspected that she was "overdue" even though she wasn't near her due date).

The AAFP has a good study on the risk/benefit analysis on different "suspected fetal macrosomia management" options. The long and the short of it - "expectant management" was the best option when compared to either inducing or prophylactic cesarean. You can read their study online.

The ACOG themselves don't even really support elective cesareans in your case. You have to get to a "Level C" recommendation to even see that option. At that point they themselves admit that there is no evidence to back it up, it's just "based primarily on consensus and expert opinion." At that point I don't really think the "consensus and expert opinion" has anything to do with what's best for mom/baby.

Sorry...this is getting a little bit long, but I wanted to give you my persepctive and what I wish I would have known prior to making my decision.

 

[Abylite]

pampered_mom,

I appreciate you telling me your story and the links. I'm going to look at those and maybe even print them up. Sorry to hear you had such a hard time. I'm so glad I decided to post on MDC. I didn't realize that u/s could be so "off" on sizes, either. I wouldn't have even bothered with one if I knew. Thanks again everyone! I'm so glad I found mothering...and can't believe I let myself "stray" a bit!

 

[kleines]

I pretty much agree with everyone else. I definitely wouldn't want to schedule a c-section for sure, and induction is really not a picnic either. Try everything you can on your own to get things going. US can be so inaccurate! My sister was told her DD was at MOST 7.5lbs and she was 10lbs9oz! My DS was 8lbs12oz and they told me he was going to be 9.5lbs or more. I won't do an US to check size anymore, no point to it really if it is so off!

Good luck with your decision, and have a beautiful birth!