You are not my doctor, and I am not asking for medical advice. I would, however, appreciate some advice on the options my doctor has laid out for me.
I am about to have a baby, and the due date is Sept. 12, putting me at 28 weeks right now. The baby has been measuring big through the pregnancy, and they are telling me that right now based on ultrasounds, she weights 9 lbs, 7 ozs (!). That would mean at birth she’d likely weight 10 lbs or more. I don’t have gestational diabetes, and neither myself nor the father are particularly large people. It just seems to be a big baby. I am also pretty certain about the due date, which was calculated from a very early ultrasound.
My understanding is that these measurements tend to be very imprecise, and my doctor advised the can vary by a pound or so. My own research shows that these estimates seem to be wrong more often than they are right, and plenty of “10 lb babies” come out weighing 7 lobs. That said, my ultrasound technician is apparently well-known for her weight estimates, and it’s pretty clear on the ultrasound that baby girl is sporting some pretty darn chubby cheeks. And even if they are wrong by a pound…that’s still a pretty big baby.
My doctor has recommended a C-section, but offered to attempt to induce first. I’m a little overwhelmed by how quickly this all came about, ad not thrilled at the idea of a C-section. However, it seems like if the baby is really that big, it’s probably the best way to go. My only real concern, of course, is what is best for the baby.
Any advice, experiences, opinions or recommendations?
No expert here. But until the Mommy Squad arrives, I’d advise you to work with your doctor. Ask for more details if you wish. But you’re not “failing” at childbirth if there’s a C-Section…
Do you have access to any information about the doctor or the hospital’s general c-section rates? That would give you some information about whether they’re generally “section-happy” in any way, and whether you might have to adjust for their biases. The WHO recommended level is around 5 - 10 %. You probably knew that
If you don’t particularly want a c-section, I would resist attempts to induce you. I can’t see any reason to induce a perfectly healthy baby before the due date, if you’re not in any distress yourself. Most people who’ve had an induction will agree that it’s sucky. (I had an induction. It was sucky.) And having one is more likely to lead to a cascade of interventions. C-section is always an option if you’re having trouble with labour.
It’s really the head circumference that’s the problem with getting the sprog out. If they’re heavy due to length, or a chubby belly…well, fat is squishy.
For completely different reasons, I had an unsuccessful induction attempt followed by a C-section with my daughter. Next pregnancy, I went straight to the C-section - all the attempt at induction did was wear me out and probably contribute to the distress that ultimately resulted in the c-section. I’m sure it would have been fine if the induction had worked- but if your doctor’s recommendation is a c-section, I’d go with that.
A C-Section is surgery, and not minor surgery. That’s the only thing that I would ask you to remember before making the decision. It’s a surgery that saves a lot of lives, but if it’s not actually necessary…it’s major surgery, not dangerous, just serious. If your health or the health of the baby is at risk, go for it. Nothing is more important that making sure you are both safe, but if your doctor is just expecting the birth to be more uncomfortable than average then you have to decide if it’s worth having surgery and the post surgical recovery period to avoid it.
On the other hand, if you are planning to induce labor anyway (don’t know if you are, but people seem to be assuming you are) then just skip it and go to the c-section. Labor induction almost always leads to c-section anyway and is hard on the kid.
Disclaimer: I am a dude, and my wife and I had planned on a home birth for our daughter (she was born breech so home birth was transferred) so I tend to lean toward the natural “your body knows what it’s doing” side of things and I haven’t had to deal with actually carrying a child. That doesn’t make any of the above less true, but full disclosure and all that is important.
Not giving you any recommendations on your specific situation, but I’ve had two C-sections, one emergency, one more or less planned (I was scheduled for a section anyway, but went into labour almost two weeks early). I really, really didn’t want a section the first time round. The second time, I chose to have one.
In my experience they are seriously not that big a deal, specially planned ones where the doctor has time to go as carefully as possible. I recovered just as fast as friends who had vaginal deliveries - faster than some who had tearing/episiotomies/etc (which are more likely with a big baby). I was out and about with the baby in a sling in less than a week, both times.
According to everyone I know who’s had the experience, though, induction sucks. It’s way worse than natural labour, and a lot of the time it ends in a section anyway - and then, because the section is less planned, the doctor might not be able to take as much care, and your recovery time might end up being longer. I know you want what’s best for the baby, but your recovery isn’t irrelevant to that.
Personally, I’d take a planned section over induction, specially if it was recommended by a doctor I trusted.
The idea of a C-section doesn’t feel like a failure, although it does seem like a bit of a letdown after all the childbirth classes, packing my “go-bag”, etc. From my own perspective, I’m most worried about the recovery. I’ve gained a lot of weight this pregnancy and I’ve hated, hated, hated how physically difficult the last few months of pregnancy have been in terms of fatigue, pain and discomfort. I’ve been fantasizing for months about hitting the gym, going on nice long walks, jogging, and generally feeling at home in my body again. I’m really not looking forward to having a major surgery to recover from. Though, realistically, I’m guessing recovering from the natural birth of such a big kid isn’t going to be a walk in the park either.
I agree that induction seems to be the worst of both worlds-- it won’t do much about baby being big, and will likely lead to a C-section anyway. My doctor does seem to take a pretty “gentle” view of induction and wouldn’t try to deliver unless my body was working with it, but I have a gut feeling she just wants to do a C-section. I am thinking that if that’s how it’s going to be, it’s best just to go for it.
Anyway, I’m not opposed to it if it is the best thing (and the complications from big babies getting stuck are pretty alarming,) but I also don’t want to be steamrollered into the typical unnecessary intervention. I’ve got a lot of crunchy friends, so I’ve heard plenty of stories about the “cascade of interventions” and all that, but it’s really hard for me at this point to figure out if that is what is happening, or if I really am getting the best medical advice for what is a genuine (likely) complication.
Is there any reason at all other than ‘big baby’ to induce? Inducing for a large baby is much more likely to create problems. Waiting for labor to naturally start means your cervix will be softer and your whole body, as well as the baby’s, will be more ready to go through labor. Some doctors like to induce so the baby comes on their schedule. Waiting for labor to naturally start is usually better, plenty of people have delivered large babies vaginally successfully.
10 pounds is at the high end of NORMAL but still falls within normal, average birth weight.
I won’t give you advice; I will merely report what my DIL said when I asked her why she was choosing to have a midwife deliver her baby (in a hospital, “just in case”). “I don’t trust ob-gyns; they are too quick to cut. I would have chosen a family physician who delivers babies, but there are only 3 or 4 family doctors in all of Manhattan who deliver babies and I am one and my colleague is another.”
I would avoid a C-section if at all possible. It is major surgery. I’ve been induced twice for high blood pressure. The induction wasn’t pleasant but it was better than the major surgery required of a section. Many of my friends have had them and found it a hard recovery. Caring for a baby the first weeks is hard enough. You’ll be incredibly exhausted because they’re not exactly noted for good sleeping habits. I wouldn’t add voluntary surgery on top of that if I personally had any choice in the matter.
Unless you doctor really thinks it a medical necessity, I honestly would wait and let things progress naturally if you can. C-sections do carry some risks. They have been linked with an increased risk of asthma and allergies. FYI, my eldest was measuring a pound larger than she actually came out. She was eight days late and just under seven pounds.
I’ve had two kids, neither of them that big. I agree - why is he talking about induction?
I was almost two weeks “late” with both, and it was no biggie. I went in a week after my due date with my second one, and he suggested induction, but I told him I’d rather wait. He put me on a monitor for an hour, everything checked out, and I went into natural labor the following Wednesday. All was fine.
The recovery from a natural birth is much easier than from a C section, IMO. Based on close friends who have had C sections, you’re extraordinarily limited in movement and in serious pain for weeks, as they have cut across your abdominal muscles and into your internal organs. With a natural birth, even a big one with an episiotomy, you’re sore in your nether regions for a week or so, and pooping is painful exercise, but other than that, you’re in pretty good shape as far as rest of your body, and all important systems for regular living are intact.
Don’t be scared of the post-birth recovery with a natural birth - you’re going to be surprised at how quickly your body goes back to normal. You’ll be dealing with fluids for a week or so, not only bleeding, but also maybe night sweats and other things as your body dumps everything, but your lung capacity and other physical effects of being pregnant go away almost immediately, like within a few hours. C sections will interfere with that, as your body is trying to heal itself, along with all the other things it does to bounce back.
Barring a medical emergency, I wouldn’t voluntarily have a C section. There is something magical about giving birth. A C section doesn’t mean failure, but you do miss something that is very cool in human terms. And look for the C section rate of your doctor as mentioned above - lots of doctors are C section happy, and not necessarily for safety reasons.
This. I also agree that checking the doctor’s section rate is a good idea.
I really don’t understand the logic of “you’re baby’s big, so let’s induce.” What is the reasoning there? Nothing about a big baby means labor isn’t likely to start spontaneously. That makes me worry that he’s thinking more of his scheduling convenience than your wellbeing.
My choices, in order, would be waiting for spontaneous labor as long as the biophysical profile says the baby is ok, then section if that doesn’t work. Second choice (and a distant second at that) is a scheduled section. As far as I’m concerned, augmentation/induction should only be done for medical reasons, and a large predicted birthweight is not on the list. Fetal distress and complications from gestational diabetes are on the list, but don’t apply here.
I’m sorry, I’m on my phone right now, so I can’t link to it, but there have been several articles in the news lately about elective induction/aigmentation, because a new study just came out showing much higher risks than we previously thought. Google should be able to help you find them.
Recovery from a vaginal birth done with a patient, skilled birth attendant, even if there is some tearing and bruising from a large baby, is nowhere near as hard for most women as recovery from a c section. And you’re absolutely right that ultrasound measurements are ndotoriously off by a pound or more…and almost always in the too big direction.
The American College of Obstetricians and Gynecologists came out with a statement in March specifically stating that suspected latlrge fetal size is NOT a medical indication for induction or caesarian before 39 weeks. After 39 weeks, they’re a little more equivocal on the issue.
I had a baby predicted to be 10+ lbs, who came out at 8 lbs 4 ozs. I was induced at 42 weeks since there was no sign of labor beginning, but successfully avoided a c-section. Something similar happened with my second, who was bigger and also didn’t want to be born (guess I have a very comfy womb!), and I have my doula to thank for saving me from surgery. The doctor was getting a little impatient.
If this is your first I say try to let nature take its course. Measurements can be wrong, and you can always do a c-section if circumstances truly warrant. Induction isn’t ideal, but it’s not always the worst thing, and doesn’t guarantee a c-section. But I’d definitely say wait until 40 weeks at least if not longer, unless problems present.
I think the theory behind inducing is that she does not feel comfortable with me going past my due date and baby growing even a little bit bigger, which is likely to happen given this is my first baby. So she’s willing to consider inducing as a (half assed) shot at a vaginal birth if I really insist on it.
So is she talking about waiting until at least 39 weeks to induce? That would make me feel a little better…
How does she feel about membrane stripping, raspberry leaf (medicinal strength) tea and/or nipple stimulation to get labor going? Those use your body’s own processes to induce, and have a pretty good success rate without the risks of pitocin or mifepristone.
You have the right to refuse the induction as well as a planned c-section, though, don’t you?
My mom is small, only 5’3" with a small frame. Little bro, who like me was 12 days late, was 10lbs 6oz and she didn’t even have any drugs. I’m not saying every woman with a baby that big can deliver without a c-section (I in fact know a woman built like a linebacker who eventually had a c-section with her 11lb baby) but a big baby isn’t automatically a problem, and the idea of inducing sounds even dumber than wanting to do a c-section.
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