Big baby- C Section or not?

In My Humble Opinion
21

I went through nine hours of labor before my c-section, which was plenty to make me grateful when the c-section finally came. Recovery was a cakewalk compared to unmedicated transitional back labor with a stuck baby. I wouldn’t hesitate to have one again; in fact, if there was any way for me to get one, I’d prefer it.

I did have problems with milk production and ultimately gave up on breastfeeding. I attribute about one-third of the cause to c-section and drugs afterward. The rest was me being a wuss and my baby being a non-eater.

22

I know this is your first, but based off of your body type and you mother/aunts/etc? do you expect an easy labor and delivery? Or do you sort of expect one of those two day marathons that ends in a c-section. A small woman giving birth to a large baby, or a large woman giving birth to a large baby?

A lot of my girlfriends have had emergency c-sections - and being wheeled down the hall while simultaneously being prepped for surgery and every second counting does not sound like the most pleasant experience. I also have a friend with a severely disabled daughter because every second counts, and there were too many seconds. I’d do the scheduled c-section, but in my case, there is a huge bias - one disabled child, one girlfriend who nearly died and can’t have any more children - and I don’t have that many friends.

On the other hand, I had a late ultrasound due to toxemia. The tech said my daughter would be nine pounds and have a lot of hair. Seven and a half, and bald as a cue ball for the first eighteen months. I didn’t get induced or offered a c-section, she came a few days early on her own.

And congrats - may whatever you do result in a healthy baby and mama and a miraculous experience.

23

I am on the small side (well, was until I got knocked up), as is my family. My mom has a long, difficult labor with me. I don’t have any other female relatives to look towards, though.

Doc had recommended raspberry leaf tea, nipple stimulation, sex and walking. I am not convinced baby is going to budge a second early, though. She is very active, but I’ve had no signs of labor starting.

24

These are the two issues I think are important:

1- Due Date - everyone knows that they’re an estimate, not carved in stone. But I’ve noticed a (n unconscious?) tendency to treat the due date like an incontrovertible fact.

But the issue with due dates goes beyond just the current methods of calculating them. Gestation time can vary naturally by as much as 5 weeks:

2- Locality Influencing Medical Attitudes - You live in DC and have a professional job*. DC, from what I can see, is a very fast-paced and intense culture. Might that not heavily influence attitudes towards birthing procedures (in both doctors and patients)?

There could be an attitude or expectation that pregnancy needs to finish up ASAP because mom is gonna need to get her ass back to her fast-paced influential job, know what I mean? And even though obviously that’s not the #1 concern of many (most) women there, it’s pervasive enough to influence general attitudes and decisions on elective c-sections.

  • I hate that term for the sneering attitude it has towards jobs that do not require a college or graduate degree, but we all know it still colors people’s perceptions so it’s relevant.
25

Actually, that quote is pretty much standard advice; full term is 40 weeks plus or minus two weeks.
Anything from 38 to 42 weeks is “normal”. Agree completely with #2, attitudes and experience will vary by location and doctor’s experience with other patients.

26

I had an emergency c-section because my baby’s head was too big to fit through my birth canal. He was nine pounds, nine ounces. They tried to induce me first but neither of us faired well and our blood pressures tanked. He ended up in Nicu because he swallowed amniotic fluid then had RSV when he was two months old. Otherwise he has been perfectly healthy.

My other two older children were regular deliveries. The recoveries were different but neither seemed worse than the other to me. Maybe it was just exhaustion from having a new baby to tend to. Either way I successfully nursed them. Had to supplement at first until we figured it all out and that went fine also.

27

My daughter was over 8lb according to the ultrasound at 36 weeks. Dr said she could gain up to half a pound a week until she was born.

She was born at 40 weeks 6 days weighing 7lb 4oz.

28

It seems like I am getting the same info here that is going on in my own head: It’s better to do things naturally if possible, but you really don’t want things suddenly going south and turning into an emergency.

I know the ACOG only recommends C sections for babies looking like they are over 11 lbs, but that is based on population level data and the assumption that a large portion of estimated weights are wrong. In other words, it’s not worth the financial costs of giving all the potential 10 lb’s C-sections when only half of them will be that big. For a given individual 10 lb baby, however, a C-section seems to be a relatively good idea.

In my experience, upscale DC tends towards the “midwives, doulas, no drugs and prenatal yoga” side of things. A C-section will actually keep me away from my job for an additional two weeks, which has financial implications I’m not particularly pleased with. My doctor does serve a primarily Latino community, however, and I think there is a cultural comfort there with C-sections that might not be present with another doctor.

29

You should print that on t-shirts. :slight_smile:

Emergency has different meanings. If you are already admitted to a well-equipped hospital, things are less emergent.
Waiting around at home until its too late is the problem, and it sounds like that’s not going to happen to you.
So trust your own feelings, is my easily-given advice.

30

Personally, I would neither plan a C-section or an induction. Everyone I’ve known who was told, “Oh, that’s a HUGE baby!” ended up having totally normal, 7 pound babies. I am in the field of health administration, and I can tell you that in obstetrics, the advice you get is deeply perverted by 1) an out-of-proportion fear of liability on the doctor’s part, 2) the fact that the doctors make significantly more money for a C-section birth, and 3) the hatred doctors have for uncertainty. (That’s not opinion–that’s fact. I have been in on these behind-the-scenes conversations. They KNOW they order many unnecessary C-section births…and they like it that way. But patients may reasonably have another opinion on the matter.)

I would take a wait-and-see attitude. You might go into labor naturally in the next couple of weeks. You can always schedule a C-section for the 41 or 42 week mark (which is as far as they will allow a pregnancy to go anyway) and see if it comes naturally before that. Personally, I would never let myself be pressured into a scheduled C-section based only on a size estimate.

31

I don’t know if it helps, but this would be my best advice: this isn’t that big of a deal, either way. Right now it seems like everything, but in terms of long-run impact, it’s not even as big of a decision as choosing your childcare or your pediatrician.

I had an emergency C-section. It was the emergency part that made it awful: my epidural wasn’t working, they couldn’t figure out why, so they went to the general anesthesia. That meant I missed the birth and in fact didn’t see my son for six or seven hours after he was born, which was hard. Worse, however, is that my pain management was poorly done because of general and the epidural still being in there. I went from undermedicated to over to under and was pretty much a groggy, pain-filled mess for 3 days. None of that would have been the case in a planned section. Recovery from the section itself wasn’t bad at all.

I didn’t feel like the C-section was a factor at all in my not feeling at home again in my body. What was a factor was 1) nursing and 2) sleep deprivation and 3) hormone cascade. Nursing was probably the biggest factor, and if you are pumping 4 or more times a day, it’s REALLY not your own. So don’t let “will delay getting my body back” be a factor. If you are planning on nursing, it’s not going to be entirely your own until long after the c-section is a non-issue. Furthermore, while your body is not your own now, your WILL is not your own with a newborn in the house. Even if you are not nursing, a baby is tremendously demanding, and unless you are planning on completely dropping the ball at work for the next six months, work + baby will probably take about all you’ve got. That’s just the reality.

For whatever it’s worth, I went back to work after 7 weeks, and my doctor would have let me go at six or even earlier, provided I promised not to drive on narcotics or lift anything heavier than the baby. I think the “8 weeks for a section” thing is a holdover from when it was a much more significant surgery. I felt like I returned to work too soon, but not because of the surgery: it was entirely because of the sleep deprivation/nursing/pumping hell. The section was fine. So don’t assume a section means you have to miss more work.

One last point about missing work: at some point you will become too pregnant to work, and it’s just the fucked up reality of our system that you can’t afford to stay home and just be pregnant. Now, if your job is very accommodating and you can work from home or go to work and half-ass it, that’s great. But for many of us, that’s not an option, and it’s reasonable to take that into consideration when deciding what to do.

32

If I were in your shoes, I’d wait until at least 40 weeks and a few days more before deciding to induce or schedule a C-section. In spite of what the dr’s offices may have you think, it’s not that hard to schedule one for tomorrow or the day after–it really doesn’t have to be decided right now. Maybe everyone will feel better if there is a contingency plan in place, but generally arrive approximately when they’re supposed to, after all…
I’m smallish, did not have gestational diabetes, and have a family history of good-sized babies. My babies were all huge, except for one puny little 8.5 fella. :slight_smile:
Personally, I’d go with the wait-and-see method, but of course you must consider your own needs and your doctors advice.
Congratulations, honey. I’m so excited for you!

33

For what it’s worth, I could have easily gone back to a desk job at 3 weeks post c-section. To be honest, by one week afterward, I was taking pain meds to deal with breastfeeding because it hurt more than the incision.

34

I had a scheduled c-section because I had triplets (they weren’t small, and were packed in there like sardines). I did not think the recovery was bad at all. I took Motrin 800 and wore a compression garment that helped a lot. I did not go back to my job, but I was physically able to care for three infants, which was harder work than I had ever done before in my life. Congrats on your little one!

35

And I ended up with a significant episiotomy after a vaginal birth and three weeks after giving birth was still having problems getting through Target for diapers. My cousin had a serious took six month to heal tear.

36

Let’s see, I was 1 week, 6 days overdue, and my baby hadn’t dropped at all. The baby was measuring big, the estimate was 9 1/2 lbs.

The one thing I DID NOT WANT was a c-section, primarily because I’m a huge wuss and thought it gross (just thinking about it made me panic), and I’m afraid of needles and didn’t want the epidural. Actually, that was pretty much the only reason. I mean, I would like to say that I thought vaginal delivery was more natural or better for bonding or whatever, but I was so afraid of the c-section I never even went beyond that in my decision-making process.

I went with induction, with no pain meds. After 15 hours of unproductive labor, I agreed to the c-section. At that point, I would have agreed to anything.

And it was fine. I was really surprised all around. Oh, then of course the baby wasn’t nearly that large at all, although that was rather beside the point by the time it was all happening. The recovery was terrific. I could have been back to work at four weeks, and I was certainly doing (slow, careful, planned in small doses) light housework/baby work within 2 weeks. I know a lot of that is the luck of the draw.

One piece of advice, that I got from a fellow Doper, was to walk early and often, as soon as I was able. Walk slowly, walk with assistance. I was doing extremely slow laps around the ward by about 9 in the evening (the time on the birth certificate is listed as 3 PM).

Breastfeeding was a slow start, but we got there eventually. I consider it successful, although we did supplement with formula periodically, so some people would find that unacceptable.

I’m posting all of this to say that a lot of this is a roll of the dice. It was far from my ideal plan, but I feel very positive when I look back at the birth experience.

37

Thank you all for sharing your experiences. This has been really helpful.

38

I just want to chime in that my 8 lb 4 oz baby was a much more difficult delivery than my 9 lb 12 oz one. Now, the smaller one was first, but I think the significant thing is that her head circumference was bigger than her sister’s. I’d personally have been reluctant to decide on an elective c-section based on a guess of the baby’s size, but then again, I was terrified at the idea of surgery anyway. So, just like everyone else, I’d say you have to trust your judgment.

And speaking as someone who started out as a crunchy-granola, let’s-give-birth-in-a-field, natural-is-always-better type, I want to reiterate that, no matter how the baby gets out, what really matters is all the stuff that comes after that day. You’ll have decades to second-guess all your parenting decisions, and in the end, if you’re doing your best and following your instincts, you’re really likely to do a great job. Congratulations!

39

And frankly "c-section"and "breastfeeding"are way way down in parenting decision impacts compared to “should I let my fifteen year old get his permit?” or “that kid sort of feels like bad news - but am I being a little racist - or is he bad news?” (he was bad news.)

I think the reason they are such a big deal is because when you are pregnant with your first, you have time to sweat the small stuff.

40

Ouuuuch. I had a vaginal birth with a baby with a huge head (9 lb 6 oz) and had a tear. Although it wasn’t as bad as your cousin’s, I seriously did not leave the house for a month. Meanwhile I knew people who had C-sections and were blithely going shopping with their other three kids after two weeks. It really is luck of the draw, I think. (Also maybe that I am a bit of a wuss, because I know I am.)

Also, I do think they don’t really understand how to tell how big a baby is, which I think is weird. Mine was supposed to be 7-8 lb. Nope.