38wk scan shows baby on 95th centile

[BobandBenway]

Help! I was planning a home birth for my 4th baby, everything was fine, low risk etc, but I was sent for a scan the other day as midwife wasn't sure whether baby was breech or not.

Turns out baby was ok and head down, but they estimate the weight to be 3.9kg and on 95th centile! My midwife phoned today and has said that the consultant now wants another scan the day before my due date to estimate weight, and if it's large then they may want to induce sooner than the 12 days they normally allow you to go over. They also recommend that I now come in to hospital for the birth.

Although I am initially disappointed about not getting a home birth, I know I would not be relaxed at home and worrying about possible shoulder dystocia etc. However, I'm now worried that once I'm in hospital it will be a slippery slope of intervention after intervention, and I'll end up with a c section, which is my worst fear! (I know that if we both needed one then obviously that is what needs to be done, but I worry that they don't give you enough time in hospital to see how things progress)

I have no idea why this baby seems to be so big. I am a healthy weight (BMI 19.5), non-diabetic (had GTT at 28 weeks, even checked my blood sugar this morning after overnight fast and it was 5.0, so no problems there). I'm not that tall (5" 4), and haven't put on much weight (about 12kg - I don't know, is that too much??), and have lowish blood pressure. Would there be any reason to worry about a big baby, or is it just one of those things?

My first baby was 9lb and was a forceps delivery, but I think this was more due to him being posterior and me having an epidural, rather than down to his size.

2nd baby was 7lb 10oz, 6hr labour and was born with no problems, no tearing etc.

3rd baby was 7lb 7oz and again a straightforward birth.

I know that scans aren't that accurate wrt weight, and I could be worrying over nothing! Please tell me positive birth stories of large babies!

I know this is my 4th baby, but sometimes it feels worse than my 1st with all the worrying!!

[gintastic]

My third daughter was 8lbs15oz, and I was induced at 13 days overdue. First contraction to delivery was 45min. She was born at 3.30pm and we were home by 8pm. I was also terrified of being induced, but my baby girl just wanted out! Hope that helps...

[Sheshelob]

It depends on the hospital but after they discovered my whopper was likely to be nearly 11lbs at 41 weeks, they were happy for me to labour in the midwife-led unit, but wanted me to push on the labour ward, in case there were any problems. So I spent 11 hours in active labour in the midwife ward, with some time in the pool, and then was taken downstairs when I was fully dilated. I did end up with interventions - a low forceps to get his massive head out - as I was so knackered after what totalled nearly 28 hours of labour altogether that I needed their help. If I did it again, I would have an epidural in order to save my energy or a C-section, as he did so much damage coming out.

If you want to have a natural labour, think you need to look how to deliver a big baby naturally, which I didn't, as it might help you avoid interventions. It is all about positions, and with it being your fourth, it is likely to be a hell of a lot quicker than 28 hours! Google macrosomic babies.

But I would also weigh up a C-Section. If you have never torn significantly, I would say a belly scar is much less traumatic than a bad tear. I lost two litres of blood, and was separated from my baby for two hours after birth.

I don't mean to freak you out but I believed everyone when they said it was going to be fine, so was wholly unprepared. Some women breathe out big babies. I didn't.

[BobandBenway]

Thanks for your replies.

I'm beginning to wish I'd never had the scan the other day - the midwife was almost sure it was a bum she felt at the top, and I hadn't felt any large movement like the baby turning to breech - the only thing she was unsure about was that the heartbeat was higher up than where it usually was. Still, it was better to make sure, as I would have been anxious going into a home birth worrying if baby was indeed breech.

Now however, I've got a whole new problem to be anxious about. Midwife has never had concerns about this baby being big, it was just the sonographer writing that it's expected to be 95th centile that has got her worried and triggered some protocol that now has the consultant involved, and talk of inducing me early etc etc!

Sheshelob - I am worried about a c section, especially if it is unneccessary, and simply results due to a cascade of intervention meaning I am more likely to need one. I believe there are more risks to myself and the baby in having an unneccessary c section, compared to the supposed risk at the moment that the baby may be big. I had an episiotomy with my first (horrendous forceps delivery), with god knows how many stitches, I was in agony afterwards and it took me ages to recover. However, I did then subsequently birth 2 other babies with no tearing whatsoever. All of them, although they have got smaller, have had large heads, so I seem to be able to manage this fine!

I think what they are worrying about is the possibility of shoulder dystocia (or is there anything else I should be worrying about wrt a possible big baby?). I understand that they want to minimise risk, and I will agree to birthing in hospital, but I am keen to avoid a cascade of intervention that will make it more likely that I end up with a difficult birth (i.e. induction, continous monitoring, possible epidural, giving birth flat on my back) and end up with the baby stuck due to those interventions and not because the baby may be big! In trying to avoid the problem they may in fact make it worse.

If the scan at my due date again shows a large baby, what are the risks and benefits of continuing the pregnancy v induction? I know that scans aren't 100% accurate regarding birth weight, but how accurate are they - what is the margin of error?

I don't feel particularly bigger this time, perhaps in the last few days but maybe more down to being uncomfortable in this heat! Also, it's hard to remember as my youngest is 8! Meant to add, all my other 3 I went into labour naturally at 40+3, so I was expecting this one to be the same!

I'm trying to relax as I know being anxious and worried is not ideal for birthing. I'm trying to be positive about this birth and not focus on "what if?", but already I feel pressure and the clock ticking! Or should I just agree to an early induction and get it all over with one way or the other??! It's hard to know what is really best for me and the baby.

[Sheshelob]

I'm sorry if my post worried you, but I should say that my son was 10lbs, 10 oz when he was born, so a real giant. My brother was my mum's 5th child and weighed 9lbs and he just fell out.

If you are worried about shoulder dystocia, read up about it, as there are positions that you can get into that reduce the chances of it happening.

And talk to your midwife frankly about it, asking them to tell them what they have experienced, to give you an idea of how your hospital deals with big babies.

I'm sure it will be fine. If you have had two other babies through your scarring without even a scuff, you'll be gravy.

[Bibblebobbleparsnip]

Just wanted to add that this time last year I delivered a 9lb 8 baby at home with my DH. (She was my DC3) All was fine and no problem at all. I did tear quite a bit and had to go in to be seen too, but was home that night snuggling a delicious baby! Hope that encourages you...