Interesting article re: Big Babies and monitoring in pregnancy

[Tinker]

here

[coppertop]

I had several extra scans when pregnant with ds1 as my BP was high. The only person who ever commented on size was my community MW who wondered whether there was a secret twin hiding behind ds1 that somehow had escaped being noticed during the scans. He was 9lb 8oz at birth and I was fortunate to escape needing a c/s.

They were a lot more vigilant when I was pg with ds2. I had more growth scans towards the end of my pregnancy as the consultant was keen to avoid letting ds2 grow any larger than ds1 had. Labour was induced 2 weeks early and ds2 arrived after a fairly straightforward delivery weighing 9lbs.

IME the baby's size tends to be overlooked during a first pregnancy.

[Tinker]

Think there does seem to be a bit more vigilance about this. Hear of a lot more growth scans in later preganacy now - I'm to have one this week but because went from 36cm at 36 weeks to 35cm at 37+ weeks

[northstar]

totally agree with coppertop, babys size was overlooked with my first pg, one consultant had noticed though and booked me in to the clinic for an assessment on the monday, but when I went into labour on the saturday and arrived at the maternity ward no-one would listen to me. I kept telling them I wanted to be assessed but they just patted me on the head and said yes dear! Eventually ds got severely stuck and went into shock. Luckily (for him)he was pulled out by a violent emergency ventouse and after spending a week in scbu is perfectly ok now. I am currently 37+5, monitored v closely and being induced next week.

[eidsvold]

surprisingly here in Aus - I had one extra scan (at 36 weeks) simply as I was wanting a VBAC and the consultant felt dd2 would be a good size and wanted to check how her size was and the impact that would have on my scar. I ended up having a c-section for many reasons.... dd2 was 9lb 7oz. In terms of the baby no one was concerned about her size as such - just how that would impact on my scar.

I have a friend who had a 12lb 2oz baby (2nd baby)- gas and air nothing else... baby was fine.

[LittleMissShy]

when I was expecting ds I was told at everyscan I had that I was having a big baby, at my last scan done by a man!! he told me that the baby had a big head imagine our surprise when he was 6lb 6oz's, and I am an older mum, so according to the statistics in the article he should have been a big boy!!

I don't know what I would have done if he had been as big as these babies as I needed an emergency c/s anyway

[jane313]

Glad I didn't go to that hospital as it was one that was offered, I had gestational diabetes which was initially picked up cos he was big at the first scan. I had lots of scans at the end to determine whether I should have a cs. The sonographer(?) said scans are better at predicting the weight of small babies not big ones. She underestimated mine by over a pound

[Aragon]

I've a feeling that scans are notoriously inaccurate at predicting size. I think there are many other things that could tell hospitals when labour is not progressing well that a large baby might be the problem. From my past experience as a midwife it seems that if labour slows down and there is no real descent of the head the action is to put up a drip to speed up contractions. This leads to an overlarge baby being forced through the pelvis only to get it's shoulder's stuck at delivery with trauma to both Mum and baby (I imagine this is what occurred here).

Proper monitoring in labour should prevent this and slow descent of the head coupled with a big baby on palpation should ring warning bells for midwives and doctors. Not a blanket prescription for Syntocinon to "speed things up" Instead a proper assessment should be carried out to establish why this baby is not descending and labour is progressing slowly. This is not rocket science and doesn't require a national consensus - just a trained midwife and obstetrician looking at a woman and baby and remembering the physiology.

Gets off soapbox

[LeahE]

DS was a big baby (10lb 5oz) and I fell fortunate that everything was done properly.

Fundal height measurements were ahead so I had a growth scan at 35 weeks where they predicted that he would be about 10 and a half pounds and referred me to the consultant to discuss options (elective c-section vs. trial of labour). When my waters broke he still hadn't engaged so I was treated as high risk throughout labour. They did put me on Syntocinon to speed dilation but always with one eye on the possibility of a c-section (actually, the syntocinon was the one thing I wasn't particularly happy about). When I got to second stage I was introduced to the team who'd be doing my c-section if we didn't progress (they didn't quite phrase it that way, but that was the general idea) and when pushing wasn't moving him down very far or very fast they were happy to call the c-section.

Picking up the size either before or early in labour, combined with taking it seriously without panicing the mother or pushing her into a c-section, seems to be the key thing so far as I can see.

[beansprout]

Ds was also 10lb 5oz and, despite late scans, they didn't have a clue. I was told he was "big", but that apparently meant 8-9lb. Failure to progress resulted in an emergency c-section. If there is any truth in the rumour that subsequent babies are bigger, I think it might be an elective second time round!

Amazing that they still can't make a good guess at the size of a baby. I'll leave it there before I start ranting!!

[hollybelle]

hi there
No one has ever been concerned about the size of my babies. Ds weighed 9lb 9oz he was overdue 5 days and I had a bad induction with bleeding and had a pph afterwards. DD was induced 9 days over, she weighed 9lb 14oz, luckily easier labour!! Now pregnant with 3rd and I have asked to be induced at term as I can't see the point in waiting and then being induced again.
Very true that it it more difficult to assess the weight of larger babies on scan as they have more fat around them and there is less room to get an accurate measurement.

[FunkyFox]

I went 10 days overdue, was checked over, full monty scans everything, told i was 3/4cm dialated and that i would go into labour that night/next morn. Nothing. I rang 2 days later and requested an induction be booked for the following day. That night my waters broke naturally and from the offset i had contractions every couple of minutes. Using gas and air, having requested epidural in throngs of contractions and been ignored, 4 hours later i was fully dialated. My first child and on pushing i said he felt too big to fit to which they smiled! Then contractions became really weak and they want to give me syntoxinon injection to intensify them, talk of this and forceps let me to think 'what the heck' and push anyway without powerful contractions . ds was born 10lb 7oz. Miraculously i had no external tearing but quite a lot of internal stiches were required. Was very shocked by the whole intensity of labour and quite put out that the scan of 2 days previous had not identified a potential size problem! Very concerned to have baby number 2 due to predicted faster labour!! and possibly bigger baby!!

[mears]

The problem with identifying big babies is that it does not identify whether there will be a problem with regards to delivery. I delivered a friends baby who weighed 12lb 2oz. He came out pretty easily.
It is the progress in labour that can ring alarm bells. If a baby is not engaging properly at term, or labour does not progress well, then that can be a sign that the baby is too big to deliver normally. Scans do not adequately predict fetal size at term.

[mumfor1sttime]

My ds was born at 9lb 12, but I had no late scans, one of the many midwives that I saw said I would have big baby [apparantley she could tell this from my 20wk scan] but it was never followed up. I had emergency c section as my bp went through roof and ds was undiagnosed breech. I often think maybe everyone should be offered a late scan,Im not sure.

[anchovies]

I had growth scans due to a bicornuate uterus, they thought the baby would have restricted space and be small and premature. His head never engaged yet they induced me at 42 weeks and broke my waters anyway. Ended up with an emergency c/s. He weighed 10lbs. I had the scan that showed he was big but for some reason this was not acted on?

[QueenEagle]

My ds1 was 9lb 14oz, ds3 9lb 4oz both overdue, so I was naturally concerned about going over with ds4 and tearing as badly as I had previously. Also high on my list of concerns was ds3 having the cord tightly wrapped round his neck - what if my next baby was bigger, with cord round neck and I was unable to push him out quickly enough? I requested that I be induced by at least term and it was agreed by the consultant as it seemed I was heading for an 11lb baby. ds4 was induced 2 weeks early weighing 9lb 1oz and boy am I thankful I didn't go to term!

[toomanypushchairs]

I was induced 14days past my due date with my ds he weighed 10lb 8 1/2. fortunately he was delivered relatively easily, but only because he has poor muscles and so was quite floppy. I had no scans after 20weeks even though I was convinced my baby was big.(he was no2, dd weighed 7lb 12

[pupuce]

Mreas- as usual you are totally right.
I have personnally seen errors in scan of 1 and 2lbs !!! (not ounces).
Also as you say there are signs in labour that a baby is too big BUT EQUALLY there things midwives can do to help women birth larger baby and they don't need to tear either.
I have seen an 11lbs from a 5'6" friend - at home.

[puddle]

My first baby was 9lb 9oz. I agreed to be induced, mainly because the consultant scared me to death by saying when I went for overdue appt 'you have got a huge baby in there and we have to get it out now'. I was terrified. Had a 36 hour labour ending in ds being delivered by ventouse (on op table as i had been prepped for a c-section 'one last try they said') damaged arm and bad bruising all over his face and head poor lamb.

DD was second baby 9lb 13oz. Easy birth, no pain relief, 4 hours altogether. So my experience tallies with Mears expert advice - a big baby does not necessarily mean a difficult birth. They tried to estimate dd's size and thought she would be around 8lb by the way.

[norash40]

If anyone gets the article please copy and paste saves us all spending a pound.

I know [cheap]

[Lizzylou]

My Ds was 8lb 13oz at birth but had got stuck as he has such wide shoulders/back (like a little rugby player ) I am 5ft 9" and big built (massive hips) so was shocked that I had to have a ventouse and he had to be resuscitated...immediately afterwards a midwife spoke to me and told me I should definitely consider having a C-section next time as 2nd babies are alwasys bigger......we are planning on our 2nd next year but this really worries me.

[zubb]

Suprised at what people think is a 'big' baby - ds2 was 9lb 9oz and I didn't think he was that 'big' - over average I suppose but I never considered that him being that size would mean that induction would be considered. He was 8 days late and the midwife predicted a mid-9lb so was just about spot on! He was delivered at home in 2 pushes, after less than 2 hours labour with no stitches, so I would agree with mears / pupuce / puddle - IME it really depends on how labour progresses rather than the size of the baby.
Ds1 was 8lb 15oz (a couple of days early) so I was expecting a bigger second one anyway. Ds3 is due soon so we'll see what size he is!

[Lizzylou]

I didn't think 8lb 13oz was big at all, my brothers were 10lb 4oz and 10lb 11oz and born naturally with no probs! It was just the delivery that was the problem with me, which I was surprised about.

[zubb]

Lizzylou - thats what I was trying to say really - it's the delivery and how it progresses rather than the actual size, so it would be very difficult for there to be a policy in place that extra scans (that pupuce has already said are not an exact science anyway) were needed if it was thought a baby was over a certain size, and that induction or even C/S was recommended for certain sizes. I'm just not sure that its just an issue of 'big' babies - whatever the 'big' is defined as - and lots of people here seem to be posting about babies under 10lb which I was surprised about.

[Lizzylou]

It would be difficult, my stepmom is 5ft 2" and quite petite, my 2 brothers were born after a short labour with no pain relief (ouch!!) and she was a "mature" Mom....here I am a veritable giantess and I have the problems!!! At least I know for next time.............
It is all relative...

[puddle]

Zubb - the average is still around 7lb though isn't it? Would be interesting to see how 'big' a baby has to be to be defined as big I think... My two were very very long (ds off the length chart) and when health visitor saw his birth length she said sniffly 'that can't be right' then had to eat her words once she had measured him. The midwife who delivered dd said 'ah, she's not big is she - around seven and a half I reckon'. She couldn't believe it when she weighed her - did it twice to make sure!