Questions about big babies, Glucose and homebirths!

[fairywing]

I went for a scan today to check placental position. All good, well out of the way with baby head down. However, i was told that baby is already about 6lb6 at 33+5 and if she carries on like this will be over 9lb4 at 40 weeks. I was told if this happens they would recommend i have a hospital birth rather than home as we are a fair way from the hospital and if she gets stuck this could be a problem.

I also had glucose in my urine for the second time. I have been booked in for a GTT on monday.

So questions...

If baby carries on growing at the same rate what usually happens? Would i be induced early? potentially offered a c section? just monitored in hospital?

Is she more likely to come early of her own accord?

If i have GTT would that mean i have to go into hospital regardless of baby's size? again would i be induced early in this case? would it have any other impact on my labour??

Any helpful comments on my situation would be greatly received! Just trying to be as well informed as possible for my next midwife appointment so we can talk all this through. Thanks

[marie23]

Hi there my daughter was born at 9lb 8 ozs but i was never really monitored as u have been did have a gtt test though and that was normal. I was advised to have hospital birth i went 3days over my due date and the birth went ok i did need assistance getting her out though in the end she was born by ventouse. I shouldnt worry too much about it just relax but i personally am glad now that i took their advise and that i had the medical team on hand. Hope this has helped in anyway possible way and good luck

[PrettyCandles]

My babies were 8lb10oz, 9lb3oz and 10lb at birth, and I had glucose in my urine with all three from about 33-35w. The midwives were never worried as long as I could control it by diet. I ate a strict low GI diet for the last couple of months of each pregnancy, and, as long as I did so, my urine results were always back to normal. I refused to take the GTT as I considered itunnecesssary to label myself in such a way that would restrict my labour choices. If I hadn't been able to control the sugar that way, then it would have been a different matter. None of my babies were 'fat' at birth, as they would have been had I had active GD, or had not controlled my sugar. They were just long and heavy - a sign of a healthy placenta. And all normal deliveries, one a waterbirth.

HTH Don't worry too much. You can probably control it by diet and it's not too bad.

[PrettyCandles]

Sorry, the diet#s not too bad. GD is not good if it is uncontrolled.

[PrettyCandles]

And another thing: one-off growth scans are not terribly reliable. If they really are worried about the baby's size, then they need to do a couple more scans to check how fast she is growing. Growth slows down over the last weeks.

[Lionstar]

Can't comment on the glucose, but I had a home birth with DS 4 weeks ago and he was a very unexpected 9lbs 5oz at 40 weeks. It was a quick 3.5 hour labour (2nd birth), however I did have a second degree tear, which the midwives repaired. I think I coped much better with the whole thing being relaxed at home, plus it was probably too quick to have got to hospital.

With my first labour I had SROM at 37 weeks, 2 days of labour at home, hospital induction, 3 hours of pushing, an episiotomy and 3rd degree tear - so a much worse experience and DD was only 7lbs 3oz.

[bigcar]

Hi! Firstly, one off growth scans are notoriously inaccurate, I think I have read on here by as much as 15%.

If the gtt comes back that you have gestational diabetes then they will want you delivering in hospital. With gd and large baby they probably won't want you to go past your due date and will probably induce if labour doesn't start on it's own. A lot depends on hospital policy so best ask what the policy is where you are, it's not the same every where. It sounds quite scarey but really isn't if you keep in mind that you don't have to do what they say, your care should be a joint decision.

If the gtt comes back that you don't have gd then they may still want you delivering in hospital but look here or here for some useful info. Big baby doesn't have to mean hospital birth.

[fairywing]

Thats all really helpful thanks

To be honest i would probably feel happier going in if she is going to be a big baby i just want to have a really clear birth plan and be aware of what my options are once i'm there. I will have a chat with the midwife when i'm back in a couple of weeks and wait and see what the GTT reveals in the meantime.

Thanks again for the useful info

[peppapighastakenovermylife]

Is it your first baby? I had a 9 pound baby at home with no problems but it was my second. I cant answer about the GD sorry.

[Tangle]

Before agreeing to any tests I'd want to know what they hope to find out, what factors would need more consideration for a -ve/+ve result and how these results would impact on their recommendations for my care. If I wouldn't accept the recommendations then I'd be thinking hard about how my baby and I would be benefitted by taking the test.

re. a big baby at home, I'd ask what research they are using to back up their position that a large baby is more likely to get stuck - everything I've seen says that foetal size is not a good indicator of shoulder dystocia, and that if SD does occur the best outcomes occur in cases where the MWs present are confident and competent in resolving the situation quickly (ie not relying on having a crash team on standby - I'd rather be at home with a good MW than in hospital with one that would wait for help)

Similarly with monitoring if you do go in - if they wanted to put me on continuous monitoring that was going to restrict my labour options at all I would want to know why they were recommending it and what research they were using to say this was going to produce a better outcome (as far as I know there isn't any). "Hospital policy" wouldn't be enough!

How strong willed is your birth partner? I decided on a homebirth with IMs for DD (my 1st - 9lb 12), as I didn't want to get into this type of discussion while I was in labour, or put DH in the position of having to argue on my behalf when I wanted him to be able to support me. Maybe I was overly paranoid but I was concerned that whatever was discussed with my CMW in advance and written in my notes, I'd be in for an argument at the time if I wanted to deviate from hospital policy (especially if I got a hospital MW who was having a bad day or was a bit of a jobsworth). Facilitating a birth environment where I felt safe and cared for was high on my priority list and I didn't see how, with my concerns, I'd be able to achieve that in hospital.

[greenbeanie]

I think the main issue will be if the GTT is positive how you manage your diet and the impact that will have on birth. There is a huge amount of evidence that being active during labour is likely to lead to a normal birth, and you may feel more able to be active at home.

I had 2 ds's the 1st was 9lb15 and the 2nd 10lb7. Both labours were relatively problem free. The second labour was just 2.5 hours and I had a minor tear that did not need suturing. The second stage of labour was 2 minutes long so he certainly didn't get stuck!!

Good luck with your GTT and the rest of your pregnancy.