to request elective section for large baby

[Miriama]

Currently 9 days overdue and grown massively over last week, indications from growth scan, and measurements is that baby is 11lbs, and I'm an older first time mum. Terrified of trying to birth such a large baby and have an appointment with consultant to discuss section. Any advice on how to make my case for a section?

Yes I would if that's what you want. With bigger babies there are added complications. With a big baby they are leaving you that long

you should be voicing your opinions now to professionals, I would have done well before then though.

The nice guidelines hive u the entitlement to a cs.

Do not leave without a date for one.

When do u meet the consultant as time is of the essence now.

The growth scans indicated DD was about 9lb the week before she was due. She arrived naturally on her due date but she was 10lb 12oz. She was in SCBU for a week.

The scans can be way out. I would get a date urgently. I am very surprised you haven't been advised to be induced/have a cs before now.

I was very obviously having a large baby. My midwife was very concerned and pushed for early induction/section. Consultant would not hear of it and insisted I would be fine to go 2 weeks over and give birth naturally.
I ended up being induced 1 week past due date due to high blood pressure.
My baby suffered shoulder distocia and was quite poorly after birth due to being stuck. I was also quite unwell and left a total wreck 'down there'.
We were told that had I stayed pregnant for another week my baby wouldn't have survived the birth.
Thankfully we now have a very happy, healthy toddler.
I would insist on a section if I were to have another baby that was looking large.
I hope all goes well for you.

You are well within your rights to ask for a CS for a baby that size, you may even find the consultant agrees with you.

I was all set for a VBAC for DS2, fully supported by the obstetrician but when scans at 37 weeks showed he was big she and I both agreed a CS would be safest. When he was born at 38 weeks he was 10lb 15oz and had a massive head - she delivered him and laughed saying there wasn't a chance in hell he'd of come out naturally!!

I didn't even get a 7.5lb baby out of me without a 2nd degree tear. To be fair though, DD had a huge head. Shoulders are suppose to be the worst part. Not with her.

Schedule a C-Sec for both you and your baby's health.

11lbs is way too big and might result in an emergency C-Sec wit other complications if you do try naturally anyway.

"You are well within your rights to ask for a CS for a baby that size, you may even find the consultant agrees with you."

I know several people, myself included, whose babies have been identified as weighing over 10lbs, who've actually weighed significantly less at birth. In one case 2lbs less.

The reason why elcs isn't offered just on the basis of estimated weight is because of the inaccuracy of scanning technology.

All that said, I'd be very reluctant to go for an induction with a suspected large baby as in can increase the risk of a shoulder dystocia.

I'd think carefully. I don't think you'll have difficulty making a case for a section if that's what you want but when I looked into it the complication rates are actually higher and outcomes no better. Do your research and make sure it's really the best option for you and your baby. Also look at the accuracy of growth scans - predicting big babies before birth is quite unreliable. My experience is though that midwives and consultants are more likely to push intervention when they suspect a big baby than refuse it.

If it helps, my second child was 10lb5, born at home with gas and air and not a stitch. Her siblings were both around the 8 1/2lb mark and their births were no easier. Having a large baby doesn't necessarily mean the birth will be complicated. The main worry is shoulder dystocia - rates are higher for large babies. But have a read, again, most cases are easily resolved and inducing the birth actually increases the risk even if baby is smaller.

Make the decision that's right for youbut do look into it first - tthere is a lot of fear around big babies and intervention isn't always evidence based. Good luck :-)

Thanks for replies, I have been concerned about large baby all the way through but dismissed by midwives. My husband is enormous, think rugby player/porridge oats man. I have appointment todaybafter having meltdoen in the day unit yesterday. Im 38, so at the older end for a first time mum. Was booked for induction on Saturday, but no indications of spontaneous labourvat this stage. I am going to argue my case today, hopefully consultant will be sympathetic.

Should say that standard of care from midwives to my mind has been poor, any concerns dismissed with comment that big babies are easier to push out. All of a sudden there is a concern about GD, although bloods have been good all the way through. Dont get me wrong, im not loving the idea of a cs, but do not want to go through failed induction then end up there anyway. I know scans can be inaccurate but we are either talking 10 lb or 12lb and I am terrified of trying to push out such large baby.

I measured consistently large for dates with my 2nd child.

Growth scans and dr said they though she would be about 10 lbs.

Had her 7 days past dd and she was born after 3 hours, start to finish weighing bang on 10lbs. Easiest birth I've had by far! Other babies been born between 8 and 9 lbs and labours from 7 hours to 28 hours.

Bigger babies are not always bad news. Just trying to reassure you a bit.

Speak to your consultant and see what they suggest.

littlejohnnydory

Also look at the accuracy of growth scans - predicting big babies before birth is quite unreliable.

I'd agree with this. With my second, I had to go ino for a check up the week before he was born as I thought he'd stopped moving (he was fine). The midwives were very anxious about whether anyone had spoken to me about my very big baby.

When he was born he was "only" 9lb but was very long and skinny.

And OP - with my first, I was actually in labour when the midwife said "don't worry, the bigger ones push themselves out!" - that was the first time I had any indciation I was having a "bigger" baby. It really doesn't relax you does it?

In fainess though, I didn't have so much as a stitch with either. Although through my life I've cused my childbearing hips so if I hadn't have had decent labours I'd have been most upset!

Do you have access to a consultant OP? They may be able to tak you through the stats, the risks, the various options etc so you can decide what is best for you.

A CS may or not be required, but you need to ensure that your consultant is aware of your level of fear, as fear can have a huge impact on a vaginal birth.

Having spent a long time reading stories of weight estimations, the docs get it right maybe 40% of the time, and midwives are no better (20 mins before giving birth to my 10lber (DC2), the midwife was swearing she'd be 8 lbs!). Plus, a lot of big babies are long rather than wide...

How big were you and your husband when you were born? I knew I was having a 9lber with first (he was 9 12), as both me and my husband were 9lbers, but I also knew I had a similar physique to my mum, so I hoped I could cope!

Research CSs, I had a 3rd degree tear with first, and 2nd degree tear with second, but my recovery was absolutely fine, with limited pain. Factor any other decisions, like need to drive...

Good luck!

Just realised you're 9 days over - no wonder you're panicking! I went early with both of meine.

If I had my time again I would push for an cs.

I am very small and had a huge bump, I raised it with midwife and was also dismissed. In fact she said she thought the baby was on the small side. I should have pushed further as I just knew my dd was big, I could feel it.

Anyway I had a failed induction and an emcs in the end. She was 9lb2 so not huge compared to some but very big for someone my size.
The consultant who delivered her by cs also commented she wasn't coming out any other way.

Husband was huge baby, his mum had huge problems birthing him, and ended up with section, she is similar build to hubby, over 6ft tall and he was 10 lb. This is my first baby, no signs of cervix ripening, and already overdue.

You will probably end up with a failed induction and ecs. I did for my first, had my second by elective. Take your DH with you to the appointment sad but it works get him to argue.

Oh, bad luck: going overdue so long is really horrible. It gives you more time to worry.

I'm not sure what to suggest, as growth scans are notoriously unreliable. Some midwives are very good at estimating size - is there any way you could track down one with a known reputation and ask her to 'have a feel' (my midwife had a very clear idea of the size of my - large - babies)?

When you consider a CS, it might be wise to factor in your plans to have any more children: would you be okay to have another section? Would you consider VBAC? Speaking for myself, I knew I wanted a large family, and I was very keen to avoid a cs first time around, because of the likely impact on later pregnancies and births.

You could consider refusing to consent to induction - I suspect they'd be keen to get a section booked in then given other factors. This is what I did when hoping for a vbac (as did not want to take additional risks of scar rupture with induced labour) & they were only too keen to book me in for a section at 12 days overdue.

But also to reassure you - following a growth scan I was told to expect that ds would be at least 10lb, probably bigger. I was terrified! When he was born almost my first thought was 'you don't look that big'. He was 7lb 12 at 9 days overdue. So they can be very inaccurate.

Remember that you don't have to consent to an induction. It does blow the medical professionals minds a bit, but will make you more likely to get your CS. I just had an 11lb baby by elcs and that was my strategy. Good luck today.

YANBU

Medical professionals rates of choosing c-section for their own babies jump massively when there is an indication of a large baby.

Stick to your guns. NICE guidelines say you should get one if you want. Unfortunately they still have targets to keep the number of c-sections down. No reason you should suffer for their stats.

Good luck!

Do you mean 42 weeks 9 days, which would be 'overdue' or 41 weeks 2 days, which is exactly average gestation for a first time mum and not overdue at all? And that's if you know your exact date of ovulation. Unless you do, you might be 40 weeks pregnant and not ready. Full term is 37 to 42 weeks. I went to 42 weeks and 5 days, by the way.

Scans cannot determine weight, especially the further on in pregnancy, they just can't and anyone telling you otherwise is lying. The error margin is several pounds.

I'd say an elective section is better than emergency c-section and better than an induction, so ask if you are really worried. While being a huge advocate of natural birth, if I was being told I was having a big baby and I thought I might be, I'd choose an elective section over induction for sure.

"You will probably end up with a failed induction and ecs."

Not sure that's helpful. Statistically the OP is more likely to have a vaginal birth with an induction than to end up with an emergency c/s.