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?

Just want to add another big baby success story - my biggest (11lbs) was also my easiest birth. My first was 9lbs 6oz, but it was the epidural and lying on my back that contributed to that birth being so hard. Even so - baby still came out destroying my pelvic floor on the way

Statistically the OP is more likely to have a vaginal birth with an induction than to end up with an emergency c/s.
Incorrect for first time mothers, but they tend to give all the statistics together which includes second, third, forth time mums who're induced having already given birth vaginally before.

Rather, the risks of having a section after induction are significantly higher for a first time mum compared to others. It's an important difference.

I'm sorry you are finding things so stressful and are not getting good care from your MWs. But just to reassure you a bit, 9 days overdue is completely normal, induction isn't usually offered until around 12 days over in my area. And my biggest baby was 9.5 lbs, 2 lbs larger than my others and was by far the easiest birth - big babies are not necessarily a problem. And the growth scans are massively inaccurate, my dsis was told she was having an 8lb baby that was actually 10lbs.

Well I'm afrad based on my experience I think you should request a C-section!

I have a huge husband and knew that baby had a big head, but I let myself convinced by the HV and midwife to try a natural birth as supposedly "I am built for this"

Biggest mistake ever, DS and I still suffer the consequences - he was born after 36 hours of hell, delivered by forceps with massive bruises on his head, couldn't feed or open his eyes for the first day - he was so traumatized the poor thing, I will never forgive myself

I lost 2.5l of blood and had a massive tear (on top of the episiotomy) and still have bladder problems (and not only).

I am still upset about the whole birth thing 6 years later and not sure I will ever get over it

Sorry I don't mean to scare you or imply the same will happen to you.... but I know that I would give anything to have made this choice. I am convinced that both my life and DS's life would have been better if he was born by CS...

MsAnthropic - you are right that there are few large scale trials which separate out primips.

Where are you getting your figures from?

My understanding is that between 35% and 45% of mums having their first baby will have an emergency c/s if they're induced. The risk will be lower if they have a good bishops score at the onset of induction. That's pretty appalling IMO, given that healthy primips not undergoing induction have an emergency c/s rate of about 13%.

Which means that the OP, just going on those basic stats still appears to have a better than even chance of having a vaginal birth if she's induced.

Not defending those figures by the way - they're shocking!

I gave birth to large babies with no issues at all other than increasingly quick labours - last one very quick.

If you are worried though the very least the MW should be doing is talking through your concerns with you - and if you are scared or really do think c-section is the way don't be afraid to push for it.

Have they offered another scan to check the accuracy of the last one ? Sometime different personnel can come up with very different answers.

I don't think YABU, but I think it would be good to discuss with a consultant who is sympathetic and open to your concerns.

Scans can be inaccurate (for that reason at our hospital they don't give an estimated weight, just work out the growth curve/centile). A series of growth scans can be more accurate than just a one off growth scan, but can still be wildly inaccurate.

I've had 7 babies, ranging from 1lb 2lb to 10lb, with 3 around the 7lb mark and there was very little difference in pushing them out, except for the very tiny ones obviously. In fact, the 10lb baby was one of my easiest to birth. I didn't have any stitches with any of them.

I'd be wanting an elective in your position.

What is the baby's head doing? My first was 9lbs 4 and his head was never where it should be so I ended up with a emcs.

When I was researching stats around VBAC for DS2 and baby size the success rate dropped after 8lbs 15. I had an elective and glad I did - at 39 weeks gestation DS2 arrived at 9 lbs 10.

I gave birth naturally to a 10lb2oz baby with ease, no tears etc.

If your consultant thinks an ELCS would be recommend for medical reasons then yes, but I wouldn't automatically assume big baby=difficult birth.

Bigger babies are just longer and fatter around the middle and legs; the bits that are difficult to get out I.e head and shoulders are pretty much the same regardless. Once the head and shoulders are through, everything else is easy.

I wouldn't automatically assume big baby=difficult birth

Definitely - I managed to get a 3rd degree tear with a 5lb baby - I was told afterwards that bigger babies can (not always, but sometimes) be less traumatic to birth as everything has time to stretch. Apparently what I experienced is known as the "champagne cork effect"...

Predictions are not always accurate.

As for giving birth to a large baby; I gave birth naturally to a 10lb baby with only gas and air and I have a small frame. My other 7 and a half pound baby was much more difficult and painful. Head shape has a lot to do with it and growth prediction charts can't account for head shape.

I had a vaginal birth and very bad tear with my 10lb DD.

Next time I will definitely have a ELCS.

Fuck having to have another 9 months of physio just so I can remain continent.

YANBU. Having had an emergency section due to a large baby AND a planned one I would advise any woman to go with instinct. My planned one was marvelous....very relaxed and lovely. I recovered fast and was taking DD1 to school after three days at home. leaning heavily on the pram

I have massive babies and I have a very narrow pelvis apparently....I think if men had babies they'd ALL have c sections as a matter of course!

They're fabulous.

DD was 11lbs, though nobody knew it beforehand cos they didn't bother to check. I was induced at +14 days over. She came too fast, ended up NICU and I ended up in surgery, lost 3 litres of blood and almost lost my womb.

If I ever go again I'm going for an elective section.

Take your husband with you to all further medical appointments - I found that DH could argue the case better than me and dealt with the consultants far better - also, you can't dismiss a bloke saying "it's just the pregnancy hormones".

Sadly, your DH saying "my wife wants a CS" will get more attention than you will IME. My DH made sure I wasn't left in pain or ignored - then we got a super midwife and it all went ok after that.

Saying big babies are easier to push out is patronising bollocks - easier for who?

Thanks to all for responses. Husband is coming to appointment. I'm hoping that getting a consultant appointment today, after meltdown yesterday means we will be listened to and hopefully this will be agreed. I have now recovered my composure and starting to think rationally about how to state my case. I've had it up to here with midwives ignoring my concerns, quite honestly had I listened to my gut feel weeks ago, baby would be here by now. In my mind im not leaving without a date for planned section. Not willing to go through induction when there has been no indication of any labour signs from my body.

As a first time mum, I have no idea if im any good at labour or not, and at this stage my mental health is more important than trying for an induced birth. I really appreciate the words of advice. Will let you know how it goes.

Hope it goes well for you OP.

The most important thing is you get the birth that's right for you and as you quite rightly say, state of mind is just as impportant. I think you're right btw - I would sooner for ELCS than induction with a big baby. I was lucky and mine both came early.

Best wishes, OP. In your position, I would request a CS. My son went way overdue (first time mother, almost 40, big baby, no cervix ripening at all), I did my research, refused induction, and saw a consultant who actually suggested (before I asked) that she thought I was a poor candidate for induction, and she would recommend an ELCS. It was pleasant and straightforward, and it turned out DS had a 95th centile whopper head and was all tangled up in the cord, so induction would have likely failed anyway.

Good luck whatever you decide.

Go for it OP and stand your ground. I am having an ELCS (after EMCS last time) in a couple of weeks, there are perfectly good medical (and emotional) reasons for it, and yet every time I see a different midwife they make me explain why I want it again! It's totally pointless as already signed off by a consultant, but always makes me feel a bit unsure in myself, even though I have spent considerable time weighing up my options.

Yanbu but not purely due to size.

I think older mums are advised not to go overdue anyway. Plus v big baby suddenly growing is also a warning sign. I would go for elcs to get baby born ASAP.

I really don't understand the obsession in this country with 'natural' birth.

It was always obvious I was going to have a whopper of a baby. I was huge. When I first went in to hospital in labour the midwife took one look at my bump and said 'wow, you're going to struggle with that one'.

I wish I'd said then and there: 'Right, let's get in theatre and have her out then.'

But I didn't, because it was my first baby and my NCT teacher and all the midwives had been on at me all pregnancy about giving birth naturally like anything else would be a massive fail.

36 hours later the medical team suggested to me that I have an epidural!

Then it was episiotomy, forceps, massive tear, rectocele, months of physio blah blah blah.

Stick to your guns OP. And trust your instincts. No one knows your body or what you're feeling better than you.

Good luck, 38 isn't that old

Push for a section OP, even if your scan isn't exactly accurate it sounds like you've got a big baby there.

I went overdue with my DC2, I knew from fairly early he was going to be sizeable but when I went in at 41 weeks to be induced the consultant wouldn't do it before I had a scan. Scan suggested around the 11lb mark and he advised a planned csection. My previous birth hadn't gone that well, with a smaller baby so I was happy to take his advice. I don't regret a thing, DS was 10lb 13oz of gorgeous squidginess with an enormous head to match. I enjoyed the experience so much in comparison to DC1 (high rotational forceps needing plenty of stitches) that when I had DC3 I asked for a csection, they weren't so keen as she wasn't measuring massive but they agreed in the end. She was 9lb at 39 weeks so potentially would have been bigger.

Hopefully one look at the size of your bump and the size of your DH will help them make the decision to give you a section