Massive baby - what would you do?

[AnxiousMamo]

I’ve just been diagnosed with gestational diabetes after baby was measuring 6lb at 34 weeks. All of the measurements were 85th centile plus, with the stomach measurement being off the scale (!)

My first baby was 8lb 15oz, and this one looks set to be even bigger. First DC I had to be induced which was awful and I ended up with an episiotomy, ventouse and I was unable to urinate afterwards for a week (I needed a catheter). It was pretty traumatic, although I was able to look after DC and be mobile straight after birth which was good.

I have another scan next week when I will be 37 weeks, and they will compare measurements and the consultant will advise me. They have given me two options - induction at 39 weeks or an elective caesarean. Both carry risks. With induction there is the risk it won’t work, I may need intervention again, tears, episiotomy and shoulder dystocia for the baby. With a caesarean there are the usual associated risks. The consultant did they that as I have had a big baby previously, that is a good sign for a vaginal birth.

I am wondering if any others have been in this situation and how it went for you, what did you decide? How was the birth?

Thanks in advance.

My first was 9.3 and a vaginal birth. It was brutal
Second 10.7 opted for a c section and it was a lovely calm experience and I recovered far quicker than the vaginal birth.
Third was 9.15 at 37 weeks so opted for another C-section and again a lovely calm experience with a speedy recovery x

My first was 8'14 born vaginally in hospital, they were just getting the ventouse out as she was born after a 14 hour labour so didn't use it. 2nd degree tear which had stitches. I didn't have GD in my second pregnancy but was flagged for big baby in scans and strongly encouraged to have induction or c section at 39 weeks. I did a lot of reading on the evidence for intervention for big babies including book by Sara Wickham https://www.sarawickham.com/articles-2/induction-of-labour/ and ultimately decided to have a home water birth. Labour was about half the time of my first and pretty straightforward. She did get a bit stuck around the tummy but as the head was out by then pushing her out was straightforward. She was big at 10'6. Second degree tear again which midwife advised would heal without stitches. The complicating factor for you is GD so I would suggest reading up as much as you can on evidence in relation to GD, big babies and intervention. At least one of Sara Wickham's books seems to cover this.

This article with various links may also be useful: https://www.sarawickham.com/articles-2/induction-for-gestational-diabetes/

My first was 7lb9 and although I didn't need a csection I had a very long difficult labour and found out she was brow presentation near the end so very lucky I manged to have her ok.
Second and third were 9lb14 and 9lb15, inductions at 2 weeks over, and both labours were very quick and only gas and air (3rd was a bit too quick and a bit traumatic that way)

Similar happened to me with my first he was born 9lbs 8 0z. And I was in the icu for a couple of days as I'd lost too much blood very traumatic experience. I then had an elective csection with my second and he was born 9lbs 13oz but was born at 38 weeks and first was born at 41 weeks. Csection was a lot easier to over come in my experience.

Inductions tend to end in emergency sections as they prompt the body to give birth before nature has decided the time is right. So I'd go for an elective C-section if I were you

The pouch is because your scar doesn’t stretch, so it only happens if you put on weight over and above your post-baby weight. And it goes away again if you lose weight. So I wouldn’t let that influence you.

If you’re going to have a lot of stitches, they’re a lot easier to cope with in your stomach.

Wow! Amazing story
i have never heard of such big babies. Were they really calm newborns?

Just to comment on a pp’s quote from a gynaecologist saying that a ‘good birth’ is an alive mother and an alive baby, I don’t agree. We can and should be aiming much higher than this.

@Nubnut My big DC was really calm and settled, especially compared to my sister’s who were all much smaller (around 7lb). Don’t know if that’s to do with being generally hardier and having a larger appetite from birth - my DC was having 4oz every 4 hours like clockwork.

@nutbrownhare15 Thank you for sharing. Most research and articles I’ve read don’t directly support induction / c-section for gestational diabetes or a large baby alone. I have the added complications of GD, large baby and previous difficult instrumental birth, so it’s weighing up all those factors - unfortunately it’s impossible as obviously there’s no research or articles that pertain to my exact specific circumstances.

Read up about your rights. AIMS have great articles about this.
you don’t have to blindly follow the obstetricians “rules”. Many people give birth naturally to big babies.

I might be biased as I had a female obstetrician tell me my baby would die if I wasn’t induced No later than my due date but I knew she was just a bully and wrong so when my baby was born a week or so late she was just fine.

Hi everyone,

I thought I’d come back and update now I’ve had my scan and consultant appointment.

Essentially, the recommended options remain the same: induction or elective section at 39 weeks. According to the scan, the baby actually hasn’t grown much from my 34 week to my 37 week appointment, which whilst I was initially happy with this (I’ve been really keeping the diabetes under control with diet), the consultant said that the disparity in the measurements is still a concern. Baby still has a big abdominal circumference and is predicted to be about 4kg by 39 weeks. The consultant said if the baby was predicted to be 4.5kg+ she’d be recommending a straight caesarean.

So, I have booked in for an induction at 39 weeks, but I have said that if I turn up and my body is showing no signs of readiness, I will consider the option of an elective caesarean. I’m going to try my hardest to induce labour in the next two weeks (walking, sweeps, raspberry leaf tea, bouncing)!

@AnxiousMamo elective c sections need to be booked in advance, so if you turn up for an induction and it doesn’t go ahead for whatever reason, you then need to get in front of a consultant and try to get a c section booked - in my area, that wouldn’t be for another week at last
good luck! X

@Coulditreallybe That makes sense. When I said that to the consultant she was very agreeable that I could change my mind and opt for the caesarean. I’ll be an ‘in-patient’ - they will want me on the labour ward for the induction at all times, so perhaps the thinking is I will wait for a section spot to be available? Or maybe I would be monitored and come back for a booked in section. No idea, but she was fine with the suggestion.

@AnxiousMamo i only mention this as I was you 🤣 given the choice of induction or section after many many apps with the consultant because baby was so big. Turned up for induction, couldn’t go ahead, was booked into hospital so sat around waiting and then hit a stalemate as they said ‘oh, you need a section. We don’t have any slots free for a week. Hmm’ 🤣 original consultant was contacted and he said yep book her in for a section then. Hospital said we’re full, you know very well sections needs to be booked a week in advance. Was all v stressful. Hope yours is simpler!

You could try acupuncture, i did, don't know if it helped but it certainly relaxed me!
I think sex is the only "natural" induction method with any evidence that it works.

Sounds like a sensible decision me.

Remember the earlier scan could be overestimating size and the current one under!!!

@RandomMess I know, it all seems very unreliable!!

My son was born via ELCS at 39+1, weighing 9lb 4oz. Growth scans had suggested that not only was he measuring big, but he was also in the extended breech position, so a slightly different situation. I tested negative for gestational diabetes and the consultant offered me the ECV procedure to see if baby could be moved into the head down position. However after going away and researching it, I decided it wasn't for me, and I was booked in for a section.

I don't regret my decision one bit. It was a wonderful experience from start to finish, and the care both my son and I were given pre and post-op was exemplary. The theatre team were amazing and I have really happy memories of my son's entry into the world. Though he tipped the scales at over 9lb, he wasn't chunky, just lanky - with very long legs just like his Dad!

The recovery was also easier than I'd imagined but if you do opt for the ELCS I agree with what previous posters have said - take it slowly and don't do too much. And take your pain meds!

I'm now pregnant with DC2 and I'm not fussed about having a VBAC. If this baby looks to be measuring big then an ELCS will be my first option without a doubt.

Good luck with whatever you decide is right for you ❤️

Mine measured middle centile and for other reasons i had an induction (after they advised C sec and changed their mind). Baby came out 9lb 11.

Had an episiotomy and shoulder dystonia but ultimately a vaginal birth. It wasnt important to me one way or the other. Stressful at the time but zero regrets.

My advice is go with your gut and what you want. Deep down you know X

I was in your exact situation. The consultant put it like this to me: there are health risks either way - with a vaginal birth, the risk is to the baby. With a section, the risk is to you. (Obviously this is specific to this particular circumstance, GD pregnancy with predicted large baby)

I still tried induction but with the consultants assurance that I could change my mind any time or if they were at all concerned we would switch to CS immediately. In the end my cervix didn't dilate enough after 24 hours with the balloon in for them to break my waters so it was all a moot point. She wasn't even big in the end! 7lb4.

Meant to be clearer - predicted a middle centile baby based on regular, medically needed scans which apparently overrule tape measurements (tape measurements turned out to be accurate).

FWIW, I'm normally a dress size 12, gained over 3 stone during pregnancy, couldn't do up my shoes, weight was all at the front (didnt look pregnant from behind) and couldn't walk more than 200ft at 9 months.

Just adding that as it's what I would have been interested in if I was in your shoes. X