To decline induction/c section for baby measuring small?

[imalreadythere]

40+2 today. Baby measuring small but also engaged so maybe that's why?

Midwives offered induction or c section but I want to wait.

Aibu? The midwife wasn't that pleased I don't think.

Was over 41 weeks with both of mine but I didn't agree with the estimated dates given when I knew I must have conceived so I don't think I was really as far along as that. And am another who got a growth scan which was way off - thought baby was small but was nearly 10lb! I agree with trying to talk it through with someone else and discuss risks etc of all options

Declining interventions that could potentially save the life of your baby is utter madness. In what other scenario would you decline life saving treatment

My baby was measuring small and I was advised to have a C-section (he was breech) and went for it as I wouldn’t go against medical advice. After the delivery the doctor saw my placenta and it was fully calcified and therefore could not provide for the baby anymore. In my case having kept him for longer would have been fatal. I would suggest you do some research and listen to medical advice and try doing the best possible decision. All the best to you and your baby 🌸

I shouldn't have to remind you on your code of conduct though, scaremongering and not respecting informed consent are not ok.

And in my case my baby was indeed small: weight at birth was 2.490Kg.

I haven’t read the full thread but have read all of the OPs posts.

OP, the decision is yours of course. However, my view is that the current emphasis on having a birth with as few interventions as possible is putting babies at risk by encouraging mothers to ignore medical advice. It’s right that we’ve had a backlash against the old ways where a mother’s opinions about her own birth process weren’t respected but we should be careful that we don’t go to the other extreme of rejecting expertise.

When I was pushing with my first I was advised to have either forceps or ventouse because DD was starting to struggle. Because I’d been convinced that interventions were bad I argued (pretty incoherently!) with the midwives and then the doctors. In the end I had an episiotomy and the ventouse delivery and it was 100% fine, everyone was healthy and the physical recovery was easy.

However, I felt like I’d massively failed because I hadn’t been able to get DD out unassisted and had “let them” do the intervention. I was not mentally well after the birth and it was quite a long time before I could think about it clearly.

Now my view is that I was absolutely mad not to take their advice straight away. DD would probably have been fine either way and I’d have probably got there in the end but I can’t imagine how I’d have felt if she hadn’t been ok because I hadn’t listened in pursuit of an intervention free birth. Of course there’s nothing wrong with asking questions and wanting to understand the reason they are recommending a particular course of action. However, in no other area of medicine would I argue with a professional’s opinion just because I didn’t want an “intervention”. There is a reason they make recommendations and it’s not because they think it’s fun to do unnecessary medical procedures.

Now, in your position I would take the advice and have the induction or c-section. If I was in doubt I might ask to talk it through with a doctor rather than the midwife to see if there are other options like closer monitoring and checks on placental blood flow that might be appropriate. However, I wouldn’t just ignore medical advice. Aside from anything else, I would feel much worse if something went wrong and I’d ignored the advice than if I’d followed it.

Best of luck whatever you decide!

Surely the midwife is also trying to avoid interventions, and she has proposed this intervention because she believes it's necessary?

I did not say that, I said "when a baby is perfectly safe", and I was talking in general terms, not specifically the OP's baby. The OP has not mentioned any actual risk factors here, nevertheless, I was not assessing via the internet, for goodness sake, way to twist things 🙄

Oh, for the love of God.

Women and babies died in pregnancy and childbirth - frequently - before we had modern hospitals and interventions.

Ignore medical advice at your own peril. I suggest you speak to them to get a full explanation as to why they think induction or c-section is necessary. Then at least you are making an informed decision.

I speak as someone who had a 'natural' delivery with my second that culminated with some hefty and necessary interventions to save my life, and that of my daughter, at the end. I am grateful that we live in a time and place where that was possible.

@ReadingSoManyThreads not sure what your problem is? I am finding your attitude quite bullying. I have given my personal opinion as this is what this forum is for. I am not advising as a clinician because OP is not my patient. i would like to remind you that you are not my trainer or my boss. so not really your place to tell random strangers off? I could go on and about what you are saying but am choosing not to because quite frankly clinical debate is for colleagues and peers. let's agree to disagree like civilised adults.

Actually you said

Stop scaremongering the OP, she is not putting her baby or herself at risk by awaiting spontaneous labour when her baby is perfectly safe and healthy in her womb.

how is that not referring specifically to the OPs baby? The medical professionals believe her baby could be at risk as it’s measuring small. Yet you've decided it’s perfectly healthy and safe.

I had a terrible time with the NHS, too many people who just want to tick boxes and couldn't really care less about what you as an individual, they shouldn't be getting annoyed with you it's so unprofessional, they should be giving you all the information and letting you decide. It's probably more convenient to them if you just agree to a c section.

I couldn't recommend an independent midwife enough, I felt I had to get one in the end as I had such an appalling experience with the NHS. Not fit for purpose sadly. The independent midwife was expensive but worth every penny, all the care was centred around me and my wants and needs, it was a completely and utterly different experience and was the first time I felt listened to in any way, shape or form.

The NHS made me have extra scans because I have a low weight even though that is completely normal for me and my family. The told me my baby was going to be small - he was over 9lbs - and they told me that I couldn't give birth in the unit where I'd had my care because I'd gone over my dates. I hadn't gone over my dates, they just wouldn't listen to me when i said I had very long cycles and that I'd charted my temps so knew exactly when I had conceived. They would only go on my LMP which was 10 days out.

Honestly I found them completely and utterly useless, there was no patient centred care and I was completely stressed out by the end of it. After they told me I couldn't give birth at the unit they said I'd have to travel well over an hour away to get to hospital as the nearest one was full.

So if you can afford it get an independent midwife and enjoy a completely different experience.

Yes but measuring small means nothing. It can be well out.

Yea, but It’s clearly a risk factor or they wouldn’t be recommending intervention. If they thought the baby certainly was healthy and safe were it was, they wouldn’t be recommending a c section.

I don’t really think the OP is wrong to consider all her options.

I didn’t blindly follow advice without seeking to know all the facts. Different hospitals often recommend completely different things as well. My local hospital routinely induced at 7 days overdue, however the hospital 10 minutes down the road waited until 12 days. So which ‘professional advice’ was correct?

Some hospitals will offer a planned caesarean in situations where others will not. There are a lot of examples. Unfortunately in many cases it’s not as clear-cut as there being one obvious correct proper choice that every health professional would agree on. So for me it makes so much obvious sense for a woman to try and know all her options, the pros and the cons, her own personal risk factors and preferences before she makes her decision.

After my first was born they examined the placenta and said it was gritty and that she had needed to be born, she was a week early. The day before they had been mulling over whether to induce because she was measuring small. I can't remember why they decided to give it another couple of days before inducing, but mother nature intervened in the meantime and I went into spontaneous labour.

In your shoes I would go for the induction.

Sorry but the midwives and doctors have years of training and experience and they wouldn’t recommend intervention unless it was needed. I sound blunt but I think you’ve been stupid and it’s even more foolish asking randoms on mumsnet after you’ve declined to follow professional guidance

On another comment, OK, I couldn't see where my other comment was, but I wrote "when", as in she knows her own situation, so if she knows her baby is perfectly safe and well, then in that scenario spontaneous labour is safe. The "when", meant if that's how it is in her situation. I wasn't stating that factually her baby "IS" safe, because I don't know the information to determine that.

From what the OP has written the medical professionals haven't actually stated what risks they believe the baby has, measuring small at full-term is not an indication that baby is 'at risk', measurements once babies are engaged are notoriously inaccurate and cannot be relied upon. Nothing the OP has written suggests that baby is "at risk". OP can request can request specific tests such as on the umbilical cord/placenta and then decide what is best. The medics clearly do not think baby is in any immediate danger, otherwise, baby would have already been born by now via immediate induction or emergency c-section. As I said, them thinking baby is measuring small at full-term is not a good medical reason to be pressuring for induction or c-section.

You are probably best off talking to your care team about your next steps, it's fine to ask to speak to another midwife or obstetrician if you don't feel your mw will support you. Agree with the PP who suggested the BRAIN decision making tool, also consider:

How was the baby measured? Was it a fundal height measurement or a scan measurement? (Or both?) Was the tailing growth based on a single measurement? Or has this been an ongoing trend over several measurements? Fundal height measurements should be done by the same person, scan measurements in late pregnancy are less accurate, and single measurements don't tell us a lot, that's not to say there isn't something going on though. Was a Doppler scan also done? Do you have any additional risk factors for still birth?

If you decide not to go for an induction/ c-section you will probably be offered daily CTG monitoring. Continue to monitor your baby's movements, any changes or concerns at all go into your unit for a CTG.

Wishing you all the best OP.

I had a C-section at 37 weeks with one of mine because of measuring small for dates which was very out of character for me as I’d had all my others spontaneously and unmedicated at 40+ but I trusted my midwife implicitly. DS would’ve died if I’d not done it. The placenta was barely functional when he came out. Not something I would ever recommend risking personally.

Thank You. Sure everyone has their ideal way to give birth. I wanted the same as OP. But had I not listened to medical professionals neither of us would be here. It could be fine but why on earth would you take the chance

I had a baby measuring small and he was induced on his due date. Came out bigger than they thought at 6.6 lbs though.

He did come out very “over done”’looking - wrinkley and without any of that vernix (?) stuff, so perhaps he was ready to come out.

Just to say I had a sweep with Dd ( 40 +9 - cheeky monkey) then went into labour spontaneously over the next day. It is quite a gentle " intervention" would you consider that ?

It’s not necessarily about ‘wanting’ a ‘certain kind of birth’ but understandably OP may be cautious of interventions like induction or caesarean section that can come with their own increased risks of an adverse outcome. I would want to be more informed of risks/benefits/accuracy that was relevant to my own personal circumstances.

If it helps, in France they consider 41 weeks as the limit they’ll allow women to go to spontaneously, rather than 42 as here.