my sisters baby is very small for dates - can anyone reassure us please?

[worriedsister]

Hi everyone, my sister is now 38 weeks pregnant with her first child and has been longing for a home water birth.

Everything has been fine and things have been progressing nicely, but she had a scan yesterday which showed that the baby is about 4 weeks behind on his expected growth.

A home delvery is now out of the question and also a hostpital water birth has been ruled out (the babies heart rate has been dipping a bit, so they will have to moniter her closely during delivery)

Her BP has been high recently, so this may be the cause, also Inter Uterine Growth Retardation has been mentioned.

Obviously they are very dissapointed about not getting a home delivery, but this has now turned into concern about their baby!

I'm just wondering if anyone else has had experience of this nd can offer any reassurance/

many thanks

4 weeks' behind - what is the estimated birth weight?

My dd was small-for-dates from the start. She was 5lb3oz at birth. IUGR was always mentioned in her scans although not confirmed.

I don't have a good experience to report - consultant recommended induction at 40 weeks (but dd had suspected heart condition and I was developing low amniotic fluid). Induction was horrible because of the wires and constant monitoring and lack of control (complete opposite of homebirth/active birth). Dd went into distress because of the intense artificial contractions. Born by emergency cs under GA. Apart from her heart, she was fine, just small. Still small. I am small.

I deeply resent that the hospital did not advise me of the high risk of first time inductions ending up in em-cs. If I knew then what I know now, I would have considered elective cs as one of my options.

Unfortunately, where the condition of the baby comes into the picture, it is best that your sis keep an open mind about her birth options. My dd's birth was hijacked by the hospital.

As for the concern about the baby, there is a high likelihood is that baby will be absolutely fine. Doctors like to cover themselves, so make things sound a lot worse than they could be. Fingers crossed for your sister.

Hi Worriedsister - I had IUGR (or my dd did !). Mine was picked up as a possibility at my 22 week scan but because dh and I are small they weren't sure if it was just that. I was scanned every 4 weeks then 2 then 1 as time went on and at 37 weeks she showed that she had stopped growing and I was induced, that failed and 3 days later I had a c-section. DD was born at 37 weeks weighing at 4 lbs 9 oz.

The good news is that once she was out of me she thrived almost immediately. She couldn't latch so I never managed to breastfeed but apart from a couple of hours in SCBU for her to get her body temperature up she has never had any problems as a result. Mine was possibly caused by pre-eclampsia although my blood pressure only went up when they told me I had to stay in hospital and deliver !!

I wanted a very natural delivery and ended up with anything but... but, at the end of the day dd was healthy (and I recovered v. quickly from my ordeal !) and that was all that mattered.

My main piece of advice (other than to go out and buy some small baby clothes - mothercare/m&S) is for your sister to get her head round the idea that she might end up with a c-sec. I had begun to think I would end up with one towards the end of my pregnancy and so when it happened I had no issues with it !

Hope that helps - if there's any other questions you/your sister wnat to ask just shout !

My ds was born at 33 weeks weighing 2lb 15oz due to IUGR he had to be born by section but had no other problems other than to learn to feed & grow.
He is now 4 years old still small for his age but is catching upbut has no other problems

Inter Uterine Growth Retardation - just means it is measuring small - it is not a diagnosis as such because there can be a lot of causes of that - often the placenta not functioning properly.

Why did they scan now - were there other concerns or was it routine ?

I would ask for a follow up scan - a series of scans confirming smallness - rather than just one - as scans can be very inaccurate.

My second twin (induced because he stopped growing) was small for his age - but now a very healthy 3 year old, and not overly small either.

ps - high BP is more likely to be a cause for concern and closely monitored hospital birth (in my experience)

I had a total of 5 scans between 20 and 38 weeks (usually they only do one at 13 and one at 20 weeks and usually no more) as they thought ds was small. They never mentioned IGR but they did keep measuring as they were worried, in particular about his head size which seemed small. He did grow on his curve, albeit at the low end so they seemed to get less worried as time went on.

And the ending - He was born 10 days late weighting 7lbs 3oz and apart from a hairy couple of minutes getting him to breathe at first he was absolutely fine

Moral of the story - Doctors don't always know for sure and a lot of these scans do depend on the skill of the person doing the scanning and anyway have quite a margin for error.

One other thing - I had an induction via a drip and would have preferred not to but I had a birth doula and she was worth her weight in gold.

I found the birth experience quite empowering really and often catch myself saying 'I didn't have a medicalised labour really' - ha of course I did but it didn't feel like it. The doula helped me prepare for all eventualities and as a result I felt more in control before the birth and when I was no longer in control I had someone there who I trusted to fight for me and to help which she did fantastically well.

I moved around quite a lot in labour despite the
induction drip and antibiotic treatment drip (for Strep B) and I don't have terrible memories of it but them I never expected it to be wonderful or awful. I just saw it as something that needed doing really.

The key is to remember births are difficult to control. If your sister can give up her 'ideal birth' scenario she can plan for another 'less ideal' one but one that can still be OK. I beieve that having too many rosy expectations of birth can sometimes be damaging; especially if after the birth we spend too much time regretting that the birth wasn't what we wanted. It's a bit like worrying about and planning the wedding day to the exclusion of thinking about the relationship and the marriage.

DS1 was 5lb 5oz at technical full term (38.5 weeks). he had an Apgar of ten, and was admitted to scbu although had to have blood sugars done. It was the result of pre-eclampsia affecting the placenta. He has no problems that relate to his birth weight.

Oh and try Vertbaudet for nice small baby clothes, and remember they're often wrong... so maybe a babygrow babs can grow into in the bag, just in case??

Sam was 4 weeks behind too btw, but only from 34 weeks.