Very big baby, should I ask for c-section?

[guinea36]

I'm currently 40+4 with first baby. We had a scan yesterday and she is measuring in at 10 pounds already. She has been predicted to be quite big throughout pregnancy and is now just under the point at which the hospital recommends a c-section
Because of her size, I'm going to the consultant led unit at my local hospital as opposed to the midwife led one - I'm very happy with this and for now want a vbac if possible. I had a sweep yesterday and things seem to be progressing, albeit very slowly and the baby seems healthy.
Currently they are talking about inducing me in around a week and half's time.
However I am a little concerned that if I go much further overdue the baby might grow some more. I'm worried that if things are left for another week it might be better and less traumatic for all to opt for a c section instead at that point rather than trying to push her out. I'm a little concerned by this as there doesn't seem to be a lot of joined up thinking between the midwife who booked in the date and the doctor who told me that the baby is big, i.e. the midwife didn't really even look at my notes. Should I at the very least be pushing for another scan and potentially a c section if I'm nearly two weeks overdue or just try for a vbac anyway? Any advice from medics or anyone else who has been in a similar situation would be very helpful. How can I make sure my concerns are properly heard?

I've lost count of the people I know who have had average size babies after months of being told they are big / small.

If it's your first, you can't have a vbac - that's a natural delivery after a previous section.

I would just relax and focus on having as good a natural delivery as possible. There is no reason your body shouldn't be able to deliver a large baby.

And good luck! It's a daunting but very exciting time!!

Growth scans are notoriously inaccurate. My DSis had a growth scan the day before being induced and they said it was an 8lb baby - he was actually 10lb!

On the other hand, I've had two 'normal' size babies and one whopper and the whopper was by far the easiest labour. If you are upright, the extra weight helps push down on your cervix and get them out. Plus the actual head diameter doesn't vary that much and that's the hard bit to get out, the body is nice and squishy and just slithers out!

It's such a personal thing, I'm not sure there is a right answer, you have to go with your own gut feeling - tbh though, mine would tell me to ask for another scan and an elective c-section if you go much longer. That's what I'd do because nearly all the friends I had that had 10 lb babies had emergency c-sections or very serious tears. I'm sure it's possible to have a large first baby without problems but imo it's not the likeliest outcome.

With the benefit of hindsight of two labours (second one over 10lb, natural delivery) I would push for another growth scan, and if they are not happy to give you one then a discussion with the consultant - I assume you are consultant led - to come up with a scenario plan. This will help you relax and know what you are doing, which will help you going into the birth, however it happens.

My agreed plan went something like this: allowed to go to 40+4 for natural delivery, after which I had a provisional c-section booked to prevent the baby becoming too large (which all agreed would happen if I went any more over due). I categorically did not want to be induced, which they were surprisingly fine about.

I was measuring big all the way through with DC2, lots of people told me about the inaccuracy of scans, but she was, indeed, huge. I delivered her with barely a scratch so it certainly can be done, but she was my second which I think makes a significant difference. My first labour with a much smaller baby was protracted and ended up with emergency forceps. Nothing to do with the size, just a lack of progress.

I think you are wise to ask more questions, if only to set your mind at rest that all the thinking, as you say, is 'joined up'.

Good luck!

i agree fab my second baby was near 9 lb but an easier labour but i'm sure for me it was the return to experience that made birth nbr 2 ok. I think I'd push really hard for a consultant appt and another scan op, I agree with that too.

I know it sounds logical that a larger baby would be more difficult to birth but I haven't seen any evidence or statistics on this. I would be interested in seeing them if they exist as we tend to have bigger babies in my family.

I've even heard anecdotal theories that larger babies (within reason) can be easier to birth because they put pressure more evenly on the cervix. Certainly I know of people who've had severe tearing with small babies, and people who've had large babies with barely a graze. To add my own anecdata, I had a fairly "normal" amount of tearing with DD (average weight, very large head!)

Try not to stress about it too much. Whatever weight your baby ends up, the brutal truth is it will always be a very large thing coming out of a very small hole...

Thanks - I have a midwife appointment today so I think I will bring it up. We had two sonographers looking at the measurements yesterday and it's been a similar pattern the whole way through. I am fairly sure they are reasonably accurate.
I don't have a consultant as yet as I was heading towards the Midwife Led Unit until yesterday as it's not deemed otherwise a risky birth.
I'm going to stay relaxed but at least push for another scan if I carry on going much longer and to get my concerns officially down on record in my notes.
I assumed Vbac meant vaginal birth? Clearly not though! So much jargon to remember! Thanks again xx

Growth scans are notoriously inaccurate.
I was told my son had IUGR and was estimated to be 4lb 8oz at full term....he was actually 6lb 9oz born at 37 weeks

My growth scan estimated an 11 lb baby.

She was 8.3

Vbac is vaginal birth after caesarean.

Growth scans are notoriously inaccurate. Have a search of here and you will see so many posts about just how wrong they can be.

Ds1 measured average all the way through and was 9lb 1 and very long, big head. He was born by elcs ad he was breech.

Ds2 - bump.measuted a week or two behind, then two weeks in front. Had growth scan, predicted to be mid 8lbs based on measurements. I was convinced he was bigger as told head was firmly down and I could feel bum and feet, he was BIG.

All through pregnancy told I wouldn't be allowed to go over due to high risk, big baby, and having vbac. Elcs booked forv40 +4. Ended up have three sweeps then waters broken at 40 +8. Ds was born vaginally, he was indeed massive (10lb 13.5) and actually labour was fine. The problem.cane with my own medical issue which resulted in needing to fldeliver him asap. As he was also back to back I ended up with episiotomy and forceps. But this was very quick and easy despite his size.

Oh I would request induction sooner. If they won't, c section. Although I had elcs with ds1 and recovered quickly and perfectly it gives you people's next time.

problems

This is a very useful website, which covers big babies.

evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

It is different for 2nd/subsequent births but in my case
Dc1 - 7lb - horrendous labour and birth. Ended up with episiotomy and forceps.
Dc2 - 10lb - much for straightforward, zero intervention, ended up with tiny tear only.

So big baby doesn't always mean difficult birth.

The sonographers and consultants I saw told me the scans "weren't even that accurate" as I was measuring 11+lbs and ended up with 9lb'er
Just stick to normal plan.whatever that is....as it will probably change during labour anyway! X

It's true what others have said
I know so many people who have been scared into thinking they are having a tiny baby or a huge one only to give birth to either the opposite or just a normal weight.

Also bigger baby doesn't mean worse birth. I could follow this up with lots of stories but I will bore you .

Good luck for he big day

I was threatened with a big baby. He was 6lbs and born by emcs, just like his big sister who was 7lbs. They were unbirthable due to position.

Position and head circumference make the difference, not weight. In fact, evidence suggests heavier babies make for easier births.

that's why I think you should push for a consultant meeting - head circumference and size of your pelvis would be my concerns. A higher weight, if it's correct, may be an indicator of a larger head circumference and since you're already marginal for a c-section due to weight I'd want it properly checked out.

If you've not had a c section before I think you will be hard pushed to get it agreed now due to potential size of baby. Most hospitals do not use this as an indicator to recommend c section.

You can't really judge it. My friend had a very 'easy' birth with a 10lb, I had a horrificly long and protracted birth with DS who got stuck and was only 6lb!

Yep, another one here who says growth scans can be very wrong. I've had both of mine by CS, one emergency and one planned, both for malpositioning. But I was warned both times I would need induction/CS etc because of their supposed size. They were 8.2 and 8.7.

I measured huge all the way through with both of them, measuring 44cm at 37 weeks etc, had a million growth scans, all said big babies but they weren't. As others have said, position is so much more important than size when it comes to ease of birth.