Help! Options for big baby

[OneForTheRoadThen]

Currently 33+4 with second baby and had a growth scan this morning which showed baby weighs an estimated 6lb 2oz and head circumference and stomach are above 95th centile.

Had consultant appointment immediately afterwards who agreed baby was big but said they don't usually induce before 40 weeks for size although they might make an exception as baby is so uniformly large and induce at 38 weeks. Booked in for another scan and consultant appointment then.

Consultant said a real risk of labour failing to progress and would need an EMCS but refused to consider an ELCS. I had a bad tear with my first baby and I'm petrified.

Does anyone have any advice about my options? What should I be asking for at my next appointment? Is it too late to push for an ELCS? Help!!

I don't want this to come across the wrong way but please no anecdotes about how growth scans are often completely wrong. Ive been having fortnightly scans where the sonographer takes each measurement twice to double check and baby is following the 97th centile, there really is no doubt this is a huge baby! TIA

Hopeful bump

What's the policy on ELCS at your hospital? I had a bad tear with my first and was told I could have an ELCS if I have another...? I think if one consultant refuses you can be referred to another (at a different hospital potentially). I'd push for it tbh! Good luck!

Thanks for replying @KatnissK. The policy in my borough is sections only for medical reasons. I'm worried I've left it too late to get anything changed now. I'm just panicking.

Gosh I'm not sure then....hopeful bump for you in the hopes someone more knowledgeable than me comes along....

Hi, the law states you can choose the birth you want so you are entitled to an ELCS. Boroughs can try to discourage but cannot say no ultimately. Please keep pushing it and you will be able to get one.

Have they said what weight that would be approx? 97th centile might sound more scary than just the weight (clutching at straws!). I had a similar panic though after a growth scan and I read a lot of stories about how big babies were sometimes easier to birth and did less damage. In the end I just needed an episiotomy to get out her giant head, she was 9lb9oz. I guess if they really won't consider an ELCS then you have to push for early induction. Stressful!

OP, they cannot refuse you an elective if you want one. I'm in a similar situation, 37 weeks and cooking a whopper (95th percentile). I have been booked in for an ELCS when I hit 39 weeks as I refused to consider induction and was similarly worried about difficulties with natural birth. The NHS made me jump through hoops to get it, but eventually they approved the surgery.

Do some research and then go armed to your next appoinment - NICE guidelines clearly state that if a maternal request for c section is denied by a consultant, they have to refer you on to someone who will approve it. Always remember that at heart the NHS is like any other business with annual budgets, of course it is in their interest to deny you the surgery as it is far more expensive for them - however the guidelines are on YOUR side.

Oh, and you haven't left it too late. I started asking for one after my 32 week scan, saw a consultant at 34 weeks, was made to see someone about birth anxiety at 35 weeks, had another scan at 36 weeks and only eventually got it approved two days ago at bang on 37 weeks. Still pushing for it now, but you still have lots of time.

Sorry- meant to say START pushing for it now.

Probably not that useful so ignore if it’s not but my first baby was only 7lb 4 and the birth was a little scary, she got stuck, had to cut me and pull her out ASAP.. rather unpleasant.

I measured big the next time but just kind of ignored it, birth was a dream, popped out no trouble (small tear but nothing major) turner out he was 9lb 8! So it is true that it won’t necessarily be worse with a big baby.

Yours does sound big though, have they said an estimated birth weight?

Can you ask the consultant why he thinks an emergency section is a better outcome than a planned one given he’s the one saying it’s likrly to be a c section birth. Maybe he’ll be able to work a better plan together given he’s the one suggesting it will be hard.

If you do decide to give vagina birth a go. Throw the uptight positions out the door with s big baby upright speeds stuff up. Side lying is useful as it slows the birth down so you can push slower but you can still open your pelvis, hands and knees can be good too.

Hello, I had growth scans showing above the top centile lines and was offered a section by a consultant covering my usual one as they said I was at high risk of shoulder dystocia, I rejected the section and when I saw my usual consultant she offered to induced me at 39 to be on the safe side rather than risk me going to 42, the induction failed after 4 days of trying to get things going I had a section (not emergency but not pre planned either) section was so much better than I expected and had I known that I would of taken it the first time they offered it. DS was born at 39.5 at 8lb 12 so not too big. Good luck!

I was in a very similar position to you. Baby measuring big from about 27 weeks so I was having regular growth scans. My consultant said they would let me go to term but if baby was measuring really big around my due date then we would go straight for a planned CS, a plan which I had come to terms with. I had a growth scan on my due date and baby was measuring 10lb11.

However, I then went in to see the consultant, but it was a different one as my usual doctor was on holiday. Well, the new consultant persuaded me to go for induction and conventional delivery, told me she had delivered babies that size and larger naturally. The labour failed to progress after 13 hours of contractions and I ended up with an EMCS. And baby was big, 10lb7, so the scan wasn't far off. She is perfectly healthy and I have come to terms with everything that happened around her birth now, but I do wish that I had stood up for myself with the new consultant and told her I wanted to stick with the original plan and had an ELCS. As PP have said, if you aren't happy then do try and get a second opinion. It is your body and baby and I'm pretty sure they can't refuse you an ELCS, especially given baby's predicted size and your experience last time. Good luck.

the law states you can choose the birth you want so you are entitled to an ELCS.

I'm afraid it really doesn't. NICE guidelines state that a woman should be able to have a CS if that is her strong preference. However, NICE guidelines are just that, guidelines, a statement of the ideal or preferred standard of care. They have no legal force whatsoever and hospitals do not have to abide by them.

You're not entitled to a CS and a surgeon is entitled to decline to do one if he does not feel it is in his patient's best interest. The evidence in this area is complex and ambiguous but doesn't really support ELCS for suspected "big babies". There is some evidence for benefit of induction before 40 weeks though. The latest evidence indicates induction is no more likely to end in a CS than spontaneous labour.

My baby was predicted to be big (10lb). The midwife referred me for early induction or ELCS as she was worried about the size. But the consultant said there was no problem with birthing big babies and they wouldn't intervene just because of size.

After an abnormally excruciating labour that failed to progress, it was obviously too late to consider early induction and the (different) consultant felt my baby had grown too large to birth vaginally, so I ended up with EMCS. During debriefing the consultant said I should have been induced early due to the size of the baby! So clearly different consultants have different opinions!

In your shoes I'd be pushing for either early induction or full term ELCS.

My consultant has just recommended a C-section (I am 38+1) and thought I would be induced but due to large growth rate (according to scan) she is recommending a C-Section for next week (came as a bit of surprise). She is concerned about shoulder issue for baby (there is a name for it where the shoulder gets stuck on way out) and due to my previous history - a late loss doesn't want to take any risks. Also because of my age (over 40), I was due to be induced at 39 weeks anyway. She says that an induction will not reduce the likelihood of the shoulder issue which makes sense. I haven't had long to get my head around it...now hoping baby doesn't come any earlier and a panic situation arises!

Wishing you all the best x

I had a huge baby (11lb 13 when he was born at 37 weeks). I had anELCS booked for 39 weeks due to his size but at 37 weeks they worried about my scar from a previous ELCS so I had him early. My first baby was 10lb 12 and the consultant recommended I had an ELCS when I went for a growth scan in the last few weeks.

I was a query for a possible section due to a medical issue but in the end the issue cleared up so i was allowed a natural birth. Ds was 2lb 2oz at 26wks, 2lb 7oz at 27wks and 9lb 1oz at 37wks. I eventually delivered 11lb 0.5oz ds naturally at 41+3 and it was a surprisingly easy labour given his size.

Hi any advise would help
A family member is due May 3rd she is only 19 and first child. Throughout pregnancy they have said baby is long (farther is tall ) in January they said baby was 1.4kg and was going to be big at birth.she has had 2 weekly Check up no health concerns so far.

She is 32 weeks or just over now, not sure of actual estimated weight of baby to date but midwife contacted her yesterday to say they are concerned her baby is going to be extremely big and they are concerned as dangerous to her and baby etc. And that she could go into labour anytime.

They have suggested that she be induced at 35 weeks ( few weeks time ) this is also part of a trial that apparently has been going on all over the country to measure something about injury's to baby shoulders etc when big and inducted compared to natural or CS births.
I'm concerned about this due due to baby being early but also that that she still would have to give birth natuarly, still could have major problems, or / and still have to have a CS.
They are going to do another scan and talk her through things in coming days.
Anyone here been part of this trial ?
Should she ask for CS rather than induction etc?
Thanks

Hi all
Update to above
Midwife said today that they baseing it on her 28wk scan which showed big.
She said baby's lungs would be developed by 35 wks but they will be looking at induction at 38 plus 4.
So 35wks they will do scan and talk through plan.

Obviously the later the better for my opinion, but why would they still not bypass induction at 38 wks and just do CS as baby will be bigger by then anyway ? so concerns regarding her and baby health and possible need to dicolatr shoulder etc would remain anyway
Sorry for such long post just trying to figure it out and help her.
Dee

Am watching this thread with great interest...have also been told I am having a huge baby, am 36+2 currently. Been so confused and stressed about it as at the 32 week scan they were talking about inducing me at 37 weeks...but then was referred to a consultant at 35 weeks who said she would let me go to term - even though I am high risk as have high BMI AND Gestational Diabetes. Had a scan this week and baby is still huge, over the 95th percentile. Im utterly terrified...baby is not moving anything like as much either which I've been to hospital for once but they just reckon she doesnt have as much room or whatever...its all just so stressful!!! I know induction is horrible and an ELCS definitely not the easy option but honestly how do you know what to do?! (I've also been told to do the big baby trial thing too - dont really know much about it) Am meant to be having another appointment with the same consultant next week so it all hinges on what she says, she was so dismissive of my fears last time, I felt so ignored. I'm not a pushy person at all naturally so am really nervous now....would feel so terrible if my baby had shoulder dystocia and it was just because I was too scared to stand my ground. Sorry for the rant as you can probably tell I'm a FTM

Hi if you Google big baby trials it should come up. If not I'll see if I can get it up and let you know quiet informative and I think some trials are good says they monitor children over few years to see if long term health po to lens due to shoulder dystocia etc
Mum to be is just 19 FT and at uni away from home, when first told about concern yesterday she has been in panic mood as she lives on uni campus feels scared she's gonna go into labour any time and have problems.
Following today's update from midwife it has relived some of the fear but !!!
She just got last week of uni next week but it's going to involve long days and traveling all over London so on viously she scared shell go into labour on tube etc. If all ok next week she will probably return to mums and do last bits of written work at home
So fingers crossed for getting next week out of way and her finishing uni work.
She only found out she was pregnant the day before moving to uni so would be a shame to waste the years work she's done away from home and pregnant.
Hope you find out more but make sure you get all the facts etc issues with your situation but at least they mentioned induction for you later than 35wks like they first said to her.didnt sit well with me personally. If me and sure that baby was huge I'd go for CS but that's me a lot of people have huge baby's with no or hardley any problems. Scans are not always accurate remember.
Hoping that her mum or I will go to next appointment with her so questions and options of CS that she probably wouldn't think of is asked and that she makes an informed choice.
Good luck keep in touch Dee

It's Big baby trials University of Warwick on Google
Dee