Induction for big baby

[Settlersofcatan]

I'm 36 weeks pregnant. My baby has consistently measured around the 95/97th percentile. I don't have gestational diabetes.

The obstetrician I saw wants to do another growth scan at 38 weeks and if the baby is still measuring that big, to schedule an induction. My midwife doesn't really agree with that and thinks induction at 40/41 weeks would be fine as I have previously had a large ish baby (8lb 7) at 41 weeks (spontaneous labour).

It does look like the evidence base is quite mixed for induction for this reason so keen to get any views on the approach and any experiences of early induction for a second baby would be good too

I was induced at 41 weeks for a big baby (9lb 7oz when born, 10lbs on growth scan the day I was induced). The induction didn't do anything (I'm convinced her head was too big for my pelvis) and so I ended up with an EMCS. That was my nightmare scenario going in, but it was actually fine - contractions were never worse than period pain even though I was having loads, and the section was lovely and relaxed. I had an easy enough recovery too. Just posting as I know it was a scenario I dreaded, but it was actually fine!

Best of luck OP

Maybe I'm misreading, but have they said when they'd schedule it for, so it could be 40wk anyway?

They have said they would schedule it asap after the scan so week 38 or maybe just into week 39 if they are heavily booked up

Some places offer induction to everyone at 41 weeks, and they may have reasons for wanting yours earlier, I assume there is some reason (may or may not be relevant) why you're also seeing an obstetrician. Maybe ask what the additional risks are as you've previously had a not tiny baby, and compromise on a date you're both happy with. Advice and policy varies, and it's up to how you feel about the advice you're given from different people (preferably professionals), it's okay to say if you want to wait an extra week if you're both doing okay.

Big baby, induced at 41
No progression whatso ever and they tried for over 24 hours then EMCS

I was induced at 40+4 for reduced movement but measured 3 weeks ahead at every appointment, same as above I did 23hrs labour fully dilated and had to have an emcs (taken to theatre for attempted forceps but she was too high up) she was too big for my birth canal! X

I’m 38+4 under midwifery led care and also have a baby that has consistently measured at around the 95th centile. I don’t have GD either (never actually been tested). It’s my first baby and no one seems interested in induction, my next appointment is for a sweep two days after due date. I am hoping he comes of his own accord soon because I am concerned about his size if we go overdue. My worst fear is him getting stuck during birth.

I would wait until 41 weeks if all is well.

My first was 7lb 6oz my 2nd 10lb6oz and I was induced at 42+3. I looked huge as I'm only 5' but always said I was measuring small 🤷🏽‍♀️ but never scanned.

The induction was fine, was induced with DC 3 at 40 weeks and it was a 3 day event just to get ARM, DC 4 induced at 42 weeks - much more civilised and quick to get into labour - they were both 9lbers.

I'm a bit in two minds. The obstetrician feels that an early induction is my best chance of a natural delivery - the baby is measuring so big that even at 38/39 weeks will likely be over 9lbs and I needed ventouse for my 8lb 7 baby last time.

But the evidence base doesn't actually show that early induction helps avoid a c section and an early induction might be really hard to get going so there's part of me that is tempted to delay induction by a week or so to give me a chance to go into labour spontaneously.

Then again the idea of not being heavily pregnant for longer than necessary is quite appealing!

Why did you need ventouse?

I struggled to push out my 7lb 6oz first baby I was tired, long induction, partly effective epidural.... next one 10lb 6oz was a doddle in comparison!

Early inductions I believe have far less favourable outcomes than post 40 weeks...

Can at 9cm following IOL at 41+1 due to abnormal CTG and infection. 10lb 5oz
VBAC with IOL for likely late onset diabetes, polyhydramnios and macrosomic baby... Normal birth with 10lb baby

I was induced last year at 38 for a big baby on the 97th (No GD) they couldn't get me going and he was born 38.3 by a 'semi elective' section at 9lbs, I'm due DS 2 next week and opted for an ELCS at 39.1 this time as my experience with DS was great

I'm in the same boat here. Measuring 97th centile and current weight estimated 6lb 10 at 34 weeks. Next scan is 38 weeks and consultant review but not sure what happens then. Seems late for me to be able to make a decision on what to do, if that's their plan anyway. Banking on going into labour naturally at 37 weeks but I know that's not likely!

Literally in the same boat a week ago.
Went in last Thursday at 37 weeks. Told it was 9 lb 5.
Booked me in for an induction the next day!!!!!
Basically, they worry that the shoulders will get stuck and then dislodge during labour.

Induction wasn’t easy to get going. I went in Friday. Had a pessary Friday- didn’t work. Had a pessary Saturday- didn’t work. Had the gel squirted up Sunday. Worked a little bit. Monday afternoon, my cervix was just about soft enough to break my waters, which they did on delivery suite and I was induced from there.
I managed a normal delivery with just the Midwife. Unbeknownst to me, an entire team of doctors, anaesthetists, extra midwives were huddled outside the door at the point of delivery in case of baby getting stuck. She didn’t and was delivered fine.

Good luck OP

I think I agree with your midwife. An 8 and a half pound baby is not in any way big for 41 weeks. I think wait for the scan.

@NeitherNowtNorSummat01 how accurate was the scan weight compared to birth weight? Congratulations on your arrival too x

I wish they had picked up my large baby early! Mine was only spotted by the consultant when I was overdue by 12 days. They estimated 10lb 6z. We argued about induction and C section. I had two previous natural births and my 9lb 6 DD took me a long time. Also I was anxious with this one as I lost my previous baby. So I got booked in for a C section and he was 11lb 4. The estimated weights can go either way. However if the weight with this one had been picked up at 38 weeks I would have opted for induction

In this case they were wrong. She was only 8lb4. I wasnt taking any chances. I was only 37 weeks at delivery though. Glad I didn’t wait. Previous baby was 9lb10.

I was induced at 37 weeks, big on scans, no GD. Had the pessaries in. Didn’t do anything to my cervix, Rock solid, unable to break my waters. Ended up having an ELCS and DS was 9lb 6 when born at 37+5. So I’m glad he was early. I dread to think how much bigger he would have been if I’d have gone to 40w or more.

I was induced on my due date due to a large baby - supposedly 9lb+

He was 7lb15

I actually loved being induced - the sense of control it gave me, I knew what to expect and when, and medical staff around me as soon as anything happened. They broke my waters and he arrived spot on 4 hours later.

I was induced at 37 weeks with my second because of issues that arose due to my big headed first baby which lead to a double episiotomy and 3 x fentons procedures.

It took a little while to get going but I had a lovely labour with just gas and air and baby arrived weighing 6lb 8