Earlier Induction? Late Induction? C-section? For Big Baby.

[QS90]

I'm at a loss of what to do, and feel like these options are like a game of "rock, paper, scissors" in that they all "trump" each other in some way but have their own flaws :(

I'm 30 and having my first baby, however it was difficult getting here as suffered with unexplained infertility, miscarriage, endometriosis which had somehow been missed for years and then IVF to get our boy. The result is that I' very mistrustful of both doctors and my own body. Furthermore my mum had a horrific experience birthing me in which we apparently both almost died, which is in the back of my mind.

Have really enjoyed my pregnancy so far, but was told last Tuesday (24th) that baby was already measuring an estimated 8.8lbs, and that because two measures are showing big (tummy and legs), he's more likely to be in the larger 10% margin of error than smaller (that is he could already have been 9lbs last week). They made a big fuss about needing to induce due to risk of shoulder getting stuck, and would have been fine with that, but they have scheduled it for almost two weeks later, on Saturday 5th! Presumably he will be at least 9.8lbs by then??

So do I push for an earlier induction, or try to induce myself at hone (have bought in castor oil and cumin seeds in case)? But then he will be born in his 38th week (I'm sure of the date as IVF), which I read online is not ideal? That is, possible short and long term health complications.

Or do I stick with the induction date they have offered, where he will be likely to be over the "safe" weight to birth? This way he will be more likely to get stuck, but his little lungs and brain will be more developed.

Or do I insist on a c-section? Then he could stay in there so his lungs and brain are okay and there would be no risk of his getting stuck? But I worry that this can go wrong and form the dreaded "pocket" in the uterus which causes pain and (more) infertility. I am also anxious about staying on the ward for ages due to the Covid (I live in Bristol) and would selfishly like to be as recovered as possible by Christmas.

What do I do?? It seems there is no right answer. Any advice would be much appreciated as need to either try self-inducing or booking earlier induction or c-section tomorrow...

Do not try to induce yourself at home, it's not safe. Ever.

Speak to your medical team about all options and express your concerns. Together you can work out an idea that meets your expectations and also keeps you and baby safe.

First of all, don't panic about the size - women can and do birth first babies that size every day (I did!) I don't think his current size would be an indication for CS on its own (usually that's 5kg unless you have GD) but you are of course entitled to one anyway if that's your true preference. There is of course a good chance that baby will come before your induction date anyway.

Talk to your team about your worries, ask if it's possible to move it a bit earlier? Don't try any home methods - castor oil will most likely just make you feel rough. Good luck!

Ok please do not try to induce your self at home. There is a reason they do these things in hospital with close monitoring. I have been in the same position as you!
My first DC was 8lb 4oz at birth and she had shoulder dystocia, I had an episiotomy and haemorrhaged. However...lots of women easily birth bigger babies so this isn’t necessarily a bad thing. The midwife said my pelvis is smaller than average and it’s just the way my birth went.
When I was pregnant with dc2 they kept a close eye on his size and by 37 weeks he was already measuring 9lb 8oz. The consultant didn’t want me to go into labour because of the complications with my first so booked me in for a Csection at 38+6 weeks to avoid me going into labour.
He told me that they don’t like to induce before 40 weeks as being induced increased the chances of you needing more medical intervention such as forceps or theatre etc, so if they is no medical reason/previous history that would indicate there could be a problem, they prefer to let you attempt to birth naturally then intervene only if needed. Most women can birth 9/10lb babies with no help!! Or they will book an induction from 40 weeks onwards.
I am assuming as this is your first baby they wouldn’t consider an early induction as there would be no medical grounds to justify that decision? Although different consultants may be willing to do so but you also have to consider those increased risks of needing intervention.
DS was 9lb 9oz but I went into labour naturally at 38+4 and ended up with an emergency csection as he was on his way out extremely quickly. The recovery was absolutely fine - was out of bed within a few hours once the feeling in my legs came back, home within 24 hours and walking/park with my eldest after 3 days but I think I was very lucky.
I think you should discuss all of this with your consultant and come up with a plan. They will listen to your concerns and hopefully make you feel a bit more reassured. A big baby does not mean you cannot birth naturally so please try not to worry too much.

C-section. Given the choice, why would you do that to your under-carriage? All the fluffy advertisements for tena pads with women smiling about "I don't care! I love being a mum!" is a euphemism for the damage that so many women sustain after giving birth.

@QS90 Firstly, please don’t try and induce yourself!! Definitely the least safe of all the options.

I didn’t experience any of the other health concerns you have had while trying to conceive but here’s my experience from a few weeks ago.
I was told from 34 weeks that our first baby was “huge” 🙄 they kicked up a massive fuss and sent me for scans and to see a consultant etc and I was strongly advised to have an induction...but they booked me in for 39+5. I also would have expected it to be earlier but was told that the point is just so you don’t go over the 40 week mark with a big baby. Our little one was estimated to be 10lb 9oz by full term at all our growth scans. They told me that it was a very accurate measurement and that baby was too big for a natural delivery of a first child 😓 I was freaking out. I decided on induction as I didn’t want the recovery of c-section if I didn’t need it. I’ve had abdominal surgery before and remember feeling horrific for weeks and I didn’t want that while trying to look after a newborn if I didn’t need to!
So induction at 39+5 with pessaries. They scared me no end going on about being a big chance of foreceps delivery or emergency section. Before they broke my waters they told me I HAD to have an epidural (which I refused) because it would be “too painful” otherwise 😓 my little one was born naturally with only gas and air and no need for any intervention. I had a few stitches internally but nothing major at all. Little one weighed 8lb 11oz, so nowhere near as heavy as predicted. Baby and I were home the same day as delivery.
Please don’t assume that it’s all going to go wrong! I was amazed how much my body just took over and it wasn’t until I was in labour and in the actual delivery suite that I became quite confident and just knew that I could delivery the baby 🤷🏻‍♀️

*deliver

Hi all, thank-you so much for the replies. It's interesting to hear that they often don't induce for big babies until their due date - the date they have me for is my actual due date so perhaps they had thought about it and scheduled it then because it's a good time? I'd assumed it was later due to them not having an earlier appointment with this baby boom that's going on.

After the advice, haven't tried to self induce other than raspberry leaf suppliments and a cup of cumin tea, both at the normal recommended doses, which I read wouldn't induce labour, only "help him along" if he was ready to go (wouldn't that be nice if he came along on his own before the 5th!).

Have decided to just go with what they have suggested with induction at the weekend but feel a lot better about it now

@RWK29 It's good to hear the similarities between our stories - I hope my story continues to mirror yours with the fewer stitches and quick escape from the hospital!

@QS90 fingers crossed all goes the same for you 🤞🏼 My advice would be to do research this week into all pain relief options and all interventions. Learn about all the risks abs benefits and know in your head and talk to your birth partner about what you’re happy with etc. I had a couple of older midwives at the start of my labour and I did feel like they were trying to push me into things until I very firmly said no. They also were only telling me the benefits of certain pain relief/ intervention and none of the risks. After change of shift I had two midwives roughly my age (same age as you 😊) and they were absolute ANGELS 😍 so encouraging and positive and happy to tell me anything I wanted to know and do whatever I wanted to try 😊
My induction was quite slow (more common with first delivery). I had 3 pessaries before they could break my waters. Take plenty of things to keep you occupied during that time if you’re not allowed your partner like I wasn’t. I was just stuck in a ward on my own with no tv or anything and midwives checking on me every few hours 🤷🏻‍♀️ Lol. Good luck and let me know how you get on 😊

I was induced on my due date in may this year due to a predicted big baby. He was 6lb4 at the 34 week scan. Born the day after induction at 10lbs.

Oops didn't mean to hit post so soon. I was so nervous and anti the induction but I'm glad I went with it, I think any bigger and I would have struggled.

Yes, certainly wouldn't want to go over that! I'm not so worried about the induction process as am prepared for the birth to be unpleasant, it's just the safety of when to do it really - when he is "fully cooked" but not too big. It's reassuring to hear the induction wasn't too bad though. I'm planning an epidural as for me it's one less thing (pain) to worry about, so am hoping the it takes away most of the pain of it.

@QS90 I think as close to your due date as possible would be best for baby 😊 at the end of the day, the growth scans can be so wrong so I really wouldn’t stress over the size 😊 I know that’s easier said than done until you’ve been through it though 😊
Definitely go for the epidural if that’s what you want and it makes you feel more comfortable 😊👍🏻 Have you looked at hypnobirthing at all? 🤔

Just wanted to add another positive induction and big baby story. I was induced with my son at 41+4weeks. I’d had a scan at 41weeks suggesting he was going to be 9lbs+ which was a bit of a surprise because he had been measuring average all through pregnancy. The induction went fine. It took a while and they had to try multiple things (hormone gel on cervix, balloon catheter, hormone drip) but I was keen to avoid a c-section. I did have to have a small episiotomy but that was partly because the heart rate monitor was showing he’d had enough and was ready to come out now, so the midwives were aiming for a short pushing stage. When he was born the midwives did ask where I’d been hiding him! I didn’t have a massive bump but he was 9lbs 5. Everything healed quickly and I had no other tears or grazing. No pelvic floor issues a year on. Bigger babies don’t always lead to more problems. I think looking after a bigger newborn is less scary too. They seem a but less fragile and you have a bigger margin to work with them losing and regaining weight after birth.

Fingers crossed for you OP. My LO was 10lb4, although we didn't know she would be big. She came out with a bit of help from ventouse but otherwise was reasonably straight forward. I'm know this is just my experience, but I want you to know big babies don't necessarily equal any unusual complications - my midwife said after that most big babies are fine, but it's just a tiny bit riskier for certain things.

I was induced with my 2nd at 38+2 because he was big, especially abdomen and head and my first was small, narrow and needed a ventouse having come spontaneously at the same gestation. He needed a ventouse/episiotomy and wasn't that heavy - did have broad shoulders, which are broader at 2 than big sis is at 5!