Big Baby - Induction or C-Section?

[MrsKT123]

TLDR: My baby is measuring large and they'd like to deliver her by 39 weeks. Would I be better with an induction or elective c-section?

I'm pregnant with my first baby and I found out at my 36 week scan that baby was measuring big (>95% centile). Have been tested for gestational diabetes and all came back normal.

I had another scan earlier this week at 38 weeks and baby has continued to grow and on seeing the midwife today she's said she needs to confirm with the consultant but that given baby's size they'd like to deliver her by 39 weeks.

She's said we can try some sweeps but it's more likely I'll need to be induced. I had an examination this weekend where the registrar had said my cervix was favourable / ripe for induction.

I would have ideally liked a water birth in the birth centre (birth centre is down the corridor from the labour ward if anything went wrong) but with the increased risk of her shoulders getting stuck this isn't advised. I know I could still opt for this but I'm so risk averse I wouldn't want to now.

Therefore, I'm really left between giving birth on the labour ward (whether through induction or going into labour naturally) or a c-section. The midwife wasn't keen on offering the latter.

I'm very concerned around the risks of intervention if I do give birth vaginally, particularly with an induction - whilst they can monitor me wirelessly so I can keep active / upright etc. I worry that the pain will be too much to manage with gas and air and with an epidural there's increased risks of intervention and severe tearing or needing a c-section anyway.

I'm also concerned about the amount of time the induction will take - I have stayed in the hospital for reduced movements and it was awful. It was unbearably hot (I had two fans and this wasn't enough - the other women were all complaining and my husband likened entering the ward to stepping off a plane into the heat). Also the bay I was in was filthy with wrappers, medicine cups, chips etc. on the floor, all marks in the baby bed left in there with me. They were so short staffed I just got left overnight with them not realising I'd not had the necessary tests until the next day (they didn't tell me I needed any to be chasing for these to be done).

I'm therefore also worried if I did require an emergency section / intervention they wouldn't have staff available!

So I wanted to ask on here - based on your experiences and if you were in my position, would you push for an elective c-section? Or is it always better to try for a vaginal birth where possible?

My baby was big (98 centile). The midwife was pushing for an induced vaginal delivery. The consultant said the risk was too high, not just for me but for the baby. She said if the baby got stuck it could lead to a dislocated shoulder or a broken collarbone and possibly permanent injury. And if he was stuck for too long he could be deprived of oxygen and end up with cerebral palsy. She said a c-section would be a million times safer for the baby because he’d just be lifted out. So I said I don’t care about myself just do what’s safest for my baby. Of course the stupid midwife was still trying to push me to ignore the consultant and choose an induction. I genuinely believe my DS would have been born disabled if I’d been induced.

I had my DS two years ago. I was induced because he was late. He was 10lb 8oz but I got him out myself and didn't tear badly. A big baby doesn't always mean a difficult labour. But I also didn't go in to it knowing he was so big so didn't have that playing on my mind. With my first baby I had an episiotomy and ventouse and found the recovery much harder. She was only 8lb 11oz.

I found the experience with DS absolutely fine, it was great actually, but I had a brilliant midwife on the day and that's not something you can guarantee.

Hmm I’m sure they know what they’re doing but I almost had this with my first baby. They freaked me out saying she was measuring large but I had a follow up appointment with the consultant who said I could wait for spontaneous labour up to a point..I delivered a day before my due date naturally and she was 7lb 15oz so not huge! It does make me wonder how accurate these are / is it just down to the individual hospital trusts policies?

@PigeonPink

My baby was big (98 centile). The midwife was pushing for an induced vaginal delivery. The consultant said the risk was too high, not just for me but for the baby. She said if the baby got stuck it could lead to a dislocated shoulder or a broken collarbone and possibly permanent injury. And if he was stuck for too long he could be deprived of oxygen and end up with cerebral palsy. She said a c-section would be a million times safer for the baby because he’d just be lifted out. So I said I don’t care about myself just do what’s safest for my baby. Of course the stupid midwife was still trying to push me to ignore the consultant and choose an induction. I genuinely believe my DS would have been born disabled if I’d been induced.

I had shoulder dystocia with my 2nd (slightly smaller) baby so god knows why I insisted on trying vaginally with my monster 3rd baby.

I had GD for both my pregnancies. First baby, measuring over 95th percentile, induced early. Had slow 2 days of waiting for pessaries to get things started, then it was all go! He was back to back, had assisted delivery, tear and episiotomy. Labour was short but painful, was allowed in pool while dilating but then gave birth on bed. Baby wasn't as large as feared, 8lb 12oz. I think would have been OK if not back to back. Wounds were sore for a few weeks but manageable.
Second baby, measuring off the charts big at 36 weeks. Induced by manual breaking of waters, which was enough to kick start labour. I'd already had several 'false starts' in the previous week. Birth was smooth, no intervention, over in 2 hours. Minor tear that healed really. Rapid recovery. Baby was much smaller than expected, at 8lb 6oz.

I got myself in a worry over shoulder dystocia, as I have a friend with this birth injury, but it's fairly rare and I have a wide pelvis. Vaginal birth was my preference, better for babies lungs, usually shorter recovery time for mum but tougher during the labour. I was put off c section as you can't drive for 6 weeks ( not ideal where I live).

Seek advice from your midwive and consultant. Despite not having GD, I'd suggest looking at a GD website, specifically the birth section. www.gestationaldiabetes.co.uk/
Then make the choice YOU are most comfortable with. Go with your gut.

@shas19 my consultant tried to scare me into a section I feel I do want to try for a VBAC she said ideally they like minimum of 24 months between last section and next birth and mine will be 15 months so I don't know If im being stupid or
How much the percentage goes up with a section scar and the added risk of it being a small gap
Such a hard choice

@jozipozi31 Jesus this scared me that's so sad. Did her scar rupture?

I would always opt for a natural birth, However baby number 3 was overdue and that is when they noticed he was big. Predicted weight of 10lb 6. They pushed for me to go for induction but my last labour was 36hrs and she was 9 6 so I said nope and that I wasn’t going to give it a go. Glad I went for section as he was 11lb 4

I had an ELCS my DS was 10lb 1oz. Consultant said during the csection I could never of delivered him myself, I never asked why I was too focused on everything else going on around me.

I wouldn't of chose induction but if he came naturally before the csection I was going to try to labour myself, going from what the consultant said it was a good thing I didn't

Personally I'd go with the elective c section , calm & planned .

Wouldn't be having sweeps and other meddling / interventions . My idea of hell.

Would rather know what is happening when .

Many midwifes have incorrect views on Electives based on NHS "policy" .

There's a great article on new scientist re risks from vaginal birth Vs elective risks ... as typically as electives data is lumped in with EMCS .

@jozipozi31

But it's a big decision as then you're C sections later too for more babies. I wouldn't risk VBAC. I know someone whose baby died and she had to have a full hysterectomy to save her life.

So C section is a choice for life.

This is very sad but is also seriously scare mongering and probably a very rare occurrence. Some women and children die during natural birth, too. VBAC is often safe. There is no 100% safe way to give birth for mum or baby!

Mumsnet tends to be very pro c section, which is interesting! I often notice there are a lot of posters on here who advocate for c sections. Personally I really wanted a vaginal birth as did most of my friends and would only have chosen a c section if there were no other options left.

However, reading between the lines OP it does sound to me like you prefer the option of a c section in which case I think you should push for it. You have the right to request one anyway, but they should take you even more seriously now they've told you this information about the baby's size and worried you with it.

For me the recovery from a (non instrumental) vaginal delivery was FAR worse than the recovery from the section. No comparison really. And that's without taking the awful pain of drip contractions into account, or spending days and days on the induction ward...

@slippersandprosecco

For me the recovery from a (non instrumental) vaginal delivery was FAR worse than the recovery from the section. No comparison really. And that's without taking the awful pain of drip contractions into account, or spending days and days on the induction ward...

Have to agree with that. I actually found c-section a breeze, minimal pain, I was up on my feet almost straightaway and never struggled to get in and out of bed or picking up baby. I'd heard so many horror stories I was prepared to be incapacitated for days but in reality, my vaginal deliveries resulted in so much more muscle pain across my entire body, like I'd been in a car crash.

And that was a c-section after 5 days of induction, and drip-induced contractions...

Elective section

I know quite a few women who had ELCS and they all said it was a really calm experience, and none of them had long term complications or problems. I know quite a few women who ended up with forceps and has lasting damage, needed physio etc. I would never choose induction due to the higher risk of interventions such as forceps.

Plus with induction of a first baby quite likely to end up in a section anyway, but an emergency one which is far more stressful than elective.

Curve ball but this is the current NICE guidance -

In the absence of any other indications, induction of labour should not be carried out simply because a healthcare professional suspects a baby is large for gestational age

In the absence of GD I would wait for spontaneous labour. I would have far more confidence in my body’s ability to birth a large baby if labour begins spontaneously than if labour was induced.

I agree. Measurements were totally over estimated in my case and had a natural labour, 25th centile baby.

I had a big baby (first one, early pandemic, 10lber 😬) and I was induced due to his size. The induction was quite quick but he got rather stuck and I ended up with forceps and episiotomy and it was quite traumatic. That's not saying yours will end this way but I have been told planned c sections are quite chilled and nice. Recovery might be harder with a c section though.

I was advised induction due to baby measuring >97th percentile and approx 9lb at 38 week scan at a fetal medicine unit (so thought this would be pretty accurate).
I was induced last week af 39+5, had pessary which got me to 2cm but I'm contractions too intense & back to back so removed & waited for waters to be broke but there was no bed on the maternity ward so had to wait 2 days. Friday they broke my waters, failed to progress past 4cm so had sereronin drip & epidural. Confined to fail to progress and baby distressed & I had fever so had EMCS Saturday night...baby came out at 7lb 15oz

...serotonin drip*

ELCS is a less risky option than assisted birth or EMCS.

What chance do you think you have (or have you been given?) of having a smooth and unassisted labour requiring no instruments, following induction with such a large baby.....?

DD1 (first DC) was very overdue as I wanted to wait to go into labour naturally. I had an unsuccessful sweep, and was then induced on the drip. After a long labour (18 hours on the drip) I was actually becoming less dilated as my body had been through so much. After ‘failing to progress’, I had an EMCS - which was calm - and DD was 10lb. (They had said 7lb....)

I found the C-section great. Recovery wasn’t painful. I then went on to have two ELCSs. All good experiences.

If I had known she was 10lb, I would def have opted for a C-section.

It’s concerning that you found the ward dirty OP. Have you complained about this? With a section you would only be on the post-natal ward which would hopefully be better?

With a section you would only be on the post-natal ward which would hopefully be better?

The postnatal ward was the worst part of my experience both times. Maybe it depends on the hospital.

Yes postnatal wards seem to vary hugely. I had two excellent experiences, both before and during covid, while you read some real horror stories on here.

@CherryMaple if you don't mind me asking, have you had three sections? My consultant advised me I may only be able to have two and she wouldn't advise me to try for a third baby after two sections wether it be a vbac or section.

@ohthestruggles mine has said they would be happy to do 3 and wouldn't rule out 4 it must be personal