Big baby - wait, induction, or elective?

[Bobbie098]

I'm 33+2 with my first and have been told baby is measuring 3 weeks ahead (based on fundal height and same again on ultrasound). I know these measurements aren't always accurate, and I do have another scan in a couple of weeks to see if baby is still on the same trajectory, but I'm getting so stressed and anxious about labour.

Doctor has been lovely and said it's entirely up to me what I want to do - watch and wait for labour to begin, induction, or elective c-section. If anything she was TOO supportive of me deciding for myself (I know I sound crazy) and I kind of wish someone would just give me their professional opinion. I feel so much pressure to make the right decision and if anything goes wrong I'll only have myself to blame.

My main worries are shoulder dystocia and severe tearing. I've read every article, forum, and thread I can possibly find but I'd love to hear if anyone has any advice or wants to share their labour experience or how they made their choice. I keep reading that shoulder dystocia is rare but then there are so many people sharing their experience of it, if definitely feels like it's more common than the stats suggest?

I don't know if any of these factors make a difference but I've pointed out some other things about my situation below:

• I had a high BMI of just under 35 at my booking appointment. I'm about 5'3 in height
• no gestational diabetes when originally tested but I am waiting for the result of a retest that doctor requested
• I was 7lbs when born but partner and his sister were both almost 10lbs
• parter isn't overweight or particularly tall but is broad, like rugby player stature, and everyone jokes about the size of his big head too!
• maybe TMI but I've always been pretty sensitive down below and regularly have small cuts quite easily from sex or even sometimes from bowel movements (have seen GP about this before and nothing sinister at play). I don't know if this means I'm destined for awful tearing or if it's not really relevant?
• I experienced sexual abuse as a child, I originally didn't think it was going to impact my birth plan but now the thought of a huge baby and all the possible interventions is making me worry I could end up traumatised.

Apologies for the lengthy post. This is my first time posting on mumsnet and I thank you in advance for any responses x

It's a very personal decision but I can share what I did - wait. Both mine were "big", I was induced with my first but not for this reason and and she was predicted 9lb6 ish and came out 7lb11oz. Its common and I've heard it happen to many others

My second was a spontaneous labour and was 10lb3oz. It was a very very easy birth with a minor tear which caused me no real bother.

Regarding your last point, I'm so sorry you went through this. Be mindful that induction often results in extra intervention. I'm not saying you should or shouldn't have one, just that it is something to consider in the grand scheme of things. You have some time and things could yet change. I hope all goes well regardless of what you decide.

I was induced at 40*2 due to ivf baby. Naturally delivery ended in fourth degree tear horrendous receiver and has left md with a prolapse. Second baby was ELCS measured small at every scan (twice monthly) delivered at 36+3 due to weight weighed 6lb 3 so not bit small. Great recovery would highly recommend!

Honestly from everything you've posted I would opt for a planned section and just enjoy the calm nature of it.

In your shoes I would have the elcs 🙂 I’ve had a birth with bad tearing and another that was an emcs , the emcs was much easier to recover from for me personally. Good luck to you with whatever you decide.

@Bobbie098 is it your first baby?

my second was predicted to be well over 11lbs.

i would avoid induction if I were you.

As other have said it often leads to more interventions and getting a baby out early makes for a harder newborn (eg they develop their sucking reflex around 40 weeks so early babies often find breast feeding tricker)

in your position I would go for elective c section no earlier than 39 weeks.

i had one and it wasn’t what I wanted. I wanted to wait for natural onset and give it a go. But my obstetrician wasn’t up for that. She wanted early induction (37 weeks ) I refused that.

we compromised on waiting until the end of week 39 and c section then if no labour.

it was fine. Recovery was fine. Nice and calm and straight forward.

with a history of sexual abuse I’d be wary of what birth might trigger - it’s intense for everyone. I had other fears triggers and they did come up during my first labour.

you could go for wait for natural onset and then straight to c section if any need for interventions or if you feel uncomfortable.

but once in labour medics can ‘encourage’ you to stick with it if they think physically it’s going fine.

and eventually you pass a point when it’s too late for a c section.

the person I know who was most freaked out by her labour on paper had a text book ‘natural’ birth.

but although in hospital the medics didn’t believe she was in labour until she was crowning. She spent most of it alone in a toilet having midwives tell her she wasn’t in labour and not to be silly. Wouldn’t call her husband.

the emotional side matters.

play it safe - elective c section.

good luck!

To be clear:

with a history of sexual abuse I’d be wary of what birth might trigger - it’s intense for everyone. I had other fears triggers and they did come up during my first labour.

here I mean I’d be wary of attempting labour and vaginal birth. It is very intense, both emotionally and physically.

one of the reasons I didn’t want a c section was that I was up for that and I did notice the difference vs my previous a vaginal birth (which had its fair share of trauma both in itself
and what it brought up for me)

but it was safe, calm. Better than vaginal birth with lots of interventions. Had one of those, wouldn’t do it again.

I'd go for a planned section. My niece tore badly after her first large baby 10lb 4oz. For her second they offered her C section but she opted for induction. Her second child was 11lb 6oz she had very bad tears and was cut too, had to have a forceps delivery, lost a lot of blood and took about 10 months after the birth to feel comfortable again. Afterwards she said she wished she'd opted for a C section and it was only not being able to drive, because of insurance, for about 6 weeks that stopped her.

All things considered in your shoes I would opt for a planned c-section. I have had three natural births and while they mostly went well it really doesn't define anything about you as a mother / your baby.
Once the baby's there and your scar is healed it will be a minor detail. If you had a traumatic vaginal birth it can lead to physical & mental pbs

Whatever you choose I would rule out the induction...

My 18-year-old d's (adopted) has a history of sexual abuse and as luck would have it, was assigned a male midwife about an hour before she gave birth.
I quietly left the room and explained the situation and with no fuss he was discretely replaced as I know she would have freaked out when he had to examine her - she had a hard enough time with female midwives doing it.
She was induced at 38 plus five to an 8lb baby and did need a lot of stitches for tears. Started off with pessaries on Saturday lunchtime but labour only really got going when she had the hormone drip when she gave birth on the Sunday evening. She really struggled to deliver the head and there were concerns about the heartbeat dipping but all good in the end.

Given the choice between an induction and an elective section, I’d go for the section every single time.

So many positives of elective surgery. You go into it comparatively well rested (as opposed to a physical and mental wreck after a long stalled labour) with the added bonus of not having to have any contractions.

The last two women I know who’ve needed inductions both had a horrific time ending in emergency section. Not worth it IMO.

Elective

Elective

I measured 47 cm at 37 weeks & they wouldn't do anything. I was induced at 41 weeks & ended up with a c section - baby was 10 4

Elective section for next one at 37 weeks as he was predicted to be bigger if I went to term or beyond. He was 9 3

Hi OP, my first two were virginal deliveries but to small babies, 5.13 and 7.14. My third was an induction (projected to be over ten pounds, was born 9.12) but once the induction had started it was complication after complication, ended up being taken for an emergency section which luckily turned into a delivery with forceps but intervention none the less, it's very common with an induction. For my fourth, also predicted to be a "big baby" I had a section as I couldn't go through the stressful delivery again. My first two were so simple and quick the third was a shock and I just didn't want to repeat the trauma so elected for a section. Fourth one came out smaller than the third 🙄 the c section was so calm and even with three others at home recovery wasn't as bad as I'd feared

Given all the points you mentioned I'd lean towards a c-section because it sounds the best fit at least stressful given all the factors you've mentioned.

I made the choice to have an ELCS in that situation and was happy I did. Scan measurements were bang on and delivered a 9lb7 baby.

My reasons were:
Risk of shoulder dystocia with natural
Risk of further interventions culminating in emergency section with induction
I considered the planned section the safest option for us both.

After delivery the consultants all said it had been the right call.

Both my DDs were 'measuring ahead' and neither were abnormally large (8lbs 3 and 8lbs 15ozs). However, for all the other reasons you've stated I'd go with the ELCS. Both of mine were and were so lovely and calm and stress free and the recovery was nowhere near as bad as I expected. You want to enjoy your pregnancy and it'll relieve a lot of stress to have it booked in.

Personally, I’d go for waiting or an elective. Absolutely wouldn’t have an induction with your first.

Thank you everyone for your kind words and advice so far. I didn't expect such quick responses, thanks for taking the time.

I think I'll rule out induction because of the increased likelihood of further intervention. I'm leaning towards elective c-section and it's reassuring to know others with experience agree. I know every pregnancy and labour is different anyway but it's an absolute mindfield when it's your first isn't it?! Don't think my anxiety can handle all the unknowns.

My next growth scan is 12th May so I'll see how that goes. I should see the doctor straight after the scan as I did with my last one, so I'll let you know the final decision.

Has anyone who had an elective got any tips for preparing or things to have ready for after? Trying to control and plan everything as much as possible has always been my coping mechanism, much to the annoyance of my family 😂

DD was 9lb 10oz, she must’ve had a growth spurt at the end, because no one predicted it! I had a VBAC, it was under 6 hours, but I did have alot of stitches and hemorrhaged, which made my recovery longer.

Mu docktor suggested inducing at 39 weeks to prevent a repeat of this-he popped out in under 3 hours, 7lb 12oz, two stitches ( old tear didn’t reopen) and I was up and about the next day.

I know that induction isn’t great for everyone, but it worked out for me.
My DH is what I’d call a “rugby player build” so I blame him for the large babies, I’m petite. 😂

Sorry, I meant to say an induction for DS, my second child.

In terms of things to have and prepare I'd say just make sure you have everything to hand as you'll have a catheter and won't be mobile for a while afterwards! An extra long phone cable as I managed to yank my cannula out trying to charge my phone! Drinks and snacks on the side table and a baby bag with nappies/wipes/changes of clothes right next to you so you can change baby. I brought changes of clothes and toiletries etc but realistically you won't be up and about to use them in the first day or so. Drinks/snacks and your phone are all you'll need. Make sure to stay on ahead with your pain relief as when it hits it hits hard. Also some peppermint or similar for the post surgery gas (oh the glamour!)

We chose a natural birth as a growth scan at 34 wks suggested baby would not be big as previously measured.

Baby arrived at 10lbs exactly, shoulder dystocia and birth injury sustained by both myself and baby. DC recovered well luckily.

Birth was very traumatic, I wish I had chosen an elective section in hindsight.

I would wait for labour, your body will know how to do this!

If you go too overdue I would then opt for a c-section. Absolutely decline induction in this instance.