Large baby - birth choice

[Leaf86]

I am currently 38+5 and I have an elective c-section booked for 39+4 next week. To cut a long story short, baby is measuring big with head on 97th centile (estimated already 9lb from growth scan two days ago) and I have a slightly higher chance of a PPH due to a bleeding condition. There is also a small small chance that the baby would be affected and could also be at increased risk. I’m a FTM.

I am really scared of a section, but also pretty scared of a vaginal birth (both for myself and the baby). I’m basically wondering whether to try for a vaginal birth if I go into spontaneous labour in the next week (pre section) or insist on the section. The consultant seems happy to let me choose but I would be on a “low threshold for c-section” care plan if I do try for vaginal.

I have emetophobia and am scared of vomiting in the c-section as I have heard it is common. I’m also worried about recovery, but most people I speak to think I should just go down the section route for the fact that it takes away the uncertainty of a traumatic vaginal delivery for me and bub. Any positive stories or advice really welcome!!!
thank you.

The vast majority of women can deliver their babies vaginally without intervention, bleeding is rare. Unfortunately the only people who talk on forums or stories feature in programmes are dramatic ones which skews public perception.

With a bleeding disorder you are weighing up the risks of known bleeding from a c-section and the potential for tearing and haemorrhaging from a vaginally delivery I'm guessing? Only the expert can advise you but it seems that they aren't overly concerned either way if they are letting you decide.

For what it's worth (as i don't have your disorder it's not really relevant) both of mine were delivered naturally, no pain relief, no sickness, 12 hours and 8 hours labour for each, not very painful so really doesn't make a good yarn for tv producers or Mumsnet (it has to be long or short it seem to be interesting). As for the size prediction, I was told dd was 8lbs a week before she was born (late scan) but she was 6lb3!

I've been induced 4 times and had whooping 10 & 9lb babies and have teeny tiny hips and am 5'

The labours were long for 2 of them but the delivery part was fine not stitches or assistance even when I had an epidural.

If you aren't coping you can easily switch to having a section.

2 big babies here (8lb 15 and 9lbs) delivered quickly (labours 2 hrs 45 and 1.5hrs) in the water. I had a second degree tear both times (their heads were over 100th centile!) but healed really well. I was running around day after the birth and think I’d have struggled with c section recovery.

In case relevant I’m 5’7 and a size 10 with slim hips so tallish but not massive. I don’t think you can tell how delivery will be so it’s a gamble vs the certainty of c section.

Have you spoken to an anaesthetist about the different anaesthetic/pain relief options for a section/vaginal delivery in the context of the bleeding disorder - depending on what the problem is it may influence the options available and might help you decide?

An elective section is safer than an emergency one.

@Greybeardy yes I have - so far it’s ok (for epidural/spinal) but I will have another blood test early next week.

thanks everyone - some really reassuring perspectives on vaginal birth here. @DustyLee123 yes this is the complicating factor ! I am probably just trying to control the uncontrollable at this point tbh. 🙈

Vomiting is common in vaginal births, so the midwives tell me when I vomited both times. So I wouldn't factor that in your decision. Unfortunately it's a possibility either way.

I had three big babies by vaginal delivery 30 plus years ago - 9lb nearly 10lbs and over 11lb. I've always been a slim size 10/12 and had no real issues - except with the last had mild shoulder dystocia

No problems till the menopause and then my pelvic floor damage became apparent. Worth considering future damage!

@Leaf86 i had an emergency section last month and honestly found recovery fine. Was discharged less than 24 hours later. I'd say I had 2days of really feeling sore but I kept on top of pain relief and I was out walking straight away.
I know everyone is different so you can't base it off my experience but i thought i would share mine.
Wishing you lots of luck. Xxx

It's totally your choice - I had an ELCS partly because I wanted to control the situation more. I did have a small PPH but it was easily dealt with and just meant I had to have an extra blood test at some point before discharge. The main thing I wanted to say though is that the anaesthetist gave me an anti-emetic during my ELCS because I was very worried about being sick.

I also have emetaphobia and had an elective c section. I just told them I had a fear of being sick and they gave me some anti sickness meds as a precaution. I didn't feel or be sick at all in the operation or after. I do know a lot of people who were sick with a vaginal birth as an early labour sign.

I was recently reading some research (sorry, can't remember where) that rates of prolapse post menopause are the same for women who have never given birth as they are for women who have.
So might not be linked to your births, though in my case pregnancy (not birth) weakened by pelvic floor considerably much earlier than menopause. Thank god for a great women's physio!

And OP, another one here who was regularly sick in one of my labours, so I wouldn't factor that too much into your thinking.

Do they know why baby is big? Do you have diabetes or anything? That can increase the risk of the shoulder dystocia I believe. Also, are there other factors at play for why you’re getting induced? It’s not recommended solely because of big baby I didn’t think? I feel for you OP it’s such a hard decision.

Ds was 9lb baby. Measured off the scale all through pregnancy. So he was big, but not exactly ‘off the scale big’.
I’m 5’4 and was size 6-8 at start of pregnancy. Fast delivery, no problems. I was sick several times during labour though

On the sickness front I vomited through my vaginal labour and had an elective section for my second. As I have HG in pregnancy I was on anti sickness tablets up to birth anyway but the anaesthetist gave me anti emetics through the drip once he heard about the HG anyway. Definitely wouldn’t let vomiting be the thing that sways you towards vaginal over section.
I can’t comment on the risks with a bleeding disorder but my recovery was much easier post planned section than with my first. Good luck with whatever you choose x

Not quite the same as my second baby was measuring bang on 'average' all through pregnancy but turned out to be 10lb 4oz. I had a home water birth (my second) and he was born within about 4.5 hours of my first contractions - no tears or grazes or any complications at all. Can't help with the emetophobia as I've not been sick in either labour but some women seem to be more affected. If you do go for a vaginal birth it's most important to keep moving and find whatever position works for you - don't get stuck on a bed. Good luck!

I vomited after having a baby naturally too so don't base your decision on that. They can give you antisickness drugs anyway either way.

I had a big baby (9lbs 13oz) and ended up with an EMCS after failure to progress and his heart rate starting to drop. If I had to make the decision again, I'd opt for an ELCS every time. Even my EMCS was a great experience overall, minimal fuss, no sickness, recovered well after.

My first baby was big (11lb 5) and I had an emergency c-section after a long labour. My
elective with my second was so much better - calmer with a much faster recovery. My friend who is a consultant anaesthetist advised me in my first pregnancy to have an epidural if it was offered during labour, as I would be ready for a c-section if it came to it. That turned out to be excellent advice. This might be worth bearing in mind if you decide to try for a vaginal delivery. It's so difficult to predict birth weight. In my case the baby was estimated to be 9lb and he was 11lb 5. My friend was told her baby was big and he was just under 8lb. It's a guessing game rather than an exact science, which doesn't really help you to make a decision. Wishing you the best of luck whatever you decide.

Honestly I’d recommend ELCS. As a poster above mentioned, it’s safer (and not as taxing mentally) than to have a failed labour turn into EMCS. Also consider things like pain relief. It’s all very well poster above saying it’s a good idea to get an epidural, but not all women get epidurals if there are a lack of anaesthetists around to administer them.

I have had one almost 10lb baby vaginally and one almost 10lb baby by elective c-section. I was terrified of the c section but it was absolutely fine - discharged after 24 hours and up around from that point. No real issues with pain to be honest. My first vaginal birth was a 12 hour labour with no pain relief if that helps.

My vaginal labour was one of the horror stories, I won't go into it as I don't want to frighten you but I'm my opinion don't risk a vaginal delivery with a baby who is thought to be large. It's not just about a bloody hard labour and tearing it's more about the safety of your baby and whether they are born alive or not and whether they have brain damage or not. Absolutely not worth the risk, trust me I have horrible first hand experience and I wouldn't wish that on anyone.

Up to you, but all my babies were 99th centile heads (as am I and DH), and...it was pretty ugly but fine, no forceps, just a butcher's shop for a while. I loved the experience of the 2nd and 3rd deliveries, which I probably wouldn't have had if the first had been c section. In your situation I'd probably lean towards c section though.

I don't get why you'd not have an ELCs.

The risks of long-term damage delivering this way are less, especially for larger babies.

The risks to baby is less too.

I've had 2 sections and no vomming

My baby was predicted to be 10lb. Everyone told me the prediction would be way off. He was 9lb 15oz when he arrived at 39+4!!

I was petrified of my ELCS however I can say hand on heart that the waiting to go down to theatre was the worst bit! I’ve previously had a vaginal birth and I was so shocked that a baby could come out so quickly 😂 He was literally born in about 10 mins of the procedure starting.

Anaesthetists are fab and if you explain your fears in advance around sickness they will look after you. I felt mildly sick just before baby arrived but within seconds of me telling my lovely anaesthetist he adjusted something in my IV and it was gone.

Also just to add, I don’t believe DS has had any health issues as a result of being a c-section baby. I always think he arrived in such a chill way. Just sitting there, lifted out, no stress, cleaned up and cuddles. My poor DD who I had first was suctioned out with a ventouse and got stuck. She had a cone head and it was all a bit traumatic for both of us.