Considering maternal request c section for large baby

[CoralFz]

I am currently 38+3 weeks and the other day I had a growth scan. I was told baby is already estimated 8lb5 and could be around the 9lb5 mark at due date. Having a large baby hadn't occurred to me before then and I was fully prepared for VB. I know hes not as big as he could be and people have birthed bigger naturally. I'm also 5ft7 and perhaps that's why they didn't seem overly concerned too.

However, after the scan I spoke to a doctor. Male, older, quite blunt and not at all reassuring. He went through the risks of LGA babys and VB telling me about increased risk of a heavy bleed, more of a liklihood of instrumental delivery, baby getting stuck, tears that extend the all the way to the back passage etc etc. In all honesty he scared me completely. Obviously these are always the risks with VB but to be told two weeks before due date that these things are now more likely has sent me into anxiety over drive.

He has booked me in for another scan when I am 40 + 1 weeks and it just wasn't sitting right with me. I kept thinking but if I go into labour on or just before my due date and he's as big or bigger than they're estimating I've had no time to consider other options.

I spoke to my midwife yesterday and she was very understanding. She reassured me that growth scans aren't always accurate and that the margin of error could be around 20% either way. (Although in my head that could be a margin of error that he's actually 20% heavier than they estimated too!)

She asked me what I would feel more comfortable with in terms of perhaps induction or c section. I am quite against induction specially at this point as I know it can sometimes be a long drawn out and more painful process than spontaneous labour. Even taking days or upto a week to give birth, and that would ultimately take me to my due date anyway.

I asked if perhaps I could have elective csection booked 1 week before my due date. Giving baby a chance to arrive sooner by VB around his current size and the csection be there as a back up so I don't go any further. She assured me this should be fine. Though I got quite upset as I know there is some stigma around mrcs and I feel some kind of shame around asking and that I may be judged. She was lovely, told me it's my body and that it's not uncommon for ladies to elect for csection with larger babies.

I now have another consultation booked for a couple of days time to discuss this all (purposefully with a different doctor to the one who scared me). But I'm still struggling with that feeling of am I doing the right thing?

I've spoken to my partner and parents and a friend and they have all been supportive and say that if a csection allows baby to be delivered safely without getting stuck without trauma and I'm avoiding all the risks mentioned then it is fine to take this route. That if I went ahead with VB and something did happen I would kick myself for not following my gut. I just wish there wasn't this guilt feeling, even though I'm fully aware a csection is in no way an easy way out either.

OP firstly if you want a C-section have a C-section. But all of this seems to have come about because a doctor scared you about risks that if you did down aren’t backed up by research.

If big babies have more interventions it is because of the medical system we have them in cause them. Eg. Inducing for a big baby, you’re basically setting someone up to fail. You want to leave the woman’s body well alone so that baby can get into the best position possible ready for birth and let labour start spontaneously.

You want to allow the mother to have freedom to move around as her body tells her to again to allow baby and mum to be in the best position, something that very rarely happens with induction, births where there is continuous monitoring or an epidural.

The research behind shoulder dystocia (babies getting stuck) shows a pretty even spread across babies of all sizes. It isn’t a large baby issue. It is another thing that induction increases the chance of though.

Tearing happens in brith, especially first babies tbh I’m pretty sure it’s why we have a perineum to allow the area to hear and heal without issue. In the vast majority of women tears heal and cause no further problems. I had a second degree tear that took about 20 minutes to stitch up and it doesn’t look or feel any different now to how it used to.

Third or fourth degree tearing is very unlikely about 3 in 100 births and is much more likely if you have an instrumental delivery. So the chances of this happening anyway are very low, if you weren’t Interfered with during labour, if you let your body push your baby out, so no coached pushing and if you’re able to be in a good position (not on your back) the chance is even lower.

Also the difference in head size with a 7lb baby and a 9lb baby is really small and that’s the part that’s effort to get out.

Sorry I have to disagree with this post.

IME, waiting for spontaneous labour is not always the best option. Many women never go into labour, myself included, hence the need to be induced at nearly 42 weeks.

Not sure where the idea comes from that the mother can’t be mobile after induction? Many mothers are sent home. I was perfectly mobile.

Don’t trivialise the birth injuries that many women go through after VB, including tearing. A midwife explained to me that the reason so many births need assistance is that the birth process hasn’t caught up with evolution and we are supposed to be still walking on 4 legs, making birth easier. Yes the NHS is asbolute crap, but there are other factors as well.

I had an elective c section, for no reason other than that I wanted it. Zero guilt. Its no-one's business why you have it.

Thank you for all responses, both in support and also ones giving a different take on VB to how I'm currently feeling. Of course I absolutely know a VB could go fine and the risks doctor gave haven't increased by huge amounts but at this point they are still risks, and risks I don't think I want to take. I'm not entirely sure where the guilt/shame feeling is coming from because I myself would never judge any one for this decision! If a friend came to me with this, I would absolutely say if that's how you feel is safest right now then it's your choice and nothing to feel weird about at all. So I don't know why I'm not going by what I would say to others.

VB with large-ish baby (8lb 8oz) lots of complications. Lots of damage. ELCS with second baby. Significantly easier recovery and much nicer experience. Have the c section (if you want it)

The OP wasn’t talking about being 42 weeks + she’s currently 38 weeks. This was a conversation about a large baby and what to plan for, not a 42 week baby.

Inductions for first baby especially are pretty likely to need the drip, It’s wrong to tell women only about the first part where ‘things might happen on their own’ because in lots of cases it doesn’t and then they’re stuck on a pathway they can’t leave. A lot of women can’t be mobile during the later stages of labour for an induction because if you have the drip continuous monitoring is required.

I’m not trivialising birth injuries. The stats are 3 in 100 for 3rd and 4th degree tears. That is very unlikely. I still stand by that the majority of these wouldn’t happen if there were fewer interventions. This doesn’t make them any less distressing for the women who have them but it does make still them very unlikely and it does mean that there could be choices women can make (if they are correctly supported) to make this kind of tearing less likely to occur.

As someone who was told their baby would be at least 10lbs, who then came out 2 weeks late weighing 7.5lbs (very long and skinny), I would just caution you to think about how you would feel if the same happened to you.

However, we are so lucky to have the option of safe cs. They saved mine & my babies’ lives. They are also not an easy option. No stigma required.

Have the CS if that's what you want. You don't need a medical reason at all. You do not have to do vb if you don't want to. Some people genuinely prefer vb and would do anything to avoid CS, but that's not you (or me!) and there is nothing to feel guilty about.

Fwiw, I've had a vb and a CS. The vb was difficult and baby was big-ish (8lbs 1) and did get a bit stuck, had a v low APGAR score immediafter birth. All very stressful, BUT, her and my recovery was great after that.

I thought I was going to have a massive baby with dc2. There is more chance of shoulder dystocia when you've had it with a previous birth, so I went with an elcs. It was really chilled delivery, very little pain or stress, got to pick music to be played when he was born and was just a lovely experience. However recovery for me from my elcs was not good. But we are all here, healthy and in one piece so can't complain. It just was not nice at the time. Also he was only 7lbs so don't know why I kept getting told he was going to be a whopper!

*immediately after

Although I think immediafter should be a word 😌

May I ask why the recovery was not good if you don't mind? I've only ever heard that recovery from elcs is far better than recovery from an emergency one (aside from one friend who had a difficult recovery with her 3rd cs but that was because it was her 3rd) obviously I know there is always a risk with the recovery from any kind of csection but just curious. Thank you

My first baby was 7lb 2oz and got stuck because of malpositioning. He was ventouse delivery.

My second and third were 8lb 12 and 9lb2oz, natural VB and I did have minor stitches but many, many people have 8 and 9 lb babies without massive complications. These are not 12lb enormous babies! I wonder why that doctor said what he did.

I had my children via ELCS, your body, your choice. I wanted to eliminate risks of a VB, recovery was hard and painful esp first 3 days, but after a week each time I was pretty normal and driving again etc. Size guidance from scans isn’t always accurate though so if that’s your only driver for ELCS you may want to give it more thought…

Don't feel guilt. Then if we can tell you about is recovery. But you can prepare and to be ready to be less mobile for a few weeks after.

I was driving by week 4 post CS but took everything very slowly for the first two weeks to heal.

I had two births. A VB where my baby got stuck and had feeding difficulties after and I had to recover from an episiotomy (they hurt when ever you walk after). He wasn't an easy new born.

My second was an emcs but baby was so happy and healthy after, fed well and was a perfect new born.

Neither might be related to the birth or maybe they were?

With my vb I had only grade 1 tear / grazes despite shoulder dystocia and macroberts manoeuvre. I did pregnancy yoga and used an epino though I don't know if that helped or it was just dumb luck. I refused painkillers after birth and the mw didn't believe me 😄

My CS had a lot of pain and could not walk a few days after. I also found sex painful for a good few months afterwards whereas with dc1 I was fine a few weeks later.

However, this is not the case for a lot of women as I had always heard and believed the same as you, that vb = agony and "frankenfanny". I think I may be an anomaly. But speaking to one other friend who had vb then cs, she felt the same as me. So not unheard of but not necessarily the norm

Oh and from a position of vanity I have a c section belly I cannot shift, but obviously that isn't the priority!

My neighbour chose to have ELCS as our local hospital releases stats of their births. In 1 year, 37.8% has EMCS, ventouse or forceps, so not including any unreported birth injuries such as tearing of any grade, incontinence, prolapse etc.

This is also considering that pain relief such as epidural is not guaranteed due to lack of staff. I literally don’t blame anyone who chooses ELCS.

There are women who have babies with large heads naturally though (I did, twice - and I’m a size 8 so not big!)

Birth is really unpredictable and you can’t always tell in advance who will have a straightforward birth and who won’t.

Mine was 9lbs10oz, I had an elective section at 41w

No regrets. I made the decision after looking at the stats for likely VBAC (I had a section for my first as breech)

Recovery great, undercarriage intact. Overhang belly but I don’t mind that. Worth looking into inoculating baby’s skin with vaginal secretions though - I did this as a precaution (I know it sounds gross, sorry).

I had a similar dilemma with my second DC. Predicted to be big. Consultant recommended ELCS, especially as DC1 got stuck (following induction) resulting in an EMCS. Spoke to postnatal physio team and they also recommended a section. Midwives generally more in favour of VB.

In the end, I booked a section for when the baby was expected to hit 4kg (definition of a big baby at my hospital). I had a good c section experience first time around and wasnt worried from a recovery perspective. If I went into labour earlier and baby was in a good position, thought I'd give a VB a go.

I knew it was irrational but I felt really guilty about booking a section. Partly societal expectations (in my head, i felt so awkward saying I had a section booked, felt like i needed a "good" reason) and guilt about not being able to pick up/play with DC1 afterwards. For some reason, it helped knowing that the Queen had a section with Charles😂

There's no right or wrong. For me, I had to make peace with either option. If it was a section, I'd never know whether I could have had a good VB but likewise, I'd never know if I'd have had to have an instrumental delivery etc.

In the end, baby had other ideas and arrived very quickly via VB. There was no time to even consider a section. His weight was slightly above growth scan prediction but below 4kg. Minor tearing but overall positive experience.

Have the section, if for no other reason than it sounds like you want it.

Mine were 9lb 7 and 9lb 12, both weights in line with scans.

On the first I was offered induction or section at a week over. I opted for the induction but it didn't work, one midwife thought because of the size of her head. I had the world's calmest EMCS the next morning, breastfed in recovery, easy physical recovery for me.

The second I was going to have by ELCS anyway but in the end she was transverse so it had to be anyway. There were a few complications because of her size and position, she needed a bit of help when born, I lost a lot of blood. But again, breastfed in recovery and had an easy physical recovery myself.

I've never had any hint of judgement from anyone, I suspect the stigma tends to be something we've internalised rather than being a real thing. And when I've mentioned the babies' weights I've been met with outright relief when I say they were sections rather than natural deliveries.

There is absolutely no shame in having a c section. I elected to have one as soon as I fell pregnant, got it booked in, hey presto. My main reasons were to avoid inductions, long labour, instruments, birth trauma etc.

It was all wonderfully easy, and I have no regrets whatsoever. I had no medical need, and the baby wasn’t particularly big. I don’t feel an ounce of shame or embarrassment. After your baby is here safely, you will simply be thankful - whatever the mode of delivery.

Best of luck to you, whatever you decide to do.

My bigger baby was easier than my smaller baby (they were both over 9lb) I'm 5ft 8

Please try and drop the guilt. Women and babies used to die fairly often in childbirth- the reason this is now so very incredibly rare is because we have so many more interventions that can be performed if necessary.

I'm going for an ELCS for my third next month.

Second delivery was my 9lbs 8oz daughter, shoulder dystocia, massive haemorrhage as a result, blood transfusion, also ended up with sepsis.

There is no way I want to repeat that experience - it was ten years ago and I have only lately been able to face down the PTSD (diagnosed) to have another.

The thing with a vaginal delivery is that it is less predictable. All might go smoothly... or it might not. There are risks to ELCS too but they seem to be more predictable/manageable.

I was told my baby was 9lb at 38 weeks. I was encouraged to go for induction which I went for. Everything they said could go wrong, did go wrong and I was left with quite a bit of trauma e.g. baby stuck, forceps, tear, haemorrhage. I'm also 5 foot 7 and baby was born weighing 8lb 13oz so was close to their predictions.

I'm currently pregnant with my second and they also think this will be a big baby. I'm 100% opting for a ELCS this time round.

I was all up for letting my body do the 'natural thing'. Uncomplicated pregnancy no additional risks. Waters eventually broke at 41+ weeks, contractions started and then no progress no matter how much I've tried to walk or bounce on the birth ball. So I disagree with the whole 'let the body do it's thing and don't intervene'. I still ended up getting an induction to speed up contractions. I was getting exhausted, baby was getting distressed and it was a very unpleasant experience. Baby eventually came out, but it was assisted delivery. I ended up hemorrhaging badly and suffered with post natal depression. I thought by waiting for a spontaneous labour, I was giving myself and baby the best chance of a positive birth experience. However, if I could go back in time, I would probably not wait this long and would have booked an induction or C-section earlier. I know everyone's experience is different and some natural births go well, but unfortunately this was not my experience. For this reason, I'm thinking a planned C-section is th safer option.