Fear Around Hospital Birth for 97th Percentile Baby

[emilyisaneary]

Hi,

NOTE: I'm looking for positive / constructive input to help manage my fear around the following. Please do not share horror stories unless there is some constructive insight on how to avoid / navigate the situation. Thank you :)

I'm based in Scotland and currently 33 weeks pregnant with my second child. Scans are showing that baby is in the 97th percentile (head and legs in 50-60th, belly in the 97th). I have been tested for gestational diabetes and everything came back normal, it looks like I (might) just have a big girl growing.

With my first birth, baby was breech and so I was booked in for an elective section. At the time, I felt relieved but I've since realised how numb the whole experience made me, especially postpartum. I struggled so much to bond with my baby and felt like I have no participation in the delivery of him. Amazon may as well have delivered him, that's how lacking in involvement I felt. Because of this experience I would really like to try for a VBAC with my second, so I can experience labour as well as the mental, emotional, spiritual and physical transitions that happen during it. Hopefully I will feel more connected, involved and empowered this time round.

In an ideal situation I would try for a home birth, I would be with my husband and my midwife and would be left and encouraged to trust my body to birth my baby, with loving guidance when needed. The only thing stopping me from doing this is that I live on a west coast island and the hospital here has only a birth centre. If an emergency were to happen (scar rupture or anything else) I would have to be air lifted to the mainland. For this reason I don't feel entirely safe giving birth here which I know will potentially affect the progress of my labour. Feeling safe is my priority for this birth.

The difficulty I'm having is that when I spoke to my consultant after my recent scan, I found her very robotic and risk focused in the conversation. She immediately started to mention inductions, risks of baby's shoulder getting stuck (which turned out to be 5-25 out of 400) and elective sections, with no mention of how women give birth to bigger babies with little to no complications very often. If she had started the conversation with "the majority of women don't experience complications but we need to discuss these just incase it happens" I would have felt much better but there was no reassurance at all and I found it to be a very fear inducing conversation.

I can feel I'm starting to get really afraid that I'm going to go to the hospital and my body and baby won't be trusted during labour and that they will try to intervene and speed things up because of the assumption that she will be big or that I'm not progressing in the time frame they think I should be. I would really love to be able to trust that I will be taken care of by those who work at the hospital but my experience so far has been 'just another patient' vibes compared to the care I get from my local midwife (who will hopefully be able to join me on the mainland for the birth) which is very personal and makes me feel very understood, respected and cared for.

I guess I'm just looking for some positive birth stories from similar situations or any advice / tips / knowledge on how to navigate what the hospital might recommend and how to differentiate what is absolutely necessary intervention vs what interventions are convenient / subjective to whoever is working at the time?

TLDR: Trying for a VBAC with suspected large baby but scared that hospital staff will not let me trust my body / try to intervene under the assumption that my body can't birth a bigger baby or it's taking longer than they think it should. Tips / advice / experience welcome.

Thank you.

Tbh you are ‘just another patient’

Thank you for that valuable input.

I have had 1 section and 2 VBACs none of these was particularly straightforward so I won't go into details.

What I will say is that if you are worried, stressed or fearful that you might not be able to birth your baby in the way you are hoping for then this alone could be a reason to go to a mainland hospital.

The more you invest in the kind of birth you want and the significance of the actual birth the more you are risking distress and anxiety when things don't go as planned.

As @NCsoloMum says you really are 'just another patient' and the consultant's primary concern is the safety of you and your baby. While the type of birth is hugely important to you, the consultant wants a safe outcome.

Good luck whatever you decide.

Hey OP, I don't have many tips but my first 2 DC were both born at 42 weeks, weighing 9lb 2oz and 10lb 8oz. They were both really positive and I had no complications. The 10lb baby was my second and as I went into labour naturally I gave birth on my knees leaning on the back of the bed upright which was far easier as she basically pushed her own way out! So I'd recommend finding the best position for you, assuming you can. I hope all goes well

Bigger babies are easier to push out because the muscles have contract less to squeeze them out. Obviously there is an upper limit to that, but I found it to be true. I’d go to the hospital and have it there and just accept that it’s not home but it’s safer for you both.

OP it's scary knowing there's a big baby in there but another word of reassurance here. DC2 was 10lbs 2oz and came out the normal way. The birth felt much easier than with DC1 (who was almost a lb lighter although clearly big by normal standards). DC2's shoulder did in fact get stuck but it was dealt with quickly and within one contraction with the McRoberts manoeuvre - I didn't even know it was shoulder dystocia until a midwife read my notes and winced a few days later.

I can't help you on where to give birth, that sounds very difficult to decide, but please be reassured that second births can be a lot more plain sailing, even with big baby! If you think your mind will be at rest by being on the mainland then maybe consider that, just make sure your birth partner is ready to advocate for you too!

Google Dr Jean Sutton's Optimal Fetal Positioning. I think you can find the text online. She explains the process of how best to enable an easy exit for your baby. I was lucky enough to have attended a couple of her talks when she was in the UK, and she was excellent, made logical sense.

I'm so sorry for the experience you have had. I am sure the doctor was not trying to treat you as "just another patient" but they do have other priorities than you ie to reduce the risk as much as possible whereas yours is to have a positive birth experience.

Honestly with a previous c-section and a large baby i would not risk being that far from a hospital. if you lived down the road or a ten minute drive away i'd say ok but flight needed could take hours you don't have.

Please remember even in hospital you can say no to interventions but please don't say no for the sake of it. Do feel free to question though.

Have you considered hiring a private doula or midwife to advocate or advise you? Make sure you do your research on them. but it might help you feel more in control

I have had 2 VBACs and my last baby was very big but I had a straightforward delivery.
However, there are risks and your obstetrician would not be doing her job properly if she didn't discuss those with you. It can be difficult to find the line between fully informing people and scaring them, and some staff are doubtlessly better at it than others, but doctors must inform their patients of significant risks.
I can empathise with you as I also didn't go into labour with my first baby and really wanted to experience it. I also would have quite liked a homebirth and live in a rural location, though not as isolated as you. I do get it, from the emotional perspective, honestly I do, but I would strongly advise you to get as much objective information as possible and base your decisions on that.
You will find positive stories - my VBACs were great experiences and I'm all for it if it's safe and what a woman wants - but don't close your mind to potential negatives as your situation is not straightforward. One of the problems is that the headline data that often gets quoted about VBACs includes all women attempting VBAC and takes little consideration of individual circumstances, plus a lot of the studies were done abroad, especially in the USA where obstetric practice is quite different, so it is quite hard to figure out your individual risk. It's a long time ago for me personally and I have no recent professional experience in the field but there certainly used to be a lot of useful data on the UKOSS website that was both up to date and UK specific. Its worth a look if it still exists. But one of the key things is that having given birth vaginally before is associated with a higher likelihood of a successful vbac. That is not to say that you will have problems if you haven't had a vaginal birth before (I didn't) but it is more likely that you will need some kind of intervention so it is worth thinking about that.
My personal opinion is that every woman hoping for a vbac should also have a plan for a section too. I think the most distress often occurs if you have a very set idea of what should happen and then it doesn't so you then get catapulted into this stressful situation where stuff is being done too you and you feel like you have absolutely no control over the situation. Obviously birth is unpredictable and nobody can have complete control over what happens but I think it helps if you have thought through potential problems in advance. I had a kind of flow chart in my head with my "ideal" birth as the start but various "If X happens, switch to plan B" points on it. Even though not your ideal, it is possible to have a positive hospital birth and indeed a positive section if need be. But don't set yourself an impossible goal whereby there is only one "right" way to have your baby and everything else feels like failure.

I haven't been in your situation but I will recommend the positive birth book. Reading between the lines it's more about your approach/ relationship with birth/ the medical staff than the actual type of birth you will have. I loved that book, for thinking about a birth plan. For example it also has thinking positively about a C-section and little things you can control (who's in the room, music, curtain up or down). So if you do turn out to need another, could be a better birth than the first.

Also based in Scotland, although not remote. I've had two high-centile babies vaginally and I'm quite petite. I had mine in an alongside midwife-led unit, so a quiet, homely environment with a birthing pool (with options for pretty lights and music and such had I wanted them), but with all the resources of hospital very close if needed. Is anywhere like that an option for you?

For what it is worth, I never felt pushed towards interventions or a section (although we didn't know DD1 would be as large as she was!). I was offered them with DD2 – GD test, growth scans, offered a section, offered induction from 39 weeks, but I felt they were very much offers, we discussed the pros and cons, and I made the decision. Of course, if there had been a strong medical need to get DD2 out early, I'd have expected them to communicate that clearly.

I would second the advice on having a clear idea of what route you want to go down if baby or your body hasn't read the birth plan. Consider the likely scenarios, and know what your preference is. Then make sure your birth partner(s) know as well and are very clear that their job is to advocate for you (whilst not overriding your prerogative to change your mind once actually in the situation).