Large baby, EMCS - can anyone explain/relate?

[Quickdraw23]

I have tried to be succinct here, I’m sorry it’s so long!

My baby was measuring on 99th centile at 32 and 36 week growth scans. No gestational diabetes.

I did a ton of research on birth and large babies, increased risks, pros and cons of intervention etc etc.

i also read a load of stuff about scans not always being accurate and spoke to a lot of people who told me that my body couldn’t grow a baby that was too big to birth vaginally. I decided to attempt vaginal birth with a mindset that if a c section was needed for clinical reasons then I was fine with that.

i had a really long first stage of labour at 40+3 days that began almost immediately after a sweep. At 4cm dilated I went into urinary retention and had to be catheterised and was moved from the MLU to consultant led delivery ward.

I carried on and got to 8cm without pain relief, with contractions that were coupling and about 2 mins apart but manageable, when all of a sudden a contraction came on that just never went off. I couldn’t breathe through it, my stomach was visibly contracted and it was showing on the monitor. The baby was fine, but I couldn’t cope at all, the pain went on for 20 mins with no break and I had to have an injection to pause the contractions.

At this point I decided to have an epidural. I could still walk on it so was stomping around with all my attachments trying to get the baby to descend, but he just didn’t, I stalled at 8cm for hours, my catheter wasn’t draining and my kidney function started to pack in. An EMCS was strongly recommended, I decided my kidneys need to last me a good while and agreed. All went fine.

i am (mostly) fine about the outcome, but i guess I just want to know why this happened. Deep down I suppose I want to know there was nothing else I could have done. sometimes I feel daft for attempting a vaginal birth in the first place.

Was it likely that he was genuinely just too big (his head was 99th centile when they eventually hauled him out). Head at a funny angle? I didn’t do enough forward learning inversions?

does anyone have any ideas or relate to this experience?

thank you if you read this far!

My Baby’s head never came down so I had an emergency c section. After the c section there were many comments that no wonder he didn’t come down with how big his head was. He was also about a third longer in body than the other babies on the ward.

You don't say how big the baby was when they were finally born?

But, it's impossible to say without knowing your frame etc really. The position of the baby also makes a huge difference in labouring.

I gave birth, at home, to a 10lb, built like a brick sh*t house child. But, clearly I'm built for it.

Genuinely, you both came out of it healthy and happy. There's nothing special about a vaginal delivery, it's not some magic experience that makes you a "woman". My belief is that a c-section is much harder, certainly in terms of recovery.

It might be worth having a chat with your midwife, or health visitor if you still have questions.

I'm sorry, I've just seen that people told you that the body wouldn't grow a baby that was too big to give birth to. What absolute bollocks! My friends' baby got "stuck" and was eventually a c-section. Unfortunately she was left with catastrophic brain injury and was left very disabled. My friend was told that she had a narrow pelvis and attempting to delivery vaginally was unlikely to ever be successful and her subsequent babies were delivered by c-section.

The body frequently grows things it can't deliver, one of the reasons that maternal mortality rate is so high in developing countries. In the olden days giving birth was an extremely risky endeavour and its not something that every female body is "built for".

In answer to the question "how do women do it in 3rd world countries?" a lot of them don't, the mortality rate is huge!

Thanks. yes I’m just “what iffing” really, it’s probably unnecessary!

He was 10lb 12oz.

I’m moderately tall with a slim build. his bio father is 6ft4, so it’s clearly genetic.

I’m of course grateful we are both here and well.

long past asking the midwife sadly as we were best with horrible weight loss and feeding issues at the beginning and I’ve only just really started to reflect on the birth months down the line.

I’m so sorry to hear of your friends experience.

i wouldn’t attempt a vaginal birth for another baby who was measuring that size. I sort of feel silly for trying in the first place.

There's absolutely no need to feel silly. A vaginal birth is sold to us as something magic and "empowering". Its the magical step between not being a mother and being a mother.

It's all a load of bollocks! The only reason I had home births is because I'm terrrified of bloody hospitals. I'm lucky in that I have a genetically high pain threshold (in the same way some people are genetically beautiful!).

Enjoy your baby, give them a sniff right now, you know you want to ❤

I think you are being hard on yourself. You researched it and decided to try for a vaginal birth but knew it may end in a section. When things looked like they were starting to go wrong (kidney function) you took the medical teams advice and had a caesarean.

I had a 10lb 9 baby by EMCS many years ago and felt bad about it - hadn’t even been picked up in scans as I had some massive fibroids that were thought to explain my ginormous bump. She also had a 99.9+ centile head, although there was a bit of a view that was swollen from labour as it was so large. My gp at the 8 week check said there’s very few women will give birth naturally to a baby that size, which made me feel better at the time. The only important thing is you are both well.

She’s 15 now, tall and slim and it’s forgotten for me.

Please don’t feel silly for trying a vaginal birth. It is easier for the body to recover, and even at that size of baby it may have been possible. You weren’t advised not to, so you have followed all the medical advice. I had a baby at over 90th percentile with episiotomy and forceps. I know several other women with much smaller babies who needed emergency c sections because they didn’t dilate enough or the baby was stuck in the pelvis. Honestly, I think it’s just whatever happens happens. We can’t predict how a body will progress labour so I believe we just have to do our best and follow medical advice.

Huge well done and congratulations on your amazing effort and gorgeous baby!

not too late at all for a debrief.
whoever told you you can't grow a baby too big to birth is a flipping div.

You are absolutely not daft for attempting a vaginal birth and did nothing wrong. Nobody has a crystal ball and you could not have known it would have been so challenging. You also don't know an elective would have been the right choice either, you could be sat here wondering if it wouldn't have been better to try for a vaginal because managing the C section recovery felt something that could have been avoided.

Give yourself credit for spending the time really considering all the options and making the best choice with the information you had, and for everything you went through to get here. It clearly wasn't a decision you made lightly.

If it helps, my husband is a doctor and all of the most traumatic births he has seen has been elective C sections. This isn't because it's not generally very safe, but because he would rarely be called into a vaginal birth or a C section going well. That means he has a very skewed view of the safety of C sections. If he were in your shoes he would have made the same call as someone who felt they knew enough to make an informed decision, because to his mind a C section is most definitely not risk free. An experienced midwife would probably make a very different call to him, and other health professionals something else again. There was no right answer and there's really no reason to worry if you could have done anything different - you did what you thought was best, you were probably right but it was still an ordeal. You can only celebrate your tenancity and bravery in the situation you faced.

I’m so sorry you went through this, I’m tiny and had a shock huge baby for my 2nd after a small 1st baby.

The first birth is always a lot more of unknown, it could be just as likely that a much smaller baby would have had the same outcome. Pregnancy and birth is high risk, thank goodness for interventions.

Thank you so much.

yes, his head…he’s 10 months now and wearing hats for 2-3 year olds. Or occasionally my hats 😳 he is very long though, so hopefully will even out eventually!

Hi op, I had a very long labour and then lots of intervention, epidural, forceps, huge tear, haemorrhage etc. It was exhausting and quite traumatic. It wasn't until I'd been in labour for some time that a midwife told me my baby was back to back. He did turn but not enough and then began to come down the birth canal sideways and got stuck. So he was the essentially pulled out by an obstetrician. Afterwards, I was devastated and felt judged (had a midwife make judgey comments about how that's what happens when you have an epidural, you can't push your baby out). I felt ass if I had failed at childbirth because it wasn't 'natural' enough.

Someone later reframed it for me and and said how lucky I was that I lived in a country with those interventions, if I'd lived a very poor country both myself and my baby would've died because the holy grail of "natural" childbirth is not always possible and it isn't because you did anything wrong. I'll be honest and say even that didn't fix how I felt, it was only having an unassisted (very rapid) birth with dc that finally convinced me I hadn't done anything wrong.

i have two boys who were only an oz apart in weight at birth but my first ended up in an assisted delivery and episiotomy because of his 98th centile head. I also had the never ending contraction. My other son was born easily with two quick pushes with a 50th centile head, I imagine it’s much more to do with that than the size and you couldn’t have known how big his head would be! Growth scans are notoriously inaccurate and you made an informed decision with the information you had

Hi OP, you can request a birth reflection meeting, I think that may help answer some of the more clinical questions you may have and help you to understand the timeline a bit more. I’ve had friends who have had these meetings and found them both helpful and healing.

My DC2 was a big baby, pretty much 10lb at birth. I had an ELCS having had a vaginal girth with DC1. I can promise you that you did not lose anything by having a c-section so please don’t worry that you missed out on a birth experience that would have been more magical than the one you had meeting your little boy. My DC1 was a smaller baby but was in a shocking position with their arms crossed over their head (!) and I laboured for 24 hours before having a ventouse delivery and an episiotomy (which I still get twinges from nearly a decade later. Compared to that, I have zero pain or issues from my c-section scar). I just wanted to reassure you that the way your little boy came into the world was just as special and magical as it could have been and you should be really proud for going through your birth experience ♥️

You definitely weren’t silly for attempting a vaginal birth and also very sensible for opting for the birth you had when it was clear you both needed more help. I wanted a home birth with my first but he was over 11 lbs and we ended up in hospital. You just adapt sensibly depending on what is needed. My next two were home births even though they were nearly 10 lbs. You just don’t know how any birth will pan out.

It’s not quite the same but I can relate to getting quite far and it just never coming to the end

DC1 I very slowly got to 6cm and it has been 20 hours since waters broke. I got to 7cm or so by 32 hours and then they got really pushy for c section. I had one at 36 hours. His head was flex or de flex or something. Aka he was sky staring and not neck tucked in. Which basically means his head would have been bigger than the 10cm I was aiming for in that position.

DC2 tried for a vbac. Got to 9cm on gas and air. Had a crash section as baby’s heart was failing. Later found out she was also head de flex and also back to back as well. Shit position. Maybe I have a weird shaped womb or cervix? Never got any answers. She’s lucky to be alive. I’m lucky she’s alive. She could have died or had brain damage.

dc3 elective

i know what it’s like to wonder what you could have done better or more of to get a different outcome. It’s horrible playing it over and not having all the info, missing info forever. My sympathies

I had a baby with a 96th centile head and skinny body. She just never descended. I thought the epidural wasn't working on one side but when they did the C section they found that she was being pushed sideways into my pelvic bone with each contraction, and that's what I was feeling.

I think a lot of people question if they could have done something differently to avoid a C section. I definitely did and used to stay awake at night wondering what if I'd chosen a different midwife, what if I'd refused certain interventions, what if I'd eaten less cake or McDonald's in pregnancy and grown a smaller baby.

Years later I met a woman who just had a C section because she never dilated past 1cm but she was convinced that if the room had been quieter she would have relaxed and delivered vaginally. Seeing someone else go through the same thought process helped me kind of snap out of it.

Thank you so much for your kind words and sharing your experiences, it’s a real salve!

After my first being a shoulder dystotia, I had 2 c-sections. I am a big fan of c-sections as my ‘natural’ birth was quite frankly horrific and we didn’t nearly get to take our DD home.

All 3 of mine were off the growth charts, no GD and I was very healthy weight and ate well and was luckily well enough to exercise throughout.

I’m sorry to hear how difficult your birth was and so sorry that the midwife said such a horrible thing, that was incredibly unkind, unfair and unprofessional.

I’m glad your second birth sounds like it went better and was helpful for resolving some of the doubt you had after your first.

Thank you for sharing your experiences.

it’s been so helpful to read these replies, and had made me feel a lot better.

I’m really grateful for all the shared experiences, perspectives and kind words, thank you so much.

My son was born at 40+1, 99th centile for head size and length and 91st for weight. Also no GD and my weight gain was quite limited. I was told he was about 60th centile at my last scan after measuring signicantly ahead until then.
My husband is 6 foot 3 and I am normal size and quite slight.
I was in labour for 40 hours (had the drip as waters broke and I was GBS+ve) and he was back to back. I was in a room with a birth pool and all I did in it was puke... It was excruciating and he had a heart rate deceleration event, I think I had got to 3cm so had an EMCS. They said they had been busy so that is why I had been left even though it wasn't going well at al, ideal eh?!
When they took me down, they said they may never know the issue. When he was born they said he couldn't move at all as there was no space and that vaginal birth would have been impossible. We then had to stay in hospital for 6 days because my waters had been broken for so long and they wanted him to have IV antibiotics... I was so upset about it at the time as it felt so unfair (I wanted a mythical magical water birth) so I completely understand how you feel. But if I had another baby I would definitely go for an elective as second babies are normally bigger.
I had physio for another issue and the physio said some women can give birth to babies that big but it's not necessarily advisable and she sees the impact... it changed my perspective so that is something to think about too.
He's now heading towards 2 and still on the 99th centile for head and height and larger than some 3 year olds... everyone who meets him for the first time and finds out how old he is, says gosh isn't he tall... so you probably have that to look forward to as well!

My only advice: don’t please go down the pathway of obsessing over a VBAC if you have more DC! And let yourself off the hook about all of this now — enjoy the fact that DC1 is here and thriving. If you don’t have any injuries, that’s a birth success story.

I had somewhat similar feelings to you about my first birth (baby was big but a 1lb and a bit less than yours!) and tried very hard to have a VBAC with DC2. In the end I had to have another section, but things were not nearly as well organized as they would have been with a carefully scheduled ELCS, the baby was bigger, the surgeon was much less skilled, and things almost went catastrophically wrong. So I really would strongly recommend sticking to the plan of an ELCS from the start and not being swayed by midwives whose job it is to sell you on the VBAC. (Many women are of course in white different positions. At the class I went to at Chelsea and Westminster the women sitting on both sides of me had had breech babies first time round; in that situation, it would be only sensible to try a VBAC if DC2 were head down.)