I want my consultant onside. But I DON'T want a sizing scan. How to handle??

[phdlife]

My consultant says she is supportive of me attempting a VBAC. However the chances are against - 40% success rate, for various reasons. I've done my research, I accept this.

At 36 weeks she offered me a sizing scan, to be done at 38 weeks, on grounds that ds was 3980g. I'd never heard of it, said I wanted to consider. Came home, did more research, decided against. Given that they are +/-10%, more likely to be more wrong for large babies, and there is a vast increase in c/s rate if large baby is predicted, I don't think this is useful information.

At 37 week check I explained all this to jr dr who couldn't quite get her head around my refusal; said she was going to check whether consultant wanted it done anyway. Sure enough next morning I get a call from radiography; a sizing scan has been ordered for me.

I have made the appt, thinking, well, I'd rather not piss off consultant as my opening move - I have mostly felt good about her approach, to this point. But more I am reading about accuracy of sizing scans and the way this info changes dr's approach, the more I feel I'd just rather not put the idea into her head (though dh says it's already well and truly in there) that this is going to be a large baby and therefore I will be less likely to succeed vbac.

Plus I am NOT good at calm, quiet, assertion. Any suggestions re how I should handle this? Or anyone got a big bag of bolshy pills I can take?

tia...

What practical difference do you think it will make if your consultant is onside? Your care during labour will be predominantly handled by midwives - it's unlikely you will even see your consultant IME.

When I was planning my VBA2C the thing I eventually realised was that I was never going to get the medics to approve of my decision - not with all the research and discussion in the world. In their eyes it was less risky to have a repeat CS, and the important thing for me was that I understood what I was doing, what their reasons were and what my reasons for taking a different course of action were. At the end of the day, my family and I were the ones who had to live with what I decided, whether that was repeat CS or VBA2C.

Yes, you might piss your consultant off if you don't have a scan. But this is your baby, your pregnancy and your birth, so why does it matter whether or not your consultant approves?

If I were in your position, here is what I would do.

1. Cancel the scan, but ask for a meeting with the Consultant, not the jnr doc.

1. Write down your reasons for not wanting a sizing scan, so you have some reference if things start to get a bit heated or emotional at the meeting.

1. Ask the Consultant their reasons for wanting a growth scan. I am sure macrosemia and shoulder dystocia will be something they mention, so read up on it.

1. Have a great VBAC and stick your fingers up to the Consultants

I had a vbac waterbirth at home, my little man was 9lb 11oz with a four hour labour and a graze. It can be done

thanks IliketoMoveIt, I LOVE having a plan

Daisy I'm in Australia - the procedure is v different here. Apparently the MWs have to write progress reports on a board outside the birth room so the dr's can keep an eye on us

You don't have to have anything done that you don't want to.

I had a sizing scan in my last pregnancy as first DC was 9lb5 and after the scan they thought my second one was going to be 11lb

They were determined to book me in for CS saying they didn't think I would be able to deliver him but I refused saying i'd rather try natural delivery first.

After much argument I agree to let them induce me at 38 weeks as a comprimise.

I had the easiest labour, 3 pushes and DS was out. And he only weighed 8lb2 so they were completely wrong about him being huge

I would go through hospital switch board and ask for consultants secretery. I'd then leave a message to the effect of 'would like to discuss scan if at all possible, is it possible to have telephone conversation/antenatal appointment'

They probably never cancelled the scan card.

well, I've fucked this right up

spent the whole week dithering researching. Did not ring anyone despite useful suggestions above.

Now have dilemma of whether to go or not. Appointment is 8:30am so no chance to talk to obs beforehand, either I go and info is there on my record for good or ill, or I don't go, then see consultant in afternoon and say "convince me why this is a good idea"

votes here now pls

ok, go for the scan...it may show a smaller than expected baby. i had a scan at 38 weeks, dr predicted a 10 lber at term, and my dd was bang on 10 lbs!

if its a smaller than expected baby, it will work in your favour, and if a large baby is predicted then you can use the info about scans can be 10 percent out or whatever...

it also goes on your baby size and build...if you are an average height and build, your consultant may allow you to try for a vbac....

better to sort it out now, and for you to enjoy the last few weeks of being pg, than to be anxious and waiting to see how things pan out.

good luck!

pants! meantt BODY size, not baby size.

I had a friend who had a 9lb odd first baby, emcs after long labour.

Her 2nd was aVBAC - he was well over 10lbs - and she's a short arse like me so there was all sorts of talk of "baby might be too big".

thanks chimchar

think I'm going to be anxious anyway; everything I'm hearing about this hospital atm is anti-vbac...

Agree with the plan from Iliketomoveit.

Would also like to know if the size of the scan will mean your consultant may change her mind about supporting you in a VBAC? If so what will you do?

Personally I would speak to the consultant first and not have any tests done unless I knew the reason for them and what the outcome of the test could mean.

It can be really hard to say "no" to these people but the first time is the hardest. Of course you want her support but agreeing to a test/intervention in order to keep your consultant onside could be a slippery slope.

Good Luck.

Thank you, MustHave, that's just how I see it. Am missing the scan right now; figured I can always reschedule if she persuades me at this afternoon's appointment. Was also greatly encouraged this morning when my dsis, a MW in the same unit, phoned to say she'd been discussing my dilemma with colleagues and they totally supported me!

How did your appt go phdlife?

Surely Consultant only thinking of your/ baby's safety? It's not as if she's trying to make you have an unnecessary cs for her own good, as it's better for her stats to avoid cs where possible. I'd listen to her if I was you - just my opinion though. Good luck with the decision!

It went v well thanks MustHave. Saw a registrar who quoted all same stats back at me and said turning it down was a perfectly reasonable decision, esp. as an erroneously large estimate could discourage me.

Knax - I'd think that, but Australia has higher c/s rates than the UK and a teeny tiny vbac rate, and Queensland has the lowest vbac rate of all. Pretty clear here they would much rather intervene than not.