CS or not.. big baby predicted, vulval varicose veins and piles, plus DS1 who is 2.8 months and will need lots of cuddles when baby arrives...

[MissyH]

I have read some of the threads on various issues relating to big babies, CSs etc - but the thing that I am most worried about if I do elect to have a CS (had natural delivery last time- not without its' complications)is the recovery time and how that will impact on my DS1 and also caring for the new baby. Apart from the big baby issue (they have mentioned a concern re shoulder dystophia (spelling?)) is the thought of pushing with the amount of swelling I have down below at the mo.... but main concern is recovery issues..

I would love to hear from anyone who has any experience of a CS while caring for a boisterious toddler etc

Am 35 weeks and seeing consultant on Monday to discuss all options... (there is a chance that even if we do elect for CS that it turns into an unplanned one as last baby was early)

In my experience as a midwife most women who have vulval varicosities stretch well and often don't need any stitches, they should improve significantly after all the pregnancy hormones are out of your body.

It is very difficult to predict baby size on scan at this late stage as difficult to get head measurements when the head is low down.

Have no personal experience of caring for a toddler after a cs, hope all goes well for you.

I'm having an elective at 38 weeks on Thursday and already have a very active 2.5 year old boy. I had an emergency section last time because he was 11lb 10oz and I chose to go with an elective this time as I am expecting another big boy. I've just been diagnosed with Gestational Diabetes in the past few weeks which explains the size of my babies and I'm glad I'd made the decision already. So although I don't have any experience of looking after a toddler I'm about to gain some!

I'm not really worrying about the recovery as I think the benefits for me outweigh the negatives. It's a total plus being able to arrange childcare for the toddler and prepare him for my stay in hospital. I've bought a section protector belt and hope that will help a little to protect the scar. I didn't find the recovery from my emergency section last time too bad, and that was after a gruelling labour so I'm thinking positively that it will be ok and at least I'll be able to sit down in comfort!

Hope you get some more experiences and will let you know how it goes.

TBH having seen 2 friends have to combine csect recovery with newborn & toddler (one 23mths the other 2.9) I would definitely question the need for a csect if you have previously given birth naturally in the past.

What size was your DS? How big are we talking this time? WRT swelling, I had quite considerable swelling last time (& again this time) and whilst my labour was long & hard I delivered naturally without any need for stitching so I don't think there is any need for additional concern on the swelling.

If a csect is right for you (& your family) then obviously go for it, but I'd want to be sure that despite the obvious pain of natural delivery, I wouldn't actually be better off trying to deliver.
LCN

MissyH, all women recover differently from cs, as you might imagine.

For me, the first 48 hours were a write-off. But other women in the ward with me were already lifting their newborns before this, something I could not do. But by the 5th day, the stitches came out and I was 90% back to normal.

By 2 weeks, I was driving again - just neighbourhood streets for the nursery run.

As for caring for my 3 year old, she went to nursery during the day so I did not take the full brunt. My dh took 2 weeks' paternity leave. After that, I had no trouble coping on my own.

The good thing about an elective is you can schedule help around it. Do you have relatives who can help, either stay in or you could send your ds to for a few days or more? Alternatively, hire a mother's help who can be an extra pair of hands or take the toddler out.

How old is your toddler?

I've not had a CS, but I've been in a similar situation to you.

With ds2 I had piles and ghastly vulval varicose veins. He was predicted to be big, and the consultant was trying to scare me off having a home birth, the business about the shoulders came up several times. But I had already had two biggish babies (8lb10 and 9lb3) and didn't see why this one should be a problem.

In the end (long story) I was signed off for HB, but ended up in hospital because there were no midwives available when I wnet into labour.

Ds2 was born in the birthing pool, after a short intense labour (2h, compared with 48h for ds1 and 27h for dd). I didn't push him out, just let gravity do the work, his shoulders did not get stuck - though I could feel them distinctly from inside me, weird sensation - and I did not tear. He weighed 11lb.

The vulval things shrank within days. Unfortunately the piles continued to grow! But I have had piles after all three babies, the best thing for them was to get the GP to prescribe Proctosedyl. I recovered faster from that birth than from either of the others.

HTH

BTW, there's a difference between babies who are big because of GD, and those who are big because of genetics or a good placenta. Mine were all long and relatively slim. GD babies are fat, rather than long, and tend to bulk up around the shoulders - hence the increased risk of shoulder dystocia.

Why is your baby predicted to be big?

Thanks so much for all the posts so far...

DS1 was 8.1 lbs at 38 weeks last time, so not massive, but if he'd gone to term am not sure what he would have ended up as.

As for size of the baby, have just been tested for gestational diabetes as my sugar levels keep reading high - GTT came back normal, so not quite sure why so big - but it has been measuring bigger than its dates (which are not wrong as I had early scan) for the last 10 weeks or so.

Tyniclogs - I look forward to reading how things go with interest... good luck with it!

Missy just wanted to share my experience with you.

With DS1 had an emergency c-section so opted to have an elective c-section with DS2 - DS1 was 2.4 at the time.

It was fine - the hardest thing was not being able to lift DS1 up but I got round it by sitting on the sofa and dragging him up to me for cuddles He understood quite quickly that I could not carry him up and downstairs as I had done before (he is a lazy boy ) although it took a couple of tantrums from him to get the message - but I guess that was to be expected as his world had just been turned upside down by the arrival of DS2

I also had the 'break' of DS1 going to nursery 4 days a week so could rest as much as possible during those 4 days. DH took 2 weeks paternity leave aswell which obviously helped.

I can't remember when I was back to normal but probably after about 3 weeks (DS2 was 5 weeks old at Christmas and I am fairly sure I was completely back to normal by then and lifting DS2 again)

Hth - it is doable

Just to update - we saw the Dr yesterday and she said that she wasn't quite sure what all the fuss was about - the differential between baby's head and abdomen measurements is not big enough to warrant being too concerned and we should stick with going ahead with vaginal delivery. Felt a mixture of relief and disappointment.. relief that all is okay and whilst baby might be big, it's not going to be a monster... and some element of disappointment as there was a bit of me secretly hoping for a c-section so that I don't have to go through labour again!! I think if I can achieve a natural delivery then the recovery should be better so better for all the family.. but watch this space. Next scan booked for 38 weeks just to check all is well... fingers crossed I will have delivered by then I had better start taking my raspberry leaf tea capsules!

Thanks for all the messages - and as I said before, Tyniclogs, look forwad to hearing how you get on once you are back online after Thurs.. good luck!

x

Missy - Ask your hospital what their standard procedure is for birthing suspected big babies with possible shoulder dystocia. Namely, do they intend to give you a big episiotomy to avoid shoulder dystocia?

If so, you might like to consider elCS instead. I had one of these big episiotomies for big baby and possible shoulder dystocia, going towards the back of one buttock, and I was bedridden for weeks. In comparison, I had an elCS five weeks ago, and was totally fine on Day 3 and didn't even take paracetamol from then on.

Re measurement accuracy - I don't know about the equipment your hospital uses but in ours, head measurements are accurate to the millimeter, like with an MRI. Weight estimations are a bit more tricky.

re "the differential between baby's head and abdomen measurements is not big"

How is that supposed to make you feel better (or delivery easier)? Surely it is the size of the head that matters, not whether it looks proportional to his torso.

Am I missing something?

my understanding had been that the abdominal measurement was more indicative of shoulder size which is the problem with shoulder dsytopia.... hadn't thought about the whole episiotomy thing... now not feeling so good again

In my (admittedly limited) experience, shoulder width can have very little to do with torso. DD was literally fat with what looked like a beer belly.

Do ask about episiotomy - if it's standard practice to do a big episiotomy to prevent shoulder dystocia in your hospital, I'd recommend elCS.

If it helps your deliberations, DC3 was 10lb 4.5oz and despite a slight pause due to his shoulder getting stuck, (resolved by moving around) he was a straightforward delivery, and I can truthfully say easier and less painful than DD1 and DD2 at 8lb 2oz and 7lb 13oz respectively. No tearing or stitches with any of them, and I went home the same day with both DD2 and DS.

I'm not convinced that larger baby = more painful, I was honestly amazed when they told me how big he was, even though the scans had shown he was probably 8lb 10oz at 37 weeks and he was born at 42 weeks.

Hiya, just to update. I had my baby boy last Thursday by elective and he turned out to be smaller than expected at a tiny 9lb 6oz! To me this is tiny as the last one was 11lb 10oz and those extra pounds make such a difference!

In terms of recovery with a 2.5 year old it's going ok. I stopped with the painkillers a couple of days ago and have been out and about. My wound has healed well and I've not even worn the protective sheild I bought yet, so far my toddler knows not to touch mummy's 'ouch'. I have my DH at home so it's working well that he takes the toddler out in the morning to run off some energy. It's also helped having such good weather as we've taken him to the park lots and let him get wet in the fountains. I'd forgotton how much babies sleep so in terms of the newborn he's not been much trouble, we had a night of winding the other night but so far we've all had some sleep. I'm not sure how it will work out when the paternity leave finishes and I'm trying not to think that far ahead, I shall just have to wing it! One thing I think is helping is sticking as much as possible to the toddlers routine and renforcing the boundaries, he's pushing against the norm at present as he's had lots of telly and treats over the past few weeks and it's time to get back to normal.

Hope all goes well and you get the birth you want, whichever way I'm sure your toddler will adapt to the situation.

Many congratulations Tyniclogs at the moment am heading towards natural delivery but have my next scan on 13th (38 weeks) just to check size again. am having a few contractions at the mo tho so fingers crossed it all happens a bit earlier anyway Thanks for sharing your experience - it all helps!!

Hi,

tyni lovely to hear from you again and to hear how you are getting on!

I am due next week and am hoping for a VBAC. I have swayed back and forth for the entire pg and it has driven me mad at times! My DH has always pushed for me to have an ELCS as he is really worried about what a VBAC might be for me but it was my wish to at least try as i feel i want to be 'normal' as much as a i can for DD (2.4). I think i will have a low threshold for asking for a CS if labour doesn't go well tho, i won't hang about and if it's not going well i shall be asking for that CS possibly.

I am also predicted to have a big bub - both head and abdo were >97centile at 32 week scan (ouch) and weight predicted over 10lbs, DD was 9 12.5lb.

missy i'm glad you are having another scan, i wasn't offered one sadly so am hoping they were a bit wrong at that last scan! This bump was breech for a while and, like you, i was secretly hoping the choice would be taken away from me, but now it's head down and ready to come out (hopefully) so i'm back on the VBAC wagon.

x

latest scan at 38 + 2 (on Monday) = 8lb 2oz baby.... still going for natural deliv at the mo although as each day passes and the scope for baby to get bigger I feel more and more anxious.... abdo now just about 97th centile.... am sure it will be fine, but just want it to come!

DS2 born 26/7 - 9lb 6.5 oz - forceps, shoulder dsytocia and then retained placenta. should have gone for the elective c-section all well now though...and think recovery quicker despite trauma of birth. no more for me!