Previous big baby, long labour and forceps delivery. Being referred to consultant for 2nd baby but what exactly are they going to do?

[GhoulsAreLoud]

My midwide has said I will see a consultant at around 30 weeks and that the hospital can arrange growth scans for me as my previous DD was 9 pounds 11 and my labour was long and ended in an instrumental delivery.

The thing is, as far as I can tell, I am not likely to be offered either an early induction or a c-section so I don't really know what I am seeing a consultant for?

Did try to ask the m/w but she didn't really answer. So does anyone know what the likely options are going to be when the consultant goes through them?

I had a big baby that got stuck, similar to you, so with my second pregnancy I saw the consultant. I had extra growth scans, and it would have been more relevant at my due date. I wouldn't have gone over it as my previous preg was 42 weeks. DS came early in the end. So they may consider induction (or even an elective CS is the baby looks big/not in a good position) earlier than they normally would.

I expect they won't do much now, but you're in the system and as you get close to or past your due date, they may treat you differently because of your history.

Not a chance of me having a homebirth!

I'd be quite happy with an ELCS, but if I have to do it naturally I really want to know sooner rather than later as I need to book the hypnobirthing classes soon.

The hosp was very reluctant to offer me an ELCS, esp before my due date. But I felt more prepared for the VBAC attempt because I knew the 'whopper baby' potential was flagged in my notes, so any problem was more likely to be identified early on.

As it was, DS arrived with no problem. Good luck

Thanks wonderingwondering, do you mind if I ask how many weeks your DS turned up at and what size he was in the end?

Just bumping in case anyone else has experience.

I would expect them to check you for gestational diabetes - I'm having random glucose blood tests in this pg due to a previous largish baby

my first baby was over 9lb and was born by ventouse after a long labour

this had everything to do with the setting i was in, the care i received and the pain relief i took. it had nothing to do with his size

i delivered my next 2 children at home, with no -pain relief in 6 hrs and 45 mins respectively!

there really is no reason to have a c-section just because you've had a big baby. i am guessing iut's just "protocol" which is why the MW couldn't really answer your question

So the protocol is to send you to the cons who does nothing (other than maybe arrange a GTT test) then send you away again?

Anyone with actual experience of being referred to a consultant in these circumstances so I can get an idea of what goes on at this appt?

I had an appointment with the consultant for my DC2 due to similar reasons to you (DS was 9lb 7oz, and was that was 3 days before his due date! He had shoulder dsystocia and needed a ventouse)

Beacause of all that he gave me the option of going for the ELCS, so I did. I have to say it was a much better experience as there wasn't all the trauma, but it all depends on the individual as to what they prefer. Good luck

That's really interesting, thanks bandgeek.

DD was born 2 days after her due date. She had whatever forceps delivery it is when they move the baby's heard (rotational?) so I'm not sure if that is a factor for seeing a cons or not. I really don't know, the midwife didn't really explain much.

Can I ask how recently it was that you had your DC2?

My first baby was 9lb 6oz at 42 weeks, my second was 8lb 4 four days before his due date. So if he'd have stayed in until 42 weeks, he'd have been a similar size to my first.

I was a size 8 (pre-babies!) so that's quite big for my frame.

I know you are not having a VBAC, but I recommend reading the National Institute for Clinical Excellence (NICE) VBAC guidelines - they say things like - if labour slows, or goes on for more than six hours, then the protocol is an em CS. So knowing what the 'problem' signs and 'cut-off' times are, and being in a position where DH could demand it (and quote the guidance) gave me a lot of confidence going in to a second labour after a difficult first one.

So you could ask some questions of your consultant, based on the NICE VBAC guidelines, and ask what protocol they use (as in, how long you labour for before the go to CS, at what stage they'd induce, how/whether they monitor size/position in the run-up to the due date) for someone with your history.

But at a first appt, what they'd routinely offer is a GTT, growth scan and a pat on the head!

That's interesting, thanks wondering. I absolutely do not want another assisted delivery, so it would be interesting to see if they would agree to a cut off point in labour and to a c-s rather than an instrumental delivery if things don't progress.

I got a referral to consultant at 16 weeks dd1 was only 6lb 6oz but long labour back to back ended in theatre for forceps delivery after ventouse had failed twice...

I said I wanted to avoid instrumental delivery again and was initially looking at Hypno birth...my consultants appointment he did the normal mw checks and we discussed previous birth and he offered me an ELCS, which I wasn't expecting but more and more as time goes on I'm thinking thats the route I'm going down no drama/truma...

My stitches took ages to heal they disolved but the discomfort lasted for more than 6months if I sat funny or moved funny so I don't want to go down that route again!! My bladder is much weaker as well not sure if that is the same reason? But I've decided to ditch the Hypno birth (borrowed book and cd form a friend but the cd annoys me so I'm going down the ELCS route..

I need to inform the consultant at my 36 week appointment, my only concern is my dd was early 9 days and they normal do a section a week in advanced, but my understanding they usually do it a week in advanced?

I plan to book a pregnancy massage, facial, manicure and pedicure the day before and have a nice meal wih my hubby, dd, mum, IL's and chill.....if baby comes early then never mind but I figure I'll make things as pleasent as possible

Ghouls, I had an em c-s with DD1 (8lb 9oz), and was referred to a consultant. The consultant asked me what I wanted for the birth, when I said I wanted VBAC, she talked me through their protocols, advised me that they would not recommend water-birth or using the MLU etc. She also asked if there was anything I definitely did not want following my experiences with DD1.

I wonder if it's just that you qualify as a 'difficult birth' first time around, and that means an automatic referral to a cons?

Thanks both, that's really interesting.

I really, really don't want another instrumental delivery and would prefer a c-s to an instrumental delivery if it came to it. I do know that c-s is a major operation but I can't face the idea of having that again - being cut and stitched in the same place. I would rather be cut and stiched somewhere else if it comes to it!

Butterscotch, that's interesting that they offered you a section - I also had failed ventouse before the forceps.

I suppose the best way to approach it is to make clear to the cons that I don't want an instrumental delivery and what the best way to avoid that would be (obviously a straightforward natural birth would avoid this!)

Hi GhoulsAreLoud, I had a similar situation with DS1 - he was 9lbs 12oz and had to have forceps delivery in the end, I also had a 3rd degree tear as well as the episiotomy and had to have a blood transfusion 3 days later, found the whole experience extremely traumatic. I had a consultation to discuss my previous birth. Going into it, I was dead-set on having an ELCS, but after speaking to the consultant and hearing that it wasn't recommended for my circumstances, I wasn't so sure. We decided that I should have a growth scan later on and another consultation with a hospital midwife (not my community midwife) after the results of the GTT come back, before I decide whether to have an ELCS or not. I intend to discuss with her my options for a VB and I also will discuss the timing of labour - exactly as you say, I feel that I want a CS rather than another instrumental delivery. After my initial consultation, the consultant sent a detailed letter about our conversation to me (to put in my hand-held notes) and my GP. This was very useful as it refreshed my memory about everything we had discussed and it seems like they will be keeping a close eye on 2nd and 3rd stages of my labour to avoid the complications I had with DS1. Overall, I found that consultation was really useful for me. I hope you find your consultation useful as well. I'm glad to know that there are others out there in the same situation as I am!

Thanks Rachel, that's good to know. Good luck with it all.

Had a very similar experience to you with ds1 who was 10 pounds. Saw consultant when pregnant with ds2 who said a c/section wouldn't be appropriate. Didn't find the consultant visits all that usefull tbh, they said each time that this would be an average sized baby.

I had a sweep at 40 weeks and went into labour naturally 2 days later, labour was four hours start to finish. DS2 was shoulder dystocia and weighed in at 11 pounds (not that average then!)

Obviously the shoulder dystocia was fairly serious and I did tear quite badly BUT I would say it was a much much better birth experience than ds1 and I recoved much quicker (natural tear healed far quicker than episiotomy)

Good luck