Strongly advised not to have homebirth due to possible large baby - overly anxious midwife or sensible?

[NorkyButNice]

I had a growth scan yesterday and the baby is estimated at 8.5lb at 35 weeks. Sonographer predicts minimum 10lb at birth, but could be more (eek).

I'd pretty much decided to have a homebirth with full support of the midwives, but after the scan the sister at the antenatal clinic said that they strongly advise not trying a homebirth with such a large baby, and they probably won't support me going ahead with it.

Surely they can't refuse to turn up if I decide to stay at home? Or am I being stubborn for the sake of it?

I have to see the consultant next week to "discuss delivery options", and then have another scan at 38 weeks.

you're right they cannot refuse and i suspect they are using this as a get out because they don't want to do it

growth scans are notoriously unreliable! margin of error of at least 20% each way anyway
if you do a search on here you'll come up with hundreds of stories from people who've told they'll have a big/small bnaby and had the total opposite

even if your baby IS big, that is no reason to suspect that you won't be able to deliver naturally. plenty of people have 10lb babies and deliver them just fine.
there is a school of thought that says that your body will not grow a baby too big for you to deliver (unless factors such as gestational diabetes are at play)

If it were me I would still absolutely go ahead with a homebirth

Plenty of women have given birth to babies of 10lb or bigger at home, but that may not be relevant in your case. Is this your first? If not, what size was your first?

Did they say what they were particularly worried about? Was it sholder dystocia? Did they say how they would deal with that if you were in hospital rather than at home?

And, no, they can't refuse to turn up if you decide to stay at home.

DS was 8lb 13 and was delivered naturally in hospital (albeit with extensive tearing).

She didn't say why they wouldn't be supportive, but that the consultant would discuss it with me. Am dreading being told I have to be induced or have a c section if it gets "too big".

"there is a school of thought that says that your body will not grow a baby too big for you to deliver (unless factors such as gestational diabetes are at play)."

That sounds like nonsense sadly.

I would think about all the risks of having a big baby at home (knowing that growth scans can't be 100% accurate), talking it through with a midwife or the consultant and waiting to see what your scan at 38 weeks says. If you are still happy with things, then you can still go for a homebirth.

Completely agree with the others. Growth scans are very innaccurate and there is no reason why you can't have a straightforward birth at home with a big baby. In my experience as a doula, the bigger babies I have seen born were easier births.
Some good info here-
www.homebirth.org.uk/big.htm
They can 'advise' you have the baby in hospital, get induced or have a CS but it is up to you whether you want to accept or decline their opinion and you are entitled to choose where you want to have your baby.
Have a look at-
www.aims.org.uk/
Selina

does it mrsgangly? makes a lot of sense to me.... the vast majority of women allowed to labour naturally with minimal intervention can birth a large baby
10lb is hardly huge either is it?

ftr my friend refused induction at 38 weeks when they insisted her baby was going to be huge, estimated at over 10lb
she gave birth at 41 weeks to an 8lb baby

bearing in mind just how unreliable growth scans are I find it hard to see any reason why you would use the results of one to make important decisions about the birth

I had a homebirth three weeks ago and DD2 was 10lb 11oz, largest by far of my three DCs - more importantly, NO stitches, tiny graze that I didn't even know where it was. So large babies don't automatically mean problems and tearing.
I was the opposite though - I was the one worried about her being huge and the midwife told me at 38 weeks she wasn't exceptionally big! 99th percentile

ahh selina you beat me to it, was just about to post the homebirth.org link!

It depends on how set you are on having a homebirth. If it's something you feel passionately about having, then you need to talk more with the midwives about their reasons for suggesting a hospital birth, and the logistics if you did need to be transferred to hospital.

If you'd prefer it, ideally, but are not against the idea of a hospital birth, then you might want to think about taking their advice for your own comfort if nothing else.

Speaking as someone who had a 10lb 4oz baby, needing a forceps delivery after a 30 hour labour and failed vonteuse, I'm very glad I was at the hospital already and didn't have to endure a painful and scary journey, mid labour, to the hospital delivery suite.

MrsGangly

^""there is a school of thought that says that your body will not grow a baby too big for you to deliver (unless factors such as gestational diabetes are at play)."

That sounds like nonsense sadly."^

Actually it sounds like perfect sense to me... Imagine an ancestor of yours, without the benefits of our modern healthcare system, grows a baby that is too big for her to deliver... Mother and Baby die... genes for making babies too big to be delivered don't get passed on. That is pure Natural Selection at work.

We all come from long lines of women who have successfully produced and reared babies and passed on the corresponding genes...

well done minnie!!! and congrats

a friend of mine had an 11lb 12 baby at home, unexpectedly huge as well lol
she had shoulder dystocia, and the midwives dealt with it fine (in the same way they would if in hospital)

OP. the other thing to remember when making your decision is that you'll have 2 midwives with you, looking after only you. you have their undivided attention.
they will spot any potential problems and can transfer you if necessary

OP - FWIW my DS1 was 10lb 6oz and delivered totally normally in hospital - I wish I'd had a home birth, especially as the pushing contractions started when i was in the bath at home and we then transferred to hospital in an ambulance - can't think why we didn't ask to do it at home once we'd got to that stage....

I had a similar scan at 35 weeks, and DS was 10lb 4.5oz when born. I had a straightforward delivery, except that his shoulders did get stuck, and as I was in a pool, had to get out and walk across the room! Fortunately that did the trick and he came out fine (no tears). However, I suspect I was lucky, and additional help could well have been needed - but that's true of any birth. (I was in hospital). My SIL also had a big baby, with shoulder dystocia - so it seems to be a common concern/complication. It would be worth understanding what the steps are if baby gets stuck, so you can make an informed decision. Good luck.

But if your DC1 was 8lb 13oz then surely they must have assumed long before you reached 35 weeks that your DC2 could be at least as big if not bigger. And you say they were fully supportive then. So if they were happy enough with you expecting 8lb 13oz - say 9 and 1/2 lbs, what is it about 10lb that worries them more?

I would listen very carefully to their advice at 38 weeks, but would want a clear explanation of what exactly is worrying them.

I was told after a growth scan ds would be over 10 lb. He was 7lb7.

My sister had her almost 10 lb baby at home (her first) and didn't even tear.

That is a massive over-simplification KnitterNotTwitter.

Yes, lots of huge babies are born completely normally with no intervention. Others aren't. I would imagine their main concern is the risk of shoulder dystocia, and although there can be some signs during second stage that it may happen, can be very unpredictable. I wouldn't want a SD anywhere, but particularly not at home.

However, another school of thought would say that you are more likely to have a SD if you end up giving birth lying on your back, which is more likely to happen in hospital.

You also need to decide how confident you will feel giving birth at home now that doubts have been raised. I would have a good talk with your community midwife and see how they feel about it.

I had a scan at 36 weeks and was told my baby's tummy was so big it was literally off the scale. The sonographer had to work out the weight by hand because the computer couldn't cope with the figures. The overall weight of my baby was estimated to be big. And they were right. My ds was born at 36 + 6 and weighed in at 8 lb 10 oz. I was pretty relieved he turned up early.

Like you, I was advised against a home birth by the doctors, but my midwife, who was very experienced, said in her opinion it depended what part of the baby was big. A big tummy was no problem because it was squishy. I guess a big head might have been more problematic. I ended up having a home birth and it was easily the best of my three labours.

Good luck!

All 4 measurements were above the 95th centile line - the highest is abdominal circumference at around 38cm putting it way over the top line.

I'm hoping I go into labour naturally as soon as the baby wouldn't be premature anymore, but I guess there's no relation between size of baby and when they turn up.

DH is getting nervous about a homebirth now and I don't know if I'd want to do it if he wasn't completely supportive of the idea.

Wait for the 38 week scan then making a decision sounds like the best plan!

Can't get my head around this birth at home thing especially when there is even the slightest contra-indication. Surely you'ra always going to be safer in a good hospital.

I don't want to sound alarmist, as I am sure everything will work out fine, and no doubt if you did have the baby at home it would probably be ok, but I would be baffled by anyone who insists on having a baby at home when they are being strongly advised not to by the medical staff. Yes - you might want to have the baby at home, and yes, if all goes well that would be a nicer experience for you than being at hospital, but at the end of the day, surely all that matters is that you and your baby are as safe as possible? If I were you I would take the advice of those who know more about these things than I do (e.g. doctors and midwives), and get myself to the hospital as instructed! Good luck.

" as instructed"

OP is neither an employee nor a child. Poor choice of words with hugely disempowering implications.

If you wish to be at home, and dislike the idea of being in hospital then stress and discomfort becomes and additional risk factor in the delivery of a baby. Unless the existing risk factors (whether estimated largeness is even a risk factor is debatable) are such that medical care that can only be provided by a hospital (such as IV antibiotics, etc) are essential then it may very often be better and less risky for the baby to be delivered at home where stress and anxiety will not undermine the progression of labour. imo and that of many

"Surely you'ra always going to be safer in a good hospital." The statistics would say otherwise. Counter-intuitive maybe, but for low-risk women, home birth is at least as safe as hospital.

i had 11lbs 4oz baby in hospital; had to be induced 2wks od, he well stuck, had to get doc at end, ventouse, but well done so baby and me ok. Wouldn't have wanted be at home, tho would have wanted to be in better hospital!! (they kept saying he not big...) Maybe if you live near hospital could be fine? Relaxed at home good, and help near if need it. Good luck

The school of thought about babies not grownign bigger than your body can cope with isn't strictly true.

My DS2 was 9lb 2oz, not huge but not small either. The midwives were aware he was large but thought I'd manage fine.

At the birth I was glad I was in hospital as there were major complications because of DS's size compared to my pelvis.

I haven't been allowed to deliver naturally since and have had more DC's since. I tried for a VBAC with DC4 but my consultant refused point blank. I won't type what he said but it was scary.

Not trying to be alarmist, just giving the point of view of someone who had a baby too big for my body.