'Small for Dates' at 39+4

[bobbledog]

Apologies, this is a bit of a rant about my midwife, but I'm hoping that somebody's had something similar and can tell me Im being daft.

2 weeks ago (37+4) at my Midwife appointment, she measured the fundal height and as it was only 35.5, said I needed to keep an eye on it (not sure how she expected me to do that...)

I've had a good, if anxious pregnancy as my son died from complicartions during his leukaemia treatment last year. This, combined with a high nuchal measurement for this baby has meant that I've had consultant led care. A throwaway comment like that about measuring small really puts the wind up me, so my consultant checked me out last Friday (38+ 5) where I measured 37cm and was 3/5 engaged.

After a more general feel, we had a reassuring conversation that this was normal, and whilst my baby wasn't huge, he/she was certainly a clinically appropriate size. Additionaly, we talked about how fundal height wasn't accurate at this stage and how she (the consultant) wouldn't usually bother measuring at from 36 weeks.

So all good until today (39 + 4). Usual Midwife had a student with her who had a feel and, once again, measured the fundal height. Now 35cm and not engaged at all. I lost it a bit and said how I'd seen the consultant and she was happy. Midwife doesn't offer to examine me further and again says I need to 'keep an eye on it'. I said if she was concerned, surely she should send me for a scan or something and she replied with, 'no need for that, your urine and blood pressure are all fine.'

I'm quite upset by now, she's writing small for dates in my notes and I'm trying to explain that it's not helpful for me to keep hearing that. I ask her to finish up quickly so I can go (and have a cry in the car).

Rationally, I know that everything is fine, fundal heights at this stage are a load of bollocks and the baby moving around is a better indeicator of health yada yada. But a bit of me is thinking, what if she's right? What if there is something wrong and no-one else could see it? Because that's what happened as my boy got sicker and sicker and they were telling me it would be ok....

Sorry again. Thanks for reading and any exeriences welcome.

And more apologies for inability to type and spell at the same time.

I'm not sure that bump measuring means much tbh. I measured 50th centile throughout and my daughter weighed below 10th at birth. In any case she was completely healthy just slight and still is. I imagine if they were really worried they would have referred you for a scan. Is the baby moving OK?

Fwiw I measured 27 on my 28 week appt 30 at my 32 week, 32 at my 34 week and 33 at my 36 week appt and they are not concerned in the slightest. My dd measured small and was 8.4 so they aren't concerned

I measured about 5 weeks behind from 20 weeks. They kept going on about my "tiny" girl. In the end she was two weeks late and weighed 6lbs15. Not huge, but not tiny either. She was absolutely fine and is now a beautiful totally healthy 18 month old.

Try not to worry about it, I think your mw has been rather tactless.

nuchal height isnt the most accurate measurement for baby tbh. i'd be tempted to ignore her tbh.

Ignore, I was told both mine were small for dates all the way through. They were 6lb1oz and 6lb10oz when they were born. I am only 5'3" and 8stone (or I used to be - am now 39wks pg with no3!!)

Do ignore it, lady in hosptial with me when having my dc2 was having her dc1 and she was told for weeks that her baby was small for dates, and she was even warned about if the baby is too small it will have to go to special care baby unit for a little while. That night she gave birth (vaginally - ouch) to a 12lb13oz baby...... so big that all the "tiny baby" babygros were far too small, her dh had to run out and get 3-6 month babygros (even the 0-3month ones were too tight!).

So ignore the comments on small for dates.

For me, my biggest belly was with my smallest baby, and I was smaller with my next baby who was 2lbs heavier. Having more water / less water makes a huge difference, they really can't say anything about the size of the baby from the size of your tummy.

I hope this reassures you.

I was sent for a scan at 29 weeks measuring 26 weeks. Stenographer took one look at my tummy and said "your midwife thinks it's small - I don't think so" and she was right. Ignore them.

Thanks all, just the sort of reassurance I was after. I've got a GP appointment on Monday so hopefully he'll say useful things too.

willitbe that story made me and DH laugh - and then cross our legs in sympathy :)

I have been measuring small for dates since the MW started measuring me at 27 weeks. At 27+3 I measured 25cm, at 29+3 I was 27cm, so consistent growth but about 2 weeks behind each time. My MW got in a bit of a flap after the first measurement and sent me for a scan (more because I am moving out of the area soon than any massive concern, I think)

My DP got himself in a right old state as it is his PFB (my 3rd so I am more blasé) so here are some of the things I told him. I hope they help you as well.

Bump size changes depending on the position the baby is in. You have seen this yourself, with your magically shrinking 2cm in 2 weeks. Unless you have been leaking fluid (and trust me, you would know!) there is no other logical explanation for it.

Mothers size makes a difference to the size of the bump. It is ridiculous to assume that a size 8 woman will grow by the same amount, to the same size, as a size 18 woman. 1cm a week is a rough guideline, nothing more. Nomone has told the babies that they are supposed to be growing at that rate, so many of them do their own thing. Some might have a massive growth spurt then a lull, some might be slow and steady growers. More again might be slow burners and plod along at less that 'optimum' growth but still come out at a respectable and healthy weight all the same.

Genetics has a part to play as well. If you and DH are both basketball player height, then odds are that your baby will be quite long. Depending on how they are laying, that could make your bump quite big. If you are both Hobbits, you might have a shorter baby who takes up less space leading to a smaller bump. How you carry any weight you have makes a difference as well.

In short, 'to dates' assumes that all babies and mothers grow at the exact same rate and are all the same. We all know that no two babies are the same so why suddenly expect them to fall into line when it comes to growth?

We actually have customised growth charts here and I managed to be 40% out. As I am 5'10 it decides that my baby should be bigger than average.

I am measuring 2cm small and as far as
my mw has said, I've got myself in a flap about it. That my baby is growing so she isn't worried.
I would call your consultant see if he/she can reassure you?

Hope you're ok, your mw seems less than sympathetic :(

Thanks again for your support / experiences. My GP has called me to check I'm ok - midwife went to see him and said I was upset.

He was reassuring - said that as long as BP was ok and baby moving about nicely (which it is) then he wasn't concerned about anything else. He thinks having the student there just threw things off a bit and led to some miscommunication.

So feeling better and will see him as planned on Monday :)

Weirdly, my experience is sort of opposite. My mw said I was measuring small for dates and sent me for a scan, which they didn't do as another mw who measured me first said I was measuring fine. My mw continued to measure me small for dates and this was ignored by the hospital.
When dd arrived, 11 days overdue, she weighed 5lbs 8oz, right on the borderline for concern.
She was perfectly healthy, just little. My mw felt vindicated!

It does sound to me that your mw needs to look at the bigger picture though, and listen to you and your concerns.