Experiences of having or refusing an elective C section due to baby size?

[SaraKatie]

I’m 36 weeks pregnant and this is my first pregnancy. At 35 weeks I had a growth scan because the baby looked a bit big on a regular scan, and the measurements were very large (above 95th percentile for basically everything). The estimated weight at the time was 8lb 8oz, and I was told that the baby could be as big as 11lbs at 40 weeks. Because of this the consultant is pushing for an elective C section at 39 weeks. I’ve to get another growth scan next week, but they seemed to be heavily suggesting that the C section would be essential. The thing is, I don’t really want a C section. I’d have one if it was medically necessary, but I just don’t know if I trust the growth scan. I don’t have any of the usual risk factors that contribute to a large baby - I don’t have gestational diabetes (they made me get the test twice because of the baby’s size), my pre-pregnancy BMI was healthy, I’m under 35, the baby is a girl, and I’ve also only gained around 23 lbs and been very active during my pregnancy. My bump isn’t very big at all. I just really don’t want to agree to a C section only to find it was not necessary. I was wondering if anyone else has experienced anything similar, and what the outcome was? I’d also like to hear how accurate people found their growth scans in late pregnancy to be! Sorry this is so long, I’m just completely stressed out by it all and finding it hard to eat or sleep due to the worry.

Measurements from late scans are notoriously inaccurate. If it was me I would try to go for a natural birth but in hospital rather than a birth center and be aware that an emcs may happen.

I didn't refuse a section but I had extra growth scans because I had GD and was told baby was huuge. She was 6lb 13! So as PP says they can be pretty inaccurate!

I had an elective C for my second as was measuring big. My first was 10lb 8oz and the second was 9,12lb at 38 weeks . The estimated weight from growth scans was less than that x

I also had this and my DD ended up being 10lb 4 - I was unlucky in some ways as went into labour naturally but had to have an EMCS in the end as she got stuck back to back and wouldn't budge. My mum on the other hand had three babies all over 11lb naturally without a problem so its luck of the draw.

I personally would not go for one unless something else develops but on the understanding that you could have an emergency one anyway.

I was told the same, dd2 was measuring big on all scans from 36 weeks onwards. Her head in particular was over 95th percentile. I was all for going for a VBAC (first ended in EMCS due to failure to progress). They said dd2 would be 10lbs+ at 39 weeks, bigger if I went over due.

I ended up having a c section at 39 weeks. Dd was 8lbs 15oz so not massive.

Growth scans are know for being wrong, even the consultant told me there was a 25% margin of error. Could you go for a natural labour in hospital rather than MLU? The hospital I used has both next door to each other, so transferring in labour is fine.

I was told at 36 weeks that baby was estimated to be 8lb13 (also off the charts for all measurements!) and offered CS or induction at 39wks. Im still pregnant (38+4) so unfortunately can't confirm the accuracy of the EFW in my case, but having spoken to a few midwives they have all told me the estimations are notoriously inaccurate. The Dr that offered the interventions told me it was a 20% margin of error either way, but from my reading the EFW tends to be over-estimated rather than under-estimated, and the accuracy of the measurements declines as the pregnancy goes on - so the later the scan the less accurate the estimates.

Ive declined CS and agreed to induction at 40 weeks but to be honest this is mostly because if i went over and ended up being induced anyway it would fall during Christmas week, which I would rather avoid. If i wasn't being a megalomaniac about potential Christmas birthdays and ruining Christmas for DC1 then I would probably decline the early induction too to give my body a chance to go into spontaneous labour

Has the CS offer come from the hospital? In my experience the hospitals are quick to offer preventative interventions where as the community midwives take a less risk-averse approach to labour. Obviously there are pros and cons to both approaches, but I found it really helpful to talk through risks, benefits and unknowns with my allocated midwife, mostly as she had more time to discuss things than the hospital Drs and midwives.

Good luck with whatever you decide!

I got told my baby would be around 6.8 she was 8.6! X

I had sections because I prefer them (have a phobia of childbirth) but with my recent baby my bump size, and growth scan estimate we're absolutely bang on. Like to the ounce.

Hi, my son measured ‘big’ all through my pregnancy and they believed he would be 10lb+ full term or over so the consultant recommended an induction at 38 weeks. They were worried I might struggle to deliver his shoulders safely etc. The induction failed, I had an emergency section and he was 8lb 9oz.
This time around, the baby (we were unaware of sex) was again measuring big but they gave me the option of a vbac or section. I felt the midwives were very pro vbac and the consultants very pro planned section. I chose the section, we had a girl and again she wasn’t as heavy as expected.
My experience for both is that the growth scans were pretty inaccurate. My bump was large for both but I had a lot of water.
Maybe a compromise for you would be an induction? You could give birth earlier so potentially safer but it might save you having a section.
Go with your gut - it’s your birth and you know what is best. Good luck xx

Not c section but I was induced early, for several reasons but one reason was because all 4 growth scans said she was huge. I had her at 38+3 and she came out a diddy 6lb 9oz

I went over, and the baby was measuring big so the induction was brought forward to 41 weeks. The day I was induced the scan measured 10lbs. They offered a section, I said I was fine with either so ended up trying induction.

Induction failed (quite possibly because she was too big to descend) so I had a very relaxed emcs. She was 9lb 7oz, with a head circumference above the 99.6th centile.

I will say my section was an entirely positive experience, I'm early in another pregnancy now and if it goes to full term I intend to have an elcs.

DO NOT TRUST GROWTH SCANS. I had a section with my first as she was measuring 9.5lbs at 37 weeks. She was 6lbs12oz when she was born a few days later! I also wanted a natural with my second as she was measuring over 10lbs and they suggested one at 39 weeks as I had already had one and a big baby can get stuck etc... she was born 7lbs10oz!!

Emergency c section with child one who was absolutely huge nearly 12lbs, second child they said I had to have a section due to growth and gestational diabetes she was nearly 8 lbs, but they worried about her shoulders getting stuck, they can estimate shoulder by the tummy circumference. I didn’t want the section but I didn’t want to re live the horrible and dangerous experience we had had the first time around. Personally I’d say do what you think is the sa fee at thing for your child. My planned c sections have been a walk in the park compared to the horrible labour and descent into emergency the first time around x

My second was predicted to be 95th centile. The constant was happy for me to continue to plan for a home vbac. She said that size was only a small part of a vb not going well. He was born on the 75th centile, which is with in the margin of error for their measurement. So 9lb rather than 10/11lb, and he was an emcs because he's very floppy and bendy and was never a stable lie.

How would you feel about induction? I'v had several late scans, some predicted less than what baby weighed and some more. In my experience the accuracy depends on the scanner and the baby on the day (are they moving around lots or squished etc).

Hi all, thank you for your responses. I’m under consultant care and will be giving birth in a hospital (I’m in Ireland and not the UK).

I did ask why induction wasn’t offered and was told that she didn’t think it would be a good idea because the contractions wouldn’t be as strong as natural ones (?) and the baby would be more likely to get stuck.

I’m just so thrown. I felt really confident/not scared about birth before all this. Like my mindset was that it’ll be painful and difficult etc., but I can do it. Now, I feel like if I go for a vaginal birth I’ll be going in with a doubting mindset not knowing if I can do it. I just really don’t want a C section for several reasons - the fact it is major surgery, potential complications for both the baby and myself, I’m worried about how it would affect future pregnancies, I’m
worried it would affect my ability to breastfeed, I’m worried about the psychological implications because I don’t want one and I feel like it could affect me mentally.

I just don’t know how I’m meant to make such a major decision based purely on a growth scan, because there are no other indications of a large baby. I’d hate to have a C section to find she is a normal size, but I’d also hate to try and have a vaginal birth only to find I was wrong and the baby and/or I end up very injured or it ends with an emergency C section anyway.

I just can’t stop agonising over this and I know no one can really tell me what’s right so I guess I’m just venting.

I had absolutely no problem breastfeeding after my emcs if that anecdata is of any use to you. Best of luck with your decision.

I had an elcs for breech, no mention of large baby. He was over 9lbs. I had growth scans for dc2, estimated at 8lbs 8. Had a natural birth, he was 10lbs 13. It was fine. Well, would have been if he wasn't back to back, but it was ok.

My firstborn was estimated at 36weeks to be over 98th centile, but at the time my trust weren’t inducing or offering section for large babies. Had an EMCS at 9cm for sepsis and he was 10lb 5oz at 41weeks. So fairly accurate.

Second time I went for VBAC , was induced at 39+4 for likely late onset diabetes and acute polyhydramnios. We knew he was probably going to be huge looking at head measurements. Had a normal birth albeit with some complications and he was 10lb. Again fairly accurate.
I’ll go for another VBAC when we have no3, probably be big again, hopefully not bigger! As far as I’m concerned, estimated large baby isn’t a reason for ELCS

DD was estimated to be 7lbs 4 at 34 weeks and over 10lbs full term. She was only 7lbs 2 when she was born at 38 weeks! So very inaccurate

I think I would go for an induction in your case but I could be bias as I had a very positive induction and there was nothing weak about the contractions. Size of baby is a funny thing as some people have small babies that get stuck whilst other easily birth 10 plus pounders. Your advise almost seems opposite to what would be advocated in hospitals I'v given birth in.

I was under the impression that contractions from induction, particularly from the drip, were stronger than natural contractions so it's strange what your consultant said. I was induced early due to baby measuring very large (above 98.5th percentile in tummy and head size and measuring 7.5lb+ at 35 weeks). Induction failed to progress and she was born by EMCS at 8lb12 at 38+6, so not exactly huge. Push for whatever feels right for you and don't feel forced into a CS if you'd rather try induction.

I believe c sections are safer than VB for the baby. They are riskier for the mother during and immediately after birth. But have better long term outcomes for her too. Breastfeeding is very possible after a c section. As is skin to skin.

I agree that now having a doubt in your mind about the feasibility of a vaginal delivery will be difficult to overcome.

If I'm honest, I think I would consider worst case scenario for both options, and the chances of those outcomes happening. You might find it steers you towards one option. Sometimes it has to be a logical decision rather than gut feeling.

My predicted 10lber was 7,11 at 38 weeks with a large head. See what the next growth scan says. I was induced for other reasons but didn’t like the idea of a c section either.