Would you ask for a CS?

[ronswansonstache]

I am 38+1 and had my last third trimester scan today. The baby has always been a big girl (measuring at 90th percentile in my last 3 scans), but it looks like she has had an additional growth spurt and is now over 9lbs already.

I had been set on a natural birth but now I am freaking out slightly and scared that if that happens the baby will get stuck or injured or hurt during labour.

For additional context, this is a surprise pregnancy after 4 years of TTC. I'd actually given up last year after cancer treatment and made my peace with it, but then got surprised with this little miracle 3 months after turning 40! I'll be a few weeks off 41 when she arrives. This will be my only baby and I've been so lucky so am now feeling extremely anxious about getting through the birth safely. I have regular consultant appointments and am now considering asking for a CS given the fact she is measuring big.

I know there are many advantages for the baby from a natural birth but I really just want her here safe and sound. Would you ask for a CS in my circumstances? Or if you have any positive stories about older mums with bigger babies that might reassure me I'd love to hear them. I've been freaking out slightly since my scan!

Honestly I wouldn't, they can be so wrong with measurements during the scans. I had tons all saying baby would be huge 9-10 pounds possibly more he came out under 7 pounds. It's a story I've heard repeatedly from others who found themselves in a similar situation since I've had him.

My babies were small but I can give you lots of positive CS stories and would recommend having one (I’ve had four for a variety of reasons).

Ive given birth to a 9lb 1oz and a 10lb 6oz naturally. Found them easier than my 7lb 10oz first born, i almost ended up with forceps that time. This time around ive expressed my concerns about how big she will be, considering each time the weight has gone up a good lb but none of my drs seems overly concerned. Im only being sent for additional scans due to other complications. I cant say whether age makes any difference though, i was in my 20s with previous 2, and early 30s now. Just my experience so far if that helps at all.

Have you had three separate growth scans 2 weeks apart?

@TinySleepThief

Honestly I wouldn't, they can be so wrong with measurements during the scans. I had tons all saying baby would be huge 9-10 pounds possibly more he came out under 7 pounds. It's a story I've heard repeatedly from others who found themselves in a similar situation since I've had him.

Thanks TinySleep I've heard similar stories about the inaccuracy of scans. Were yours all showing big throughout the pregnancy? Mine have always been at 90th percentile but shot up to 97 today.

@Lockdownseperation

Have you had three separate growth scans 2 weeks apart?

I had scans at 28, 32, 36 and 38 weeks. The final one was supposed to be at 39 weeks but they didn't have any appts free then. So yes the last two were just two weeks apart. Do you know whether that makes any difference in terms of accuracy?

Were yours all showing big throughout the pregnancy? Mine have always been at 90th percentile but shot up to 97 today

He was measuring as big throughout and this fluctuated at anything between 89th and 97th, in reality he came out on the 9th percentile!!

Assume you’ve had a diabetes check? That would change things a lot.
If I were you I would definitely raise the discussion with your consultant and see what they say. There’s always a balance and it all depends what is most important to you. Agree with PP there are big variations in scan estimates vs reality - but the fact that you’ve had consistent large measures means probably the baby is truly on the big side. Doesn’t really tell you whether or not delivery will be complicated! But even without the baby being big, a first (and only) baby when you are over 40 means it’s worth considering elective CS anyway as you have higher chance of tears. I am very pro vaginal birth myself but I do think when you’re only planning one child then lots of the advantages of vaginal birth are lost (as lots of the risks of CS actually relate to subsequent pregnancy).

You need three separate growth scans at least two weeks apart. You’ve had more than that so your result will probably be pretty accurate. The prediction does have 15% error margin either way. My second was predicted to be 11lb + and I was high risk with a previous c section. I agreed to have a c section at 39 weeks if she hadn’t made an appearance first.

I would definitely explore a c section if I was you.

DC1 growth scan the week before I was due estimated baby would be 6lb, born day after due date at 7lb 8oz! So my experience of growth scans is that they aren’t all that accurate! I had an elective section with DC2 due to medical reasons and I have to say it was an absolute dream and recovery has been easy compared to the episiotomy/forceps delivery I had with my first. Having experienced both I wouldn’t hesitate to recommend the elective section but equally I understand I have been very lucky with my section experience and very unlucky with my vaginal birth!

@Itsalwayssunnyupnorth you need 3 growth scans to predict the size of a baby, did you have 3 growth scans?

After two csections that took 4 and 5 months of 3 times weekly wound checks relying on others driving me to the doctors/hospital I am here as the voice to say they aren't always the easy option even if planned! I would at least try vaginal even if you say beforehand that you are happy to move on to section on the quicker side.

@WilsonandNoodles

After two csections that took 4 and 5 months of 3 times weekly wound checks relying on others driving me to the doctors/hospital I am here as the voice to say they aren't always the easy option even if planned! I would at least try vaginal even if you say beforehand that you are happy to move on to section on the quicker side.

Thanks Wlison. I'm definitely not viewing a CS as the easy option. I wondering if it might be the safest option for the baby as I'm terrified of putting her at risk of getting stuck or injured just because I want a natural birth.

Having a CS is definitely not ideal at the moment as it would probably mean an extended stay in hospital without DP because of Covid rules, plus the extra recovery time etc.

Thanks to all for your advice and viewpoints. It's given me plenty to think about and I'll be discussing with the consultant later today.

@Lockdownseperation yes I had 7 in total I had them routinely every 2-3 weeks from around 26 weeks as due to another medical condition I had a risk of blood clots in the the placenta/cord which would effect growth

Just on the extended stay my hospital is trying to get CS people discharged within 24 hours (slightly scared of that as I'm having twins!)

I had a CS for my first child and it was really lovely no panic etc. BUT it hugely affected my long term health and I actually ended up completely infertile within 2 years as the c section scar tissue destroyed both my tubes but if you are sure this will be your only baby then the risk of this shouldn't affect you too much x

I wouldn't ask for it yet, but I see your point. There is a reason that female doctors have a high c-section rate, and it's probably because they see so many things going wrong. This may mean they have an unrealistic view of the dangers of birth. On the other hand, birth has evolved to keep you and some of your surviving/ future children alive, not to be perfectly safe every time.

You'll probably go into labour just fine in the next week or two. If not, I guess they'll induce you at term? I think you have to be prepared for a reasonable chance that that will end in a c-section, but I wouldn't ask before then. On the other hand, if I were you I would take an elective c-section at 40 weeks (if available) over going 1-2 weeks overdue.

@worldwideover that’s really interesting about female doctors CS rate - where does that come from? Is it UK specific?

Sorry OP I didn't mean to suggest that you were looking for the easy way out, just to point out cs isn't always as straight forward as it is for the lucky ones. My first was an emergency and as soon as there was a problem I was straight into surgery, it was very quick. If I could pick with number 3 I think I would opt for vaginal but make sure my other half was well prepared to suggest cs if there seemed even the slightest concern.

@ivfbeenbusy so sorry to hear that about your section and fertility. Was it an emergency section?

@FoxtrotSkarloey

DS1 consistently measured above the 91st at 28, 32 and 36 weeks and was born on the 50th centile.

Have you had a conversation with your consultant to see if age affects options? I've just had DC2 at 41 and was told they wouldn't let me go overdue due to risks of placental degradation, so would want to induce me at 40 weeks. You may need to factor this into your plan.

Hi Foxtrot, yes I'll be induced at 40 weeks. The consultant advised me to hang tight to see if I go into labour in the next week and a half and attend the induction as planned if not. Then they can make a decision at that point about how to deliver. I'm not feeling massively reassured tbh as there was a 2lb weight gain according to the scan between wk 36&38, but the different viewpoints here have made me realise there's no easy answer and the measurements are not always spot on.

I'm going to keep on bouncing on my ball and drinking raspberry tea to see if the old fashioned methods might be more effective and I can get her out naturally while I still can!

Just thought I'd update on this. Baby arrived yesterday and was indeed on the 97%tile and well over 9lb. I managed a vaginal delivery but needed ventose and episiotomy. I did sign the consent form for an EMCS as it looked like she was going to need it towards the end. I would have been very annoyed to have an EMCS after going through full labour, pushing and attempted instrument delivery!

Anyway, alls well that ends well and DD is here safe!

@ronswansonstache that's lovely news

@ronswansonstache I had the opposite, was measuring big throughout, then growth scan said she was a normal size and a lot of fluid. She came out 9lb 13oz and ended up with an emergency c section once I got to 9cms due to fetal heart rate drop. I'm now 29 weeks and measuring big again but waiting for growth scan (which I have 0 faith in anyway) before they decide if I will need a c section or not.. it's such a hard decision, c section obviously has longer recovery and baby could be smaller than they are predicting xx