Advice needed on big baby following growth scans

[Caldey11]

I'm currently 37 weeks pregnant. I've had a few extra scans during the pregnancy to check on my baby's bones and all has been fine. However I had a scan at 34 weeks and the sonographer indicated the baby was measuring 2 to 4 weeks ahead of gestation depending on the body part. I was scanned again at 36 weeks and the computer said the baby is 7lb 10oz so I have been told to consider an induction at 38 weeks or a planned c-section at 39 weeks to avoid the baby getting stuck (shoulder dystocia) in labour at full term.

The situation is further complicated by the fact that if I have an induction at 38 weeks it will be done at my local hospital, but may end up in a c-section if it doesn't work. I live in Wales where partners can only be present when the woman is in active labour so I could spend several days waiting for labour to start/being in early labour totally on my own. Once induction has started I am not able to leave the hospital to even see someone in the grounds.

If I have a planned c-section at 39 weeks it will be done at a different hospital (Royal Gwent in Newport) which are taking maternity patients for 1 week due to a transfer of maternity services from our local hospital to another hospital. With this option I am most worried about post natal care as I have mostly heard that you will be left to your own devices and midwives are often overstretched which worries me. Again I wouldn't be allowed any visitors after the birth until I'm discharged. I've heard they are discharging patients after 24 hours which sounds crazy as I don't know how I'll feel that soon after the operation but apparently that's what the process is.

The third option is to do nothing and wait for labour to start naturally and hope I can deliver without it getting stuck. If I get to my due date I will have to deliver at yet another hospital (a new one opening in South Wales).

I have read that the weight estimates are often inaccurate and that most big babies deliver fine, rarely do they get stuck and its even rarer that it is a real problem but knowing that it might be is making me anxious.

This is an IVF pregnancy so very likely will be my only one and I was hoping to have a normal labour, I know it shouldn't matter how the baby arrives but induction and C-section are making me feel quite sad/anxious, complicated by the hospital moves and no visitors.

I will be scanned again at 38 weeks and will then be asked to make a decision, if anyone has some experience with delivering a big baby I would love to hear from you.

@Caldey11 just following because I’ve been referred to a consultant at 35 weeks due to baby suddenly growing bigger than expected and I don’t know what’s going to happen. The only thing I will say is that if I find myself in this position I will try and put aside the visitor issue and not let that cloud my judgment.

My kids were 9lb5 and 10lb5 - second was estimated at 6lb at 33 weeks!

Both were fine. DS1’s head was 99.9th centile (MIL didn’t tell me until later that DH’s was similarly huge) but was fine, I needed a few stitches and that was it. He had other complications (knot in cord) but nothing to do with size.

DS2 was bigger but easier - but I did need more stitches afterwards but still only a second degree tear. He came out, stretched himself out and never curled up again.

I should say though that I’m quite tall!

@peachypetite Thanks for your message. The reason the no visitor thing is bothering me is that I don't know if I will be able to be relaxed enough to have a successful induction, I know how important the environment is to labouring well and I just don't think I'll manage very well without my husband, adrenaline is what slows labour down.

If I have a c-section I'm more worried how I will cope in the hospital on my own after the delivery, it's not about not seeing people to get flowers or anything, I just worry if I'm in too much pain to get out of the bed and the midwives aren't responsive I'll be unable to care for the baby. I'm looking at it from a glass half empty point of view I know but it's just a lot to take in and a big decision to make.

I really hope everything goes ok for you.

I have a 1 year old who was measuring big from halfway through the pregnancy onwards, was born at 41+3 at 9 lb13.5- not overwhelmingly massive but she was/ is long and solid.

I went into labour naturally, was ready to push very quickly, but nothing happened after 6 hours of pushing. We got told that they were going to try forceps, got ready for theatre, and then as it happened she hadn't started moving down the birth canal at all, so they scrapped the forceps and I had an emergency section. The section was much easier than expected, the recovery wasn't bad and if I ever was to go through this again (no chance) I would have an elective section.

I felt from about 34/ 36 weeks that DD was too large to be birthed naturally. She popped in and out of being engaged, but they told me that was normal for a second baby- apparently not so with a 15 year age gap, as your body has fully returned to pre pregnancy. I had a sweep where she was engaged, couldn't do the next as she was out again. It felt numerous times like my body was trying to start labour- at one point I was having contractions but decreased movements, not engaged so couldn't do a sweep and a quick scan showed she was transverse. by the time a doctor got there to check, she was engaged again. I feel like she was trying hard to get out, but there just wasn't room In the birth canal for her.

@JassyRadlett I need more of these examples, thank you! I am only 5'3" and haven't put on massive amounts in the pregnancy, I was worried I had eaten too much but my midwife told me some people put 5 stone on and that doesn't necessarily give them bigger babies. I've put on 2.5 stone which is on the upper side of normal according to Babycenter.com. I know these next few weeks are when they gain the most weight though! My husband was big at birth and long (relative to sizes in the 1980s) my midwife has said babies are just getting bigger across the board, there is also a tendency for IVF babies to be bigger apparently.

@Caldey11 my 3rd baby was 10lb 6oz at 40+5. I was induced and my labour lasted approximately 3 hours. My first was 7lb 10oz, and almost a forceps delivery after over an hour of pushing and no progress. By comparison the 3rd was easier to get out by miles. I'm only 5"6 and pre pregnancy was a size 8-10, so not exactly big myself. And he was never engaged prior to labour either, being my 3rd I was told it was completely normal for that to happen! This time (no.4) she's measuring smaller (50th centile) and no one has any concerns about her size,just the fact that she's transverse at 33 weeks. Which again could be down to the fact that its my 4th baby and my stomach muscles are completely non existent now. Oh and all 3 of my previous births were VB with just gas and air, and I was home within 24 hours of all 3 births. My last I had at 3am is and was home by lunchtime

This is such a hard decision.
My first baby assisted birth was over 9lb but late, my second at a 36 week scan was shown as 42 weeks... They were concerned that although I'm tall and not a tiny frame the baby could be 11lb or over if went over like first.
Doctor was pushing induction at 38 week or section.

My friend had first baby big and assisted, 2nd inducted at 38 weeks (took forever) and 3rd emergency c section as just over 11lb. I asked her which way I should go... She spent ages on decision and then couldn't pick...disadvantage for c section was scar and no driving. She found induction long and drawn out.

On review I found its be better to be left... Met consultant rather than one of her team ready for an argument...she much to my suprise agreed to leave me till week due and then decide.

Baby arrived naturally at 38 weeks... Just under 10lb but a natural good delivery. So it can be done 😂

Are they particularly concerned about either head or shoulder size? Or could they just be long.

My baby measured really big at a scan half way through, but the sonographer said only small babies are a worry to her and sent us on our way. Nothing was ever said about it by any other midwife after that.

Labour started naturally the day before my induction was booked in. It was back to back so bloody painful and a bit of a slog. Did have shoulder dystocia so they popped her out with a McRoberts manoeuvre (basically just push your legs at you to open up your hips). DD was over 10lb and 99 percentile head.

This was our first so no basis for comparison, but I thought it was alright. A friend had a baby half the size and she had it a lot worse!

@Caldey11 I am in the same boat, only further along. Since about 36 weeks baby was measuring big, currently being predicted to be over 10lbs at full term. It's my first, I don't have GD, I am 5'6 and quite small framed with pre pregnancy size 6-8. Currently 39 weeks and have a growth scan tomorrow with a potential sweep. I have to say I am a little uncomfortable at the lack of plans past 'we might do a sweep at your next scan' as I am worried baby might get stuck during labour. Let's see what the conversation will go like with a consultant tomorrow.

Re being by your own, yes, it sucks. I am planning to bring a book and some cross stitching I started if I will be induced to keep my mind occupied and calm.

Number 2 was measuring big but there was no massive drama around him and they left me and I laboured naturally one week early - he was 8.9.5 so nowhere near the size they thought. Number 3 was measuring even bigger and there was a lot of talk around needing emergency induction and her being macrosomic (the lady with the big baby is here) sort of thing. I was advised different things from induction, to c section. I asked for a section as I was scared by then and then a different consultant cane and said - no best just have a natural labour. Unfortunately I was petrified by then. Unfortunately pain relief didn’t work during planned section (this is extremely rare and I am sure you would have a much more positive experience should you choose this option). She was 9.10. I remember being so upset that I had a section that hadn’t gone to plan over trying a vaginal birth at that weight (but it’s so hard to know as she could have been up to around 13 pound with the errors margin they explained to me. I’m due again in April and I know this one will measure big again so interested to hear about others experience. Good luck - it’s a hard decision to make x

My baby measured big from 20 week scan. He came out weighing just over 6lbs. Which makes sense genetically as both DS and I are small. DMIL also said DS was only 6lb 8oz and small babies run in the family.

@Caldey11 wasn’t implying flowers, just more try and think what you would do in normal times. I’ve had friends give birth recently at different hospitals and midwives have been supportive post birth, understanding you’re alone with only a small visiting window. I think for me I would take a planned c section over an induction due to how long the induction could take like you sau.

I HAD a big baby and had shoulder dystocia. It is not recommended by NICE or RCOG to induce for risk of shoulder dystocia (look it up) but many trusts advice it anyway because it is the most litigious maternity issue.
Anyway, I birthed a 10.5 pound baby with shoulder dystocia; and all was fine. You have a risk of shoulder dystocia with a baby that isn’t big, too! And you need to bear in mind that 90% of dystocia cases are sorted successfully, with no harm to mother and baby. So in the slim
chance it happens, the chance is slimmer still that anything goes wrong.

@happytoday73 It's interesting to hear your story. The concern is possible shoulder dystocia although they can't measure the shoulders so it's a guessing game to know if it will be a problem. Upon reading that most of the time big babies deliver fine I was keen to wait, but I've been changing my mind on a daily basis because there are pros and cons with all the options. In some ways I wish they didn't know what size it was. I was told by my consultant that if labour stalls around 7cm that can be an indication that it might get stuck so that is when an emergency c-section would be suggested.

I think we will have to see what the weight is at 38 weeks but I haven't decided what my cut-off should be yet to determine intervention.

@Mc3209 very best of luck tomorrow at your appointment. I was told if labour stalls around 7cm that can be a sign the baby might get stuck in which case they would probably suggest a c-section at that point. It should be said though (as one poster has here) that the vast majority of big babies deliver fine, even those that get stuck are delivered without issue (all obs and midwives have training in shoulder dystocia). It's only because this has been highlighted as a possible problem that we are so focused on it. Other things can happen in labour which I'm not thinking about because there is no point, I know I should take the same approach to this and I think once I have made the decision with what to do I will hopefully stop stressing, I just feel like I'm in limbo at the moment.

My son was ahead at all his scans, I was planned to have growth scans at 28,32 and 36 weeks but because of covid only the first one went ahead. All fundal height measurements were above the 90th percentile. Midwife, sonographer and consultant weren't concerned at all as they said it's only an indication but I was very concerned about him being massive. I was 11 days overdue before I went into labour naturally. He was 9lb 7.5oz my first baby. I had to have episiotomy but no manual help to get him out. At his 6 week check his moon head was still over the 91st percentile. If I had been offered to be induced I would have snapped their hand off!

An alternative view from me is that I would jump at the chance to book a c section at 39 weeks.

I had a planned section with my big baby (coupled with small pelvis) after induction didn’t work and it was a smooth, calm, relatively low pain experience. Going straight to section would have been even better.

Do you know how your mum got on giving birth? I have family history of women struggling with big babies and I know my experience was a lot better than my mum’s and my maternal grandmother.

@edgeware I'm surprised that induction is not recommended for shoulder dystocia, does that mean c-section is what is recommended or is it best to just birth naturally and see what happens?

I was told I was having an enormous baby. He was 7lb 8oz.

I measured 2 weeks ahead with my first, had a growth scan at 38 weeks and was recommended to have an induction the following week - DD came of her own accord but was an assisted delivery, I found that and the lengthy recovery traumatic. She was exactly the weight predicted at the scan. I've opted for an elective section this time, and expecting another big baby. It's as much self preservation for my mental state and vagina as anything! I originally opted for induction because I just couldn't manage being pregnant anymore - I'm relatively slight anyway but grow these ginormous heavy bumps!

I think it's hard to know how you'll birth - I've got friends who've had 9lb/10lb+ babies with barely a tear and others who had shoulder dystocia (this was my big fear) or ended up in theatre.

It's such a difficult decision. My 2nd measured big on scans and she was - 9lb6. But she was a very easy labour, born in the water, a really lovely experience compared to my smaller firstborn. Having said that, shoulder dystocia is no joke. Have you maybe been offered another scan to assess in a couple of weeks? I'm a big fan of waiting until your body is ready for labour but maybe then be prepared for a section if necessary.

@AnnaBegins I'm being scanned again at 38 weeks so we think we will make a decision when we know what the weight is then. The problem is I know the weight estimates can be wrong, I just hope the weight is a number that helps us make a decision.

@Caldey11 I’m in a similar position - had a scan at 36+1 which estimated the baby weighed over 7lbs. I saw the consultant who recommended an induction at 39 weeks but I said no. My first son was just under 9lb and I had a fast and easy labour (3hrs, just gas and air for pushing), though I did have a second degree tear from his 95th centile head (healed fine), so I know I can give birth to big babies.

My issue is that I was induced with him at 12 days overdue and I have a gut feeling that this baby will be late too. They think she will be 9lbs at 40 weeks so could be 10lbs+ at 42 which does sound scary! Weirdly though my fundal height has been average throughout and my v experienced midwife is baffled as she says the baby feels a very normal size. I’m asking for another scan this week (I’m 38+3 today) so I’ve got something to compare the first one to - feel like it could be totally wrong but if this one shows consistent growth it might feel more reliable. I’m seeing the consultant again at 39+5 and at the moment thinking I might agree to induction after my due date. I’d really like to avoid a c section if I can.

PS I’m 5’7 and was size 10 pre pregnancy, have gained just over a stone in weight. Apart from DS all babies on both sides of the family have been small so no idea why I’ve been making giants!