28 weeks, LARGE baby. Induction? C-section? I don't know what to do!

[Decaffrappe1988]

I'm 28+3 and I had a growth scan today as my fundal chart was showing baby was on the large side and it was right, baby is on the large side (I don't have GD as was tested a few weeks back).

Head and stomach circumference are 95% percentile and legs are 51% so averaging at 87% and currently weighing 3.2lb. HOLY SH*T.

I'm now being monitored every two weeks but the consultant advised that if baby continues growing at this rate I'll be looking at an induction or a C-section and the choice is completely mine. (However, baby currently in breech position at the moment so I may not even have a choice) but if you had to choose between induced or c-section what would you pick, and why?

TIA! :)

Hey! Ahh wow you have a little chunk in there
Ok so I've never been induced or had a c section so I'm just offering some support based on what I've researched for myself and what other people have told me.
I guess some factors would be at what point they would want you to deliver and how you feel about the recovery time of a c section. But I
think if I were in your shoes I'd be more inclined opt for a c section if it's going to be a good few weeks or more before your due date as I've read an induction generally works more quickly the closer you are to being ready naturally. Obviously they wouldn't offer you the option if it wouldn't be successful but I'd just imagine there could potentially be a longer labour with being induced very early. That would be my main reason, I'm sure you've read that there are pros and cons for both methods of delivery on offer to you. Either way, good luck & hope you're feeling ok! X

It's still early for you to decide - baby may not continue on this growth trajectory (that's why they do more scans) and if he/she stays breech the decision is pretty much made.

I've had two inductions, and two big babies (10lb and 9lb12) and both were fine. DS1 was a surprise being so big, but DS2 was induced a little early because of his size. Would do the same again, but not everyone would agree with me!

@SockQueen I know, that's why I mentioned "if" as i'm just wanting to put some research incase I'm left to these options. The idea of being paralysed waist down horrifies me as I hate feeling that out of control, but my SIL recently prolapsed due to a big baby induction birth which I know is rare but makes me squirm!!

Lovely to hear you had big babies and it was all fine though - makes me feel more at ease, thank you! :)

My fundal height for DD1 was really small so I had a growth scan. Suddenly, she was predicted to be 95th centile and there was talk of inductions and c-sections and expecting a 10lb+ baby. Given the quick about-face of the measurements, I decided to wait and see how labour progressed on its own at full term, and have a c-section if things stalled (she was back to back so I was told I'd probably end up with a section anyway). It was a 2.5hr labour start to finish and she weighed 7lb 7oz so all that panicking was for nothing.

If you don't want to wait it out like I did, I would wait and see and probably go for induction over c-section if baby is still looking bigger when you're closer to your due date. (This is if you plan to have other children due to risk of complications with subsequent pregnancies/births. If this baby is likely to be your last then I'm not sure what I'd choose).

I had a planned c-section and loved it. I didn't feel out of control, I loved the fact I knew exactly what was happening and it was totally pain free. I had my baby in my arms so quickly. Of course the recovery can be tough but I don't have any of the pelvic floor/tear problems etc that my friends with vaginal births have. With a big baby I'd definitely do it again but it's such a personal decision and I've never experienced an induction.

I had a baby that was measuring about right on the scans but was bigger than they expected when he was dragged out via cs.His head was very large and I had a long labour with failure to progress.
Second baby booked a cs, went in to labour and had a vbac. her head was 1.5cm smaller and she was a pound lighter, it was a very tight fit.
I had the drip in my first labour to try a speed things up with an epidural it made no difference.
If you go into labour and are dilating 1cm in an hour and a half or less time there's a good chance. If you get stuck at a certain point its probably down to size in my experience.

I swore to never volunteer for induction again after having one with our 1st. If you go that route and have the hormone drip get the epidural early.

Our 2nd was huge, he was 4 weeks ahead on growth scan at 28wk. They would only induce if I went 2 weeks over and there was no mention of cesarean. He arrived at 40+5 weighing 10lb 12oz! His shoulders got a bit stuck so it took 15mins to push him out and the midwife had to catch him as he kinda flew out once the shoulders dislodged lol. I had to have cesarean with breech twins last time. I'd heard nothing but bad things about the procedure and recovery from family members who'd had one but after having mine I think they were just being drama queens. The surgery was calm and recovery was no worse than my 3 naturals despite heavy blood loss and my wound getting infected later on. When I 1st got up to walk about 12 hours after surgery I felt like a lead weight but by morning could walk about as normal and felt fine other than being very tired.
I have the option of vbac of ercs this time, if baby is in a good position I'll probably go vbac. Prepared to go cs if I have to, that will mean more time out of the gym though which I'm not keen on.

I can't remember the actual measurements for mine, but my external measurement was 40cm at 30 weeks, and had growth scans every week. Told that they wouldn't let me go a day past my due date, and would probably end up induced or C section. Baby came 2.5 weeks early and weighed in a 7 13, would have been big at full term.

They estimated my daughter as 97th centile and she was going to be 11lbs! I was terrified that I would be torn apart and I wanted a C-section. I was offered an induction but I declined. In the end I went for a natural labour and she came out 8lb 6 oz (ended up with an EMC but this wasn't to do with her size). I was so proud that I went through most of the labour and to have the experience. These growth scans are highly inaccurate and they terrify you for no good reason. Just go with the flow would be my recommendation, lots of people have successful natural births with big babies (and the baby might not be that big anyway).

I've had 4 sections, the 1st was an emcs as I failed to progress. Dc2 was an elcs as she was breech but she did turn the night before the section, she was delivered at 38 weeks weighing 10.9lbs, so large babies can turn, wasn't very comfy mind! My other 2 were elcs and dc4 again another 38 week section weighed in at 11.6lbs. All of mine measured large with no gestational diabetes, consultants and midwives were never worried but after my 2nd having a section was my only option. Some people just grow big babies, infact dc4 who was my heaviest is now the smallest in his class, no one ever believes me when I tell them how much he weighed at birth.

Child 1 - 9lbs 6 induction with epidural, small tear, awesome birth
Child 2 - 10lbs 6, induction failed epidural, no tear but rectocele, urine incontinent, he had a brachial plexus injury no shoulder distocia, traumatic birth, body and mind took forever to heal, bad pnd
Child 3 10 years later - requested c section, 10lbs3 at 39 weeks, what a dream!!! Planned, in control, everyone lovely, discharged the next day, took co-codamol once and coped well with paracetamol after that, pulled up my spent tomato plants 3 days after a section!
So for me- section over induction? Section all the way. But it is very very individual and sadly totally unpredictable.
Good luck x

My baby was about the same centile and only offered an induction due to gd, she was 8 pounds 7... I'd opt for an induction but I should have gone for an epidural as I struggled alot more than my 4 non induced labours

Try not to worry too much about the baby being big. I had four big ones (first was 9lb, the others all 11+). The first three were all easy and fast, at home with only gas and air. With the fourth I had various minorish complications and was under an ob. I was booked in for a midwife appointment at 39+2 and then an induction the following day, but I was going to ask the midwife (who'd been there for two of the other births) if we could give it until 39+5 (the previous two were both 39+4). However, an unfortunate combination of circumstances meant that the induction was pushed forward, the midwife was still on holiday, I was recovering from pneumonia, etc, etc. So I let myself be talked into the induction at 39+1 and it was a disaster. Again I only had gas and air (nobody offered anything else, and I was in no state to discuss options or even know they were available) and labour was unbelievably difficult. If my body had been ready like it was with the others, it would have been a three hour labour with me doing basically no pushing (it just happened)--although clearly a lot of the preparation would have happened before the last three hours. This time, once contractions (finally!) started it was also three hours but just impossible. It was like 0-60 in three hours whereas the previous ones had probably been at 50 before "labour" started. I had to push but had no idea how to. And the result of the speedy labour was that I had a traumatic birth injury and couldn't walk at all/stand/do anything except lie in a medical bed for three months.

So if I had to do it over, I would definitely have pushed the issue on waiting (hard to do when you're ill and exhausted and have forty pounds of extra fluid in there on top of the baby weight, etc!), and if it hadn't happened with a sweep and pessary at 39+5 I'd have requested a section if they still didn't want to wait. Although I really wish the ob had paid more attention to the fact that I'd pushed two of these humungous beasts out quite safely already and that the midwife hadn't been on holiday at the crucial moment when I needed her for back up.

I haven't had a section so can't speak to the recovery, but I think induction is really hard unless your body is already starting the process itself.

I've had three sections for giant babies. They thought they would be massive and they were, 10lb 12 and 11lb 13 (three weeks premature). I'm glad I had planned sections as the dr said I would never have managed to get their heads delivered.

You've still quite a way to go though so it may be that your DC doesn't continue on the same trajectory. Good luck with whatever you decide to do.

C section. For my first I ended up induced as went overdue and it was sooooo painful, baby went into distress... needed Emergency c section.

OP, although it seems to be often suggested by HCPs, it as against NICE guidelines to offer induction purely on having a large-for-dates baby. The thinking being induction carried its own risks, and having a larger than average baby is not that unusual or risky. The accuracy of growth scans can also vary.

See this evidence based blog for more info:

midwifethinking.com/2019/09/02/big-babies-the-risk-of-care-provider-fear/

My 2nd was a 90 something centile when born. I'd had growth scans as they thought he was too big at 20th scan. Then he was too small, then too big again. In the end he tracked along the same lines and noone was terribly concerned. Good job as I wouldnt of had him early since my dad died 9 days before my due date and funeral was the day before due date.

Anyway, he was born 40+3, 8lb 14oz and was an absolute doddle of a birth! 5 hours start to finish, no pain relief, in the pool, waters broke started pushing and 4 mins later he was here. Tore slightly but not enough for stitches.

Not an answer to your original question but wanted to make the point that big baby doesn't equal difficult point.

To answer your original question... I think Id wait and see (if possible). The reason being that if they can burst your waters fairly easily then you miss the days and days part of an induction. If they can't get in to break your waters then it could be less fun.

I had my waters broken and drip with my first. Wasn't officially induced and hadn't had a single contraction but they were able to break my waters without any earlier intervention. Contractoons started immediately, drip an hour or two later (not sure why they bothered), baby born 7 hours after they broke my waters.

I am more scared of c sections, probably because I've never had one. But equally I wouldn't be up for pessary after pessary, the rods etc so I'd want to know what 'stage' I was at at the time.

My best friend who has had a c section and vbac (never induced) would choose a c section over induction in a heartbeat. So I guess it is fear of the unknown more than anything.

Good luck, but I would try not to overthink it too much until you are at least 1 if not 2 scans further along the growth chart.

[quote InTheFamilyTree]OP, although it seems to be often suggested by HCPs, it as against NICE guidelines to offer induction purely on having a large-for-dates baby. The thinking being induction carried its own risks, and having a larger than average baby is not that unusual or risky. The accuracy of growth scans can also vary.

See this evidence based blog for more info:

midwifethinking.com/2019/09/02/big-babies-the-risk-of-care-provider-fear/[/quote]
I was just going to say this. I wish hospitals would stop offering intervention like this where it isn't evidence-based! Next time you see a consultant about this (if you do), please raise this point with them, I'd be interested to hear their reply. You can find the NICE guidelines on this easily via a Google search.

I've not had an induction but am 10 days post c section and can fully vouch for it. Mine was an almost emergency and even so my recovery has been pretty straightforward. I can honestly say now, even after a week, that I did not at all feel like I had major surgery. I feel a bit bruised but honestly have felt more pain after an intense ab workout haha. The first 2/3 days you're pretty immobile and sore from where you're in one position for a long time, and also quite dependant on midwives or other half, but once that passes and epidural/spinal tap are out of your system you're mostly ok. The only thing I think I'll struggle with is the not being able to drive for 6 weeks, but that's my only con and even so I have family and friends nearby to help so a good excuse to take it easy. I'll definitely be opting for an elective section if we have another and can imagine my recovery would be even easier with it not being an emergency. Also, I like that I'm still 'intact' down there and have no pain or stitches in that area to contend with! So if you do end up having to have one because of baby's position, really don't worry about it 🙂 and in your position I would be opting for one anyway, but worth taking into account other viewpoints and midwife advice to see what works best for you and your situation! Good luck!

I’d go induction (if not breach) but with a view to moving fairly quickly to section if progress was slow.

I considered ELCS (different circs) and now very glad I went for induction (which failed incidentally!).

@MeadowHay shoulder dystocia is not something to take lightly, if you are at risk then it is infinitely better that they take preventative measures. Horrific thing for everyone to go through.

That being said, I was told that if everything is in proportion then they don't worry so much. If the head is too big for you to deliver then you can have an EMCS. The worry is when the body looks larger proportionately than the head which obviously increases the risk of shoulder dystocia.

100% c section. That’s only based on my experience of a EMCS after failed induction. Xx

You can refuse induction remember. You will be asked to go in for daily monitoring instead. Personally, I'd have the section (having had an emergency section myself).

@Chelyanne Your comments about drama queens after c sections are horrible. I've had 2 sections, the first was a nightmare recovery, took 5 months to heal. The second was fantastic and I was back to normal after 6 weeks. After the first I was dead set against another section and advised everyone to avoid them. After the second I'm much more balanced. Just shows that not all bodies and experiences are the same.

OP in your position I think I'd watch and wait.

I had an induction with my first and it was utterly horrendous. Ended up two days later with an emergency section and a horrible long recovery. This time I'm having an elective section and feeling much calmer about it (although of course it isn't an easy decision because it is major surgery which carries its own risks). I personally couldn't go through an induction again, particularly not when there is a risk of ending up with an EMCS anyway.