Failed by midwife?

[Shannoncn7]

I'm 39 weeks pregnant with my second baby and have been pushing for vbac birth. My midwife has assured me all the way that this is a low risk pregnancy and should be fine, however she measured me yesterday and said my baby hadn't grown since last app. She booked me a scan at the hospital for today.
Today they scanned me and baby is nearly 3lb heavier than she had estimated and now they want me to have a c section again.
I had multiple issues with my first pregnancy, placenta previa, diabetes and another big baby at 10lb. Placenta moved last minute had 4 failed inductions then emergency c section, midwife knew all of this... How has she gotten it soo wrong?

I've refused the c section and asked to be induced instead, doctor has said we can try but chances are the c section will be necessary... I just don't know what to do now. So upset and angry. Has anyone been through something similar?

Trust your gut and if you want to try for induction then do that. You’ll be in hospital anyway so if a c section is necessary then they can go ahead. Xx

It depends, how did your first section go? I had a really complicated section with 4.5 litre blood loss, and was told that for all future pregnancies I could either go into labour naturally or have a c section and that it wouldn’t be recommend to have an induction//for use of induction drugs again. For what it’s worth, I found my second planned section recovery a breeze - much much better than an emergency section but I know this isn’t the case for everyone x

Sorry, complicated emergency section for my first that should say!

So let me get this right: midwife has been measuring fundal height which suggested an average sized baby. You've just had a scan after no change to fundal height and the scan says baby is large.

Fundal height (and an individual scan and not a series of scans done over time by the same sonographer) are used as a rough indicator of growth. So no, judging by this, you haven't been 'failed' at all!!

The health professionals are simply providing advice based on the circumstances as they become known.

Both my babies were big 10lb at 39+4 - first one got stuck after induction, and wouldn’t come out with forceps and my second was 9lb 5 at 38 weeks x

Like @physicskate I'm struggling to see how you've been "failed". It's unfortunate, but fundal height and individual scans are only approximations.

For both your sakes, please accept the C-Section. Safe arrival is the priority.

Honestly OP, I'd seriously consider the nice relaxed ELCS rather than risking another failed induction and EMCS.

I've had two big babies, and I genuinely don't think either fit in my pelvis - the first was a failed induction. The second was transverse and a small pelvis is one of the risk factors for that.

I don't think you've been failed, although in my hospital with a previous 10lb baby and EMCS you would've had shared care which would have included scans.

The important word in there is ‘estimate’.
It’s not an exact measurement.
I’m sorry this hasn’t worked out the way you wanted but I can’t see what you think should have been done differently?
Your bump Size hadn’t increased? So the baby wasn’t looking big? That’s all the midwife has to go off??

I know you are disappointed and stressed, but honestly I don’t think she has done anything wrong. She sent you for the scan which was the right thing to do and now you have more information. Sorry it wasn’t good news and very beat of luck to you and your baby.

Sorry but this doesn’t seem like the midwife’s fault.

It's not the midwives fault, it's not an exact science. If she's been measuring fundal height then she's followed policy.

Some babies just sit differently. If it's far back then there's no way she could have known.

A planned c section is much safer than a emergency one - for you and the baby . You needed an emergency section after failed induction last time so why would you risk that again .

They don’t advise c-sections lightly. Please take their advice and accept it. I had a planned section for my second baby and it was really smooth and easy. Very different experience to an emergency one from speaking to friends who have been in this situation. I recovered quickly and easily.

Why do you want to be induced? Is your baby healthy? Is it just because they're big (or measuring big on the scan)?

You're much more likely to have complications if you are induced especially having had a section before. (I had
vbacs with Ds2 and 3) but neither induced.

There's lots of other ways to encourage labour if you feel you want to

Hope it goes well whatever you decide

My fundal height was all over the place so I don't think you've been failed - my midwife even said with only a tape measure to go by she could measure me on a sofa vs a hospital bed and the measurement would be different!

I had a planned section with my now 3 week old and it was fab - so calm and serene and my recovery was great. This was after being terrified that baby wouldn't cry, would need assistance, that id need a transfusion etc. Whatever choice you make is the right choice if you do end up with an elective please take heart in how beautiful and natural they can still be.

I don’t think you’ve been failed and I don’t think she has got it wrong. She will have done a correct fundal height measurement. The fundal height measurement just doesn’t marry up to the scan…..doesn’t mean the fundal height measurement is wrong. Also doesn’t mean the scan is wrong….they’re two different things.

A fundal height measurement is a screening tool. It is a rough guide but any inaccuracy in its validity doesn’t mean it’s operator error.

It is possible the scan is inaccurate. Mine certainly was at 39 weeks…estimated an 8lb baby and she was a bit over 6lb.

I understand your disappointment though. Personally I’d go for a lscs but you need to think how would you personally feel if you hadn’t tried an induction first? Are they worried about the risk of shoulder dystocia?

There's not a chance in hell I'd be asking for an induction in your shoes.
Big baby that may poss end in an emergency c section.... why would you risk it becoming an emergency situation?

You haven't been failed. DD2 was measuring big by fundal growth all the way through and growth scans told me to expect a big baby (8.5lbs plus) In the end she was 5lbs 13 and diagnosed with IUGR, just showing that midwife and growth scan sonographer were wrong. It's an inexact science and you get the choice to attempt an induction if you want that to see if they're right or wrong but nobody has failed... everyone is just acting on the info they have at the time to ensure both your safety. I understand your upset tho, I do, but deep breath and remember hardly anyone gets the birth they imagine and you'll have a lovely baby regardless soon enough x

I think these midwife guesses ard only approximate so I don't think you've been failed. I wouldn't likd a c section but in your circumstances I would definitely have one if thats the medical advice.

Hi,
There’s a lot going on here isn’t there.
Just going back to your first baby and that birth, it all sounds very complicated and confusing. I’ll try to clear a few things up so moving forward you understand the process more.
With your placenta previa, the placenta was very close to or covering the cervix. As the uterus stretches the placenta stretches and grows with it usually leaving enough safe space by the cervix to contemplate natural,childbirth.
You said you had diabetes, with diabetes comes the risk of a larger baby (I assume you had all the necessary tests this pregnancy to rule out diabetes again?)
Induction is an ongoing process, you’re not generally induced a numbe4 of times, you might have multiple pessarys for example but they wouldn’t be classed as individual inductions.

Anyway, so it’s been picked up that in your current pregnancy your baby is measuring larger then average according to scan
You’ve had a previous c-section following an 8mduction that didn’t progress.
Can I ask how far into pregnancy you was and how if you dilated at all?

I think in your shoes (with the information you’ve given so far) I’d decline induction hoping to labour spontaneously but if this hadn’t happened by 41 weeks opt for elective c-section.
Electives are usually a much better experience then the emergency you would have had, as disappointing as it may be there’s a time and a place to consider and opt for them

Good luck with deciding which route to take

I don’t think you have been failed.

I think that the midwife has assessed your pregnancy at each visit and reassured you that all we going well. When she saw you last time, she recognised a deviation from normal and took the appropriate action to refer you in for assessment. I think you have said that you were ‘pushing’ for VBAC. You can disregard the medical advice, but it will be at your own risk.

Lastly, your midwife only measures the SFH in centimetres, not pounds. There will be a growth chart in your notes if you are in England. The weeks and cm side is for the midwife, the weeks / weight is for sonographers only as they are the only ones who can estimate foetal weight.

If you've had a previous big baby you're likely to have another. Induction only ups the risk factors, if you've been through that before why risk it again? Elective C Section is the safest option.
I get wanting to give birth vaginally, I did and baby was only 6lbs at 41+1, I certainly did not want a c section. But with other factors at play please take a cold hard look at what is safer for you and baby. I'd have changed my tune pretty damn quick if I had one of the many issues you've already had previously never mind with this baby.

You've not been failed and IMHO you're stupid to consider an induction

Firstly, your pregnancy has never been low risk. A previous section automatically makes you high risk so although your midwife may be right that things seem to be going ok this time, I'm sure she can't possibly have told you that you're low risk.
Secondly, as others have said, fundal height measurements are subjective. You haven't been failed in that respect because your midwife noted the static growth and referred you for a scan, as she should.
A section has been recommended for good reason. Your baby is assumed to be big and, coupled with your previous large baby, there is a valid reason for wanting to deliver this baby asap. Your body hasn't laboured before and there is a limit to the amount of times they can try induction techniques before moving to section again. They don't want to risk scar rupture and your baby and you being at risk of complications from the induction.
A planned section is much more gentle that the emergency one you had last time. Many women will tell you that this has been a positive birth experience for them and they've been glad they went with a planned section.
There is also the risk that, if you did go for induction and it didn't work, you would be more prone to postnatal depression.
Good luck with whatever you choose though.