Whoppa baby - who can I talk to about this?

[LadyHalesBroach]

Wondering if anyone else has been in this situation? Part of the problem arises from me having antenatal care at one trust (Hospital A), and booked for delivery at a second trust (Hospital B) because of geography and the two don't communicate. Ever.

My fundal height at 28w was 30cm, so a bit on the big side. Now I'm 31w and now 36cm. So... still very very big. All measured at Hospital A.

I am 5'4, my husband is 5'4, we're both slim to average build, my first baby was 7lbs. I had a consultant appointment (Hospital B) last week who did some blood tests (random glucose?) and they said it was fine, although my iron was very low. Just had community midwife (A) appointment who was alarmed at the latest fundal heigh measurement, suggested the random glucose wasn't enough and if I was delivering in her trust, she'd urge for another scan. But because it's not in her trust, it's up to me to push and raise these concerns.

So I did. I called Hospital B and repeated everything and they just sounded like I was wasting their time. I'm already booked to have an ELCS at 39+5 (falls between xmas and new year) so they've said "it's coming out the sunroof anyway, there's nothing we can do at this point".

My worry is - what if there is something wrong? If his growth continues this way, I'll be having a 15lb baby at full term. If I go into spontaneous labour and can't make it to the hospital in time (geography not my friend here) and he gets stuck because of his size. Have I done something wrong? I thought I was eating too many packets of cheesy wotsits but surely not enough to develop a baby that's the size of small hatchback?

Please can someone help - as you can tell, I'm panicking.

(And no, I can't switch to deliver at Hospital A. I mean I could, but whilst their antenatal hs been fine, their maternity unit has been on the news for neonatal and maternal deaths. I'm just not risking delivering there. It's notoriously bad.)

Fundal height measurement is not very accurate, it doesn't take into account your own body shape or size etc. Even growth scans can be inaccurate. They'll have tested your glucose to check for gestational diabetes as that can cause a bigger than average baby, but it sounds like they don't think it's that. You could pay for a private growth scan? My growth scan said baby was measuring small under 6lbs at 36 weeks, but he came out at 38 weeks weighing 10lb 8oz and I don't think he put on 4lbs+ in 2 weeks! There's always a margin of error with these things.

Yep, fundal height is really inaccurate, have you had a growth scan? Those are a little better, but not perfect!

My last scan was the standard 20w one, and because he's already booked to be evicted by elcs, they aren't offering another scan.

Might well book a private scan tbh.

but that's good to know that there's potential for this to be wrong and I'm worried over nothing.

Fundal height is notoriously unreliable. I had two box babies by c section and having the section booked would reassure me. Will you be having a pre op appointment at your hospital to give consent and go through everything then? Ask then what to do if you go into labour and if there are any risks to delivering vaginally if it comes to it. Presumably even if you do grow a whopper (by no means guaranteed based on fundal height), presumably if there are no signs of diabetes or other problems then the size only becomes an issue towards the end when he's bigger than "normal" full term babies iykwim.

Should emphasise I have zero medical training, just based off my own experience.

Has it been the same person measuring fundal height each time? it's notoriously inaccurate even if it is but it's basically useless if it's different people! some people carry high, some low, it depends on your shape and size. If your GTT was normal then you don't need to worry. Scans are also notoriously inaccurate - up to 15-20% out.

My trust does a routine 36 week scan which estimated my baby to be 6lb. He was born at 41 weeks, 11lb4, at home, no pain relief. IT was absolutely fine, much easier birth than my 6lb12 firstborn! I really would not worry at all. Your body grows the baby for your body.

Fundal height is not great way to measure. A scan will be much better but even those can be out a fair bit. If you go in to labour before an elcs they will get you on that days list, may be a wait if you are not progressing very fast though.

I've had big babies. Our 2nd was way ahead on fundal and growth scans, had polyhydramnios (high fluid) and he was 10lb 12oz @ 40+5. I had an unassisted vaginal birth with 14mins pushing so not too bad. Had another big singleton vb and then big twins via elcs as breech. Our 6th was measuring far ahead too, 20wk 50th centile, 31+6 97th centile, 35+6 off the charts and those were scans. She came out at 38+6 via cat3 CS 10lb 15oz, the day before my elcs was booked in. I started contracting in the early hours but was in complete denial that it was labour, by 3pm I had to go to hospital and they confirmed active labour. They didn't get me in to surgery until after 11pm, there were more urgent cases put before me. I ended up with scar rupture and heavy blood loss so unwell after but I recovered eventually and baby was perfectly fine.

OP my baby was 10lb but measured completely average on fundal height and bump measurement. They are not very accurate.

The glucose test is to rule out gestational diabetes. If that was negative then I wouldn't worry.

Lots of evidence suggests that larger babies are actually easier to birth because they are stronger.

I really would not worry at all. Your body grows the baby for your body.

I know you're trying to reassure OP, but this is a dangerous myth that gets repeated around hypnobirthing groups. Both of my babies were too big for me to deliver naturally - not a drama as I had c sections which were lovely but there was no other way they were coming out.

I’m also on the short side and midwife consistently said fundal height measurement put baby over 90th centile. A friend who’s an OB told me fundal height is less accurate in small people -basically baby has little room in your torso so bump has nowhere to go but out. My baby was entirely regular sized …. But I did have growth scans before any decision was made re delivery.

I'm tiny and measuring on the 90th centile for both fundal height and on the growth scan. I think the baby did slow down in growth after 33 weeks or so as I don't appear to have gone up much since then. They haven't said anything about needing C-sections, further growth scans, or inductions. If they thought there was a big issue I'm sure they would have said! Plus, like PPs have said, fundal height when you're a small person is probably more likely to be big because there's nowhere else for baby to go.