Petite FTM with GD and big baby how to deliver?

[katerose2022]

I'm a petite (just under 5ft, 37kg before pregnancy) 38yo FTM with GD. Had posterior placenta previa / low-lying placenta but it seems to have finally moved at 36w, 2.3cm from os. Baby was scanned at 36w+4d estimated to be 3.1kg, which is 66th percentile on non-customised chart but over 90th percentile on my own GROW chart. HC and AC both over 80th percentile.

I'll be having another scan at 38w. My consultant asked me to think about how I want to deliver at 39w which is when the baby will need to come out otherwise can get too big. It will depend on whether the baby's head is engaged or not by that time. If not, then I guess c-section.

The question is if baby's head has engaged, how should I choose? Shall I try vaginal birth to start with even knowing the baby's head and overall size is big for me? I don't think I want the induction drips but maybe the other ways of induction first? Or shall I go straight to a c-section?

Really can't decide. Would love to hear some suggestions and experiences please. Thanks!

DS2 was measuring very big and I was warned I might have to have a c-section, but he was bang on average when he arrived (vaginally) at 38+4. I had no idea measurements could be so wrong, but they must be right at least some of the time. I'm afraid I haven't got an answer for you though - if the consultant isn't pushing you in a certain direction, it's totally up to you. If you're worried about giving birth vaginally, don't - stress just messes the whole process up.

I was a petite first time mum with GD who got told she was having a big baby, said baby was 6lb5 and needed tiny baby clothes that mum hadn't bought because she was advised otherwise haha. I have since learnt how common it is for babies estimated weight to be off 1 or 2lbs even for those with GD

I think it depends on your attitude to risk of birth injuries. I am (was) very petite and I have no regrets about delivering twice via c-section.

I'm not petite. I'm 5'8. However, my 3rd baby was a big baby, although I was told at my growth scan 2 weeks before giving birth that he was weighing 6lbs12oz. However, when he arrived(vaginally), he weighed a big 9lbs6oz. I suffered during that pregnancy and had a 3rd degree tear, and baby suffered shoulder dystopia. However, he has no problems now with his shoulder or arm.
I am now currently pregnant with my 4th(21 weeks), and I'm opting for a c section this time round.

Hope all goes well for you

My friend was in the same situation as you OP and really had to fight for a section. First consultant refused and told her she should try for a vaginal delivery.
She got her section in the end and just as well - he was almost 10lb!

I am petite (although not as petite as you are), and I had two large-for-me babies vaginally. My personal grow chart for DD2 actually lists DD1 as '100th centile' for me; DD2 was a mere 90th. (Both mine were tricky little things, and not predicted to be nearly as large as they were, despite serial growth scans for DD2 after the surprise of DD1.) I did have a fairly serious tear with DD1, although probably caused or worsened by something nothing to do with her size. For me the tear healed easily and well, and I opted for vaginal again with DD2 (personal preference plus easier recovery with a mummy-centric toddler).

However, both my labours started naturally, I didn't have induction to consider. I also didn't have GD, which I think increases the risk of shoulder dystocia.

It's not an easy decision – how you balance your preference for one best case scenario against the severity and likelihood of different complications is very personal.

It's so hard to know what to do as unfortunately you have no idea whether a natural birth would be straightforward.

I'm 5'2", not slim, both babies around 9.5lbs.

First one I was induced at 41 weeks as they didn't want her growing any more. They offered a section but I decided to try the induction. In the end it didn't work (one midwife thought possibly because her massive head couldn't fit down my pelvis to cause dilation) and so I had a very uneventful emergency c section. They did need forceps to get her out (who knew) but she was fine.

Had decided before I left recovery that I'd have an ELCS for any future babies. In the event, DC2 was transverse so it was necessary anyway. Again, her size and position made it tricky to get her out and we both had some complications but were fine by the time we were out of theatre.

In your shoes, I'd have the section because of the predictability but if you want a natural birth that's understandable and there's no guarantee you'll have a tough time/.

You should very similar to me only I didn't have GD.

Largest baby was 10lb 6oz.

TBH you need to be concerned with Jews and shoulder size. My DC were all very long/tell hence being heavy.

I wish I’d had CSs. Birth injuries can have such a huge impact, my kids are teens now and I’m still having issues and waiting for surgery again.

Jews = head

Thank you all for the super helpful comments! Yes I'm concerned about potential should dystocia as well, as my consultant has repeatedly mentioned to me the risk. Guess it's not a time for me to try to be a hero... baby's safety is the top priority. I'll most likely go with a planned c-section then.

What happens if labour starts spontaneously before the c-section date? I'll just go to the hospital and request for an emergency c-section?

Thanks again everyone!

Yes I was booked a section and was told to present at the hospital with the first sign of labour and it would be classed as an emergency section but quickly it would actually happen would depend on whether there were any others who also needed one e.g a Cat 1 section where the baby needs to be out asap.