Small baby

[anna2101]

Hi!

Im currently 34 weeks and baby has been measuring small since 28 weeks, so I've been having scans every 2 weeks. Some days he is measuring above 10th centile, others below 10th centile. He's a very active baby so I think that often skews the measurements. He's otherwise healthy and every scan im told he's doing well and there is nothing to worry about. And despite that, during yesterdays scan, I was offered an induction at 40 weeks. It doesn't seem to marry up in my head - if he's healthy and doing well, and he's just small (I'm also small, and no baby in my family was ever born over 3.2kg, I was 2.9), then why induce? Surely it makes sense to have him bake awhile longer if he's doing well inside the belly so that he can come out weighting more? Until week 28 I was having a textbook pregnancy and am myself healthy - I was planning a low intervention birth centre delivery. And now I'm guessing I would not be allowed into birth centre due to continuous monitoring - which don't fully understand - i keep being told that he's doing great and everything is well and yet I'm also told I need to have an induction and am basically high risk for a birth centre ? But for what reason? I just feel like I'm missing something - clearly not fully understanding something very obvious... Thank you!

This literally happened to me with my first baby. To be fair he was small at 5lb 10 but was perfect and is now a healthy three year old. I let being told small babies don't have the reserves to get through labour... they coerced me into induction at 40 + 3 and I was also high risk due to size so continually monitored. His heart rate dropped and it was emergency c section. Up until 36 weeks I'd had a really normal
Pregnancy and was planning a home water birth.

It's hard as I always struggle with the question "what if I said no to induction" would it have gone differently.

Just remember - You can say no to anything so you could just request a personalised birth plan and ask for intermittent monitoring not continuous so you can be upright and active? And you can decline induction and just agree to extra monitoring as a compromise.

Good luck x

They picked up that DS was small at about the same stage. He hovered between the 4th and 9th percentile and we eventually went to weekly appointments to check on him, particularly given that his older sibling was a decidedly average weight the whole way through. They take it seriously as consistently measuring small can indicate an issue with the placenta and be a marker for an increased risk of stillbirth.

Ultimately towards the very end of my pregnancy DS’s growth plateaued and he was delivered via section at 37w on the dot. I am a cautious person and I’d had a few losses prior to him, so I was quite happy to go with their advice. When he arrived he was at about the 25% percentile, which is obviously still on the smaller side but not quite as tiny as predicted.

Both my daughters were born at 37 weeks after induction on the 2nd centile and 5lb 3oz. I was more than happy to get them out and safe in my arms as their growth was not improving.

Happened to me with both mine, I had home births and they both came out over 8lb. MW was astounded, but it happens a lot. I’m a small person with a long back and it’s not an exact science.

This happened to me also.
Baby was measuring 2nd centile all the way through pregnancy and they offered me an induction at 40 weeks but I refused as my birth plan was no intervention no medication. Baby was born naturally at almost 42 weeks at 6.3lb with no worries at all. We had to attend small baby clinic for the first few months but quickly got signed off as doctors were happy given both me and my partner are also very small.

I think in these circumstances, the worry is the further past 40 weeks you go, the more risk of the placental function decreasing. This coupled with an already small baby can be a concern and it is often thought of as safer for them to be out where their condition is easier to monitor.

It is also the case that a 'small for gestational age' baby does not have the same reserves to cope with the stress of labour, hence the continuous monitoring.

Is it possible to see how things are when you get to 40 weeks and go from there? You are totally within your rights to decline an induction and opt for regular CTGs if you prefer, if at your growth scans all remains the same and there are no concerns with your placenta.

Sorry i probably should have added to my original response that I did have placental abruption straight after baby was born, this is a risk you take not opting for induction but I got extremely lucky that my placenta lasted up until a few minutes after he was born. I had to have some placental tissue 'massaged' out weeks later...(totally not a massage!)

@carbiee can I ask whether any placental issues were noticed on the scan (if you were having regular scans anyways)?

@anna2101 I had scans at 7w, 13w, 16w, 20w and then every three weeks until 36w and then every week from 36-42w and no placental issues were picked up on the scans. I also had low papp-a which is linked with placental problems but no issues with my placenta throughout the pregnancy. I suppose placentas are only designed to last full gestation so anything over it starts to become less efficient