Birth decisions - age 40, large baby

[CCrowe]

Wondering if other people have any experience of weighing up whether to try for a vaginal birth or have an elective caesarean with a similar risk profile to me?

I'm 40, we are planning to go ahead with the recommended induction at 39 / 40 weeks if we try for vaginal birth, the baby's head circumference is measuring big, in 97th percentile (all of which increases risk of tears, emergency caesarean and other complications) and we have an anterior placenta. If we try for a vaginal birth I've planned to have an epidural for a number of reasons.

I'm just not sure what to do. I don't have an ideological view one way or another, I just want to weigh up what might be likely to be the best option Last time we saw the consultant she still believed it would be better to try for vaginal birth but that was before we got the latest head measurement.

If I had to choose between an induction and a planned c section (for a first baby) I'd choose an induction. Personally I was determined to experience natural births but I know some women don't have that same need or desire and if you are one of those women who don't mind then c section seems most sensible. Inductions are iffy - they can take days and days to get started and there's no gradual build up to the pain (from what I have heard) which must be so stressful and frightening for a first time mother. Either way good luck!!

I was induced with my first baby as he was ivf and they wouldn't let me go over. The birth was fine but he came very fast thanks to the induction. I tore all the way through. Pelvic floor completely gone into my bum. Horrendous. I had emergency surgery 10 mins after he was born to repair it all. They found I had also torn into my uterus. I had a PPH and needed a blood transfusion. I had a nights stay in ICU as I was unwell and another night on main ward. He wasn't particularly big. 7lb 4. The recovery was really shit. It was right at the start of covid so that didn't help as shit/no after care.

Second baby I had a planned section. They did it at 36+4 as they were worried he was small/not growing. It was an absolute dream!!! So calm and peaceful. So very different to first birth. The recovery was amazing even with a 2.5 year old in tow. I was in the park with them both day three (and DH) but still. Baby was 6lb 4 at 36+4 so not small really (and a tank now!)

Read up all the research and make an informed choice. Good luck

Your experience is exactly what I experienced with my first even to the days overdue. Second time around now and I've point blank refused induction and told my midwife that I won't entertain the idea. If im not ready by then, I want c section. I know plenty of people who went for induction and ended with emcs and experienced the horrors of 24+ hours of intense labour only to end up with emcs anyway risking baby and mum. I would rather cut to the chase and go straight for c section if that's where im heading anyway. Of course my preference is vaginal birth but induction, no thanks!

Yes op you can ask for an elective while you’re on the ward. They class anything that’s not an actual emergency as an elective. But i would still push to get it arranged now if that’s what you want.

They don’t clean it via the uterus, they put the forceps up the vagina

I am really surprised to hear that. Seems to defeat much of the purpose of avoiding an instrumental delivery. How do you know?

I am almost certain that didn’t happen during my c section.

I remember flinching when they placed the catheter once I was lying on the table and the epidural was in. I could feel someone or something touching my genital area (it felt strange - fuzzy/tickly). Then one of the theatre nurses explained what they were doing. Would have been nice if they’d explained first…

I work in maternity theatres.
It’s to clean blood/clots out. Maybe they don’t do it in every trust, but they do it where I work

Thanks again for all your help!

Labour started naturally at 39 weeks. By the time we saw the consultant, I was already in latent labour so we agreed to just go ahead with a trial of labour. After two days of contractions I had an epidural which was lovely.

Baby got completely stuck - they tried forceps (fortunately no cuts or injuries as they realised quickly that it wasn't working) then went to emergency c section.

It was a bit of an 'I told you so' on my part as the baby did have a big head head and we did need an emergency section but I avoided the tear I was scared of and the c section went very well with very straightforward healing so far. Ten days later, I'm out walking for 30 mins to an hour a day.

We are SO in love with our little boy and so happy to have him with us. Caring for him has been so joyful. Looking forward to each step now.

4 large babies and twins and all normal births. Had them all at home and didn't need pain relief. It's different for everyone but don't be fooled by measurements we got told 3 were to small then were born the opposite

Congratulations OP! ❤️

Congratulations, OP.

I'd opt for c section over induction at that age, with your first, measuring large. You have a few factors that increase your risk of shoulder dystocia for a vaginal birth.

Shoulder dystocia is not talked about enough because people don't want to scare pregnant women with a worst case scenario but I think women deserve to make an informed decision.

Ah - just saw baby is here, congratulations x

Congratulations! Really glad you didn't tear and that your c section recovery is going smoothly.

I was 45, only baby, ds' head was measuring large. I definitely didn't want a section so I went for natural delivery. Midwife wanted to do a sweep which I also didn't want so refused that too.

Went into labour at 40+4, DS born early morning 40+6. I had a long slow labour which helped. It was all very calm and gradual but I got there. I needed a bit of help right at the end (ventouse) but managed to avoid too much damage, and was up and walking the following day. Driving within a week. It was very tiring but I was happy not to rush.

Congratulations

As someone who experienced that I take all the stories of "I birthed big babies with no problems" with a pinch of salt! Just pot luck!

Congratulations OP!

I had a big baby naturally when I was 40, I was also induced. Extremely long labor but no major tears. I mean it really depends on your body. In retrospect I wish I’d had a scheduled C section but they wouldn’t let me. My labor was sooo long and I lost a lot of blood so was anaemic after.

I’d just go for elective c section.

I ended up with an episiotomy once and a bad tear the second time (10lb baby) both of which were really painful healing and I have lasting continence issues.

If you don’t have an older child to worry about while you’re healing, go for an ELCS.

Oh congratulations! Great news