C Sec or Induction for predicted big baby (10/11lbs)

[PockerMaus]

Hi guys

I finally managed to get my growth scan after being referred three times and it be cancelled each time. I was 36 weeks on the dot and they estimated him to be about 8.10lbs at present so predicted to be around 10/11lbs full term.

I know growth scans aren't necessarily accurate however I was a large baby (10.10lbs 3 weeks early) and my brothers were both big too so it didn't particularly surprise me, plus my bump is measuring above the 97th percentile too

I have been tested for GD and that came back negative.

The consultant is going to book in another scan at 38 weeks but basically said we were looking at either a planned CS or early induction.

Just wondering if anyone was in a similar situation and how it turned out? I'm not against a planned C Sec necessarily, the idea of being in theatre does scare me a bit but if it's the best way to get him out I will just get on with it. My biggest fear with an induction is him getting stuck and ending up with an emergency C Sec anyway which I imagine is a lot more traumatic than a planned one.

Just after some advice really and other people's experiences with predicted big babies :)

I was in a similar position with my first. I chose induction. It was done at 39 weeks. After 3 failed attempts over 48 hours, they then used the drip to induced, which actually worked. But I don't think the baby or my body was ready for birth, and it ended in an emergency section.

I'm having a planned section this time. I dont remember my baby's birth and afterwards I was physically unable to hold him for hours. I don't want that again.

Obviously not all induction experiences are like this, but it's not an experience I would willingly repeat. In hindsight, I wish I'd just done the section the first time they offered.

I would consider also looking at how your mum and sisters (if you have them) birthed. Did she go over? What type of birth did she have?

You don’t necessarily have to be induced or have a c-section early if you think spontaneous labour would be a better option in terms of risk (even if it is later). Obviously that’s something to discuss with the consultant though.

I had an induction with my 1st at 40+5wks. The labour started easily enough but it was excruciating from the start (by 2cm dilated). I had an epidural by 6 cm and all was great. Then I was pushing for ages, his head was stuck, I endured failed forceps and a cat 1 emergency c-section.

My 2nd is due next week and I’m hoping to go into spontaneous labour soon, but they don’t want me to go over 41wks due to my prev c-section. I will still choose induction over a c-section because I would like a 3rd child and I don’t like the idea of the scar tissue complications that can come with 3 sections. However, if this was to be my last baby then I’d definitely choose the planned c-section any day. I would possibly be more weary having a big baby at an earlier gestation stage with an induction. Your body might not be ready to birth at 39 wks which could make the induction more difficult.

I can’t really advise because it’s such a personal decision but thought I’d give my experience in case it’s helpful.

Predicted size isn’t meant to be used alone to make medical decisions to induce/section only identify other potential issues eg GD which has been ruled out for you. Have they given any other reason to suggest c section or induction?

Neither.

Have a read of “The Big Baby Trial” that was abandoned before the study was complete…..because frankly all the theories they were trying to prove turned out to be bollocks 🤷🏻‍♀️🤷🏻‍♀️😂
Participants of the study had to be over 18 and diagnosed as carrying a baby that is “large for gestational age” - 90th centile for weight. The women were randomly assigned to either induction of labour or standard care to see if the induced group had lower instances of shoulder dystocia.
The before it was stopped, results of the women studied actually showed that there was no significant difference in instances of shoulder dystocia in the group that were induced compared to those who laboured spontaneously, 58% of the babies predicted to be on the 90th centile for weight were actually within the normal range for their gestational age 🫠
Growth scans are notoriously inaccurate.
I was the other end of the spectrum with my 2nd baby. I was told that my bump was “worryingly small” and sent for a growth scan. They told me they suspected he had intrauterine growth restriction, and if he continued to follow the same curve on the chart, he’d be no more than 4lb 8oz at term. Placenta and cord blood flow were checked, and all fine.
My son ended up being born at 36+0, spontaneous labour, and he weighed 6lb 9oz.
I’d put more faith in a 2-day-old kebab than a growth scan 🤷🏻‍♀️😂

Came to say the same as @Ghht - how did your Mum’s births go? You’re likely to have similar pelvis to her (not guaranteed!) so if she had three vaginal births of big babies you’re more likely to be fine. If it’s your first baby it would also be worth taking into account whether your midwife/consultant thinks that baby’s head has engaged well (come down into your pelvis ready for birth), this can be quite useful. I think if choosing elective CS it might be worth thinking about how many kids you plan to have - if wanting a really big family then might be better to try for vaginal with the first one because CS can increase chance of future complication and definitely of future CS if that makes sense. Pros and cons to either approach, hopefully you’ll just have a gut feeling g of what you want to do :)

Evidenced based birth has some good info.of this. In essence a big baby isn't any more likely to have issues being born.of the support for mum is good.

My first was big. 10 pound 2 Oz. I laboured at home using the shower and breathing for a while. When we went I really wanted to get in the pool but was at 9cm so they didn't have time to fill it. I had gas and air. I mainly pushed side lying which was good as it slowed down his arrival a bit. I think if I'd opted for more upright positions he would have come to fast. I had a small tear needed stitches.

My second was 97 percentile with an off the charts head. My first was slightly smaller and was a rough birth that ended in surgery. I had forceps as it was quicker. I opted for a c-section second time round and was very happy with the outcome. Much calmer, I wasn’t exhausted from a long birth and although the recovery was tough, so was the recovery from my first. It was weeks before I could sit down properly!

Yes scans can be inaccurate but mine were both spot on. I was also concerned about the impact on my pelvic floor that another large baby would have and I’ve thankfully been able to avoid any severe damage. Have a chat with an OB about your options would be my advice.

Thank you all for your replies 😊

With regards to births in the family.... I don't have a sister but my mum had 2 x quite difficult births followed by a planned C Sec with me. It's hard to compare though as my eldest brother came at 34 weeks. He was 6lbs already but he got stuck and this actually resulted in him having cerebral palsy due to lack of oxygen. My other brother was then a difficult delivery as I believe the 'birth canal' was shaped wrong so she tried for a vaginal delivery but ended up with an emergency c sec for an 11lb baby.

So yea not a great comparison but think it's hard to say the same could happen with me as my brother was born a lot earlier...?

I know growth scans can be inaccurate but with our family history of big babies it does seem they might be correct in my case 😊

I think due to my brother's head getting stuck resulting in lifelong disability, I am extra cautious of this happening in my case.

C section

I would also like at least 1 more child if I am able to, ideally 3 so trying to take that into consideration.

I didn't know it came with much more risk having multiple CSs. I will have to look more into that :)

I had a planned induction for a big baby. They reckoned at 37 weeks he was 9lbs. Bump was way over 100th centile etc.

Induction took 3 days, 55 hours of labour and I've not been the same since. Wouldn't do it again.

He was 8.12 at 39 weeks 🙄

I had an elective c section after my now 11 week old was predicted to be big. She was 10lb 1oz in the end.

It was a really positive experience overall, I was up and about really swiftly and felt 95% back to normal by 3 weeks post section.

I know a number of women who have had 3 or more sections, along with a few who went the VBAC route. So having a section now doesn’t mean you can’t go on to have another child or even two.

Totally understand why you have extra reasons to be cautious, sounds like your mum had a really tough time!

It doesn't mean you'd have the same issues as we don't necessarily follow the same patterns as our mothers. My mum had vaginal births with twins followed by 3 singleton pregnancies and never had any issues - pretty sure as the youngest, I just fell out!!! Whereas I had the most complicated birth, and my sister had one very long labour with forceps and an episiotomy with her first and a super quick vaginal birth with her second. No patterns followed there!

But I have friends who have had elective c sections who said they were amazing and they felt well-recovered much quicker than I did after my emergency one. Having an emergency one at full dilation has put me at potential risk of pre-term labour with this pregnancy. There's risks any which way you look at it, sadly.

Bless you, it's stories like this that really lean me towards planned CS. ❤️ All the best this time around! Sounds like it will be a much better experience.

I think it's hard being given the choice because then if I go for induction and something bad happens I will just blame myself. (I know there are risks with CSs too).

They haven't yet other than asking about family history. I guess at my next scan the consultant will give us a more detailed chat as he only really spoke to us for a couple if minutes as they were super busy!

My first was 11lb 6.5oz and was delivered by emergency CS following three failed inductions over three days.

My second was 9lb 13oz and delivered by elective CS at 39 weeks.

I'd recommend an elective if you can. Far nicer experience knowing that everything - as much as it can be - is under control. The emergency CS was done due to no progression, weakening baby and everything felt very chaotic and scary.

Wow what a whopper!! Were they predicting that size?

Thank you for sharing your experience, it is very helpful 🙏🏼❤️

It was frustrating in the sense that they were convinced I had GD, even though there was zero evidence other than the bump size and scan measurements. They were correct that he was a big one though.

I know others have said ot to go for either option, but that is sometimes easier said than done. If it comes down to needing to choose one, I'd choose the section - there's plenty of evidence that inductions lead to higher rates of further intervention like forceps or c sections.

They predicted she was going to be big, but the consultant said that the scans could be inaccurate, so was a bit dismissive. He did have the decency to come and see me the day after the birth and commented on not appreciating how big she was going to be. Despite being a chunky baby/toddler, by 3 she was always in the right clothing size for her age.

Second time round, I had regular growth scans which predicted that she was going to be bigger than she actually was. She was 60cms long at birth though, so bigger in a different way 😂

My first was a brilliant pregnancy no issues at all but I felt that I was 'big'. Son was born after a slow labour. I had gas and air, no epidural and then ended up with an episiotomy, two failed forceps attempts and then shoulder dystocia. They managed to get him out but it was an unpleasant experience to say the least. He was 9lbs 8. 5 days after DD. December 2019.
With my second again I felt that I was big and was under a specialist due to previous shoulder dystocia. I had extra growth scans but they lost the data ( it was outsourced to a private scanning clinic) and so two weeks before DD I had a conversation where I decided to opt for a C section. I knew it would be my last baby and was worried about labour and things going the same way.
The c section was brilliant, it was calm and the staff were lovely. My daughter was born 9lbs 12. The surgeon said that it was the absolute correct decision to make as she struggled to get her out she was tucked in.
It's a really hard decision to make, and even when considered and rationalised things are unlikely to 'go to plan'. You can only make the best decision for you . On a side note healing from the c section was 100% easier than healing from previous traumatic birth and actually gave me some psychological healing. But obviously, every individual is different. I do know friends who have had x3 C sections and also women who had emergency c sections followed by vaginal birth for their second. Good luck OP

It’s not ‘much more’ risk, it’s a slightly higher risk. Be aware of the risks but also be aware that it’s a ‘risk’ and not a guarantee of something bad happening. If you have 2 inductions that end in emergency c sections will you decide you don’t want a third child? It probably won’t change anything for you.

2 very high risk pregnancies here. 2 elective c sections in my late 30s/early 40s. GD, 2 big babies born at 37 weeks by elective section. Clotting disorder.

My advice is think about that what ifs and ask about them. My questions were how many inductions for my demographic ended in emergency section (the answer was about half). What was the risk of emergency section compared to elective? Took my risk of a clot from something like 0.5 (no intervention) to 1.4% (elective) to (2.8%) - however the doctors were eager to stress that even at 2.8% this was still a very small likelihood. As it was I had a perfect, quick and easy recovery both times - much better than friends who had inductions, intervention and then emergency sections. I was also classed as complicated surgery because I had had multiple surgeries in that area already. They were expecting scar tissue, adhesions. Risk again - good to be aware of in case an issue arose, but as it was there were no issues.

An hour after the 2nd section my OB came and told me if I wanted a third child she appreciated that I was in my 40s but to wait a year before conceiving. So … risks … be aware, ask the detailed questions, and make your decisions based on your personal medical advice. Good luck.

Agree with above - it’s not a huge increase in risk at all, just one factor to consider amongst many others. There’s not really a right or wrong answer here OP, just what feels best for you.

Picking up what PP says, growth scans are also very unreliable. My first was 8lbs 5oz and I felt bigger as soon as my bump appeared with second. Was continually told I didn’t need any extra growth scans, despite tape measurements being bigger (blamed on different measurements). I was probably the only one who wasn’t surprised when DC2 was 9lbs 10 oz (home water birth).

Fast forward several years to DC4 when I had more appointments due to being 42. Lots of discussions re not being late (all my others were…) but again no concern re the size of my bump. DC4 was 10lbs 2 oz and I had to stay in hospital overnight to make sure I hadn’t super sized him with sugar. Birthwise, another water birth in a MLU.

Important to do what you feel most comfortable with and do keep raising concerns. Anecdotally, those of my friends who have had planned C sections following emergency ones have all commented how positive an experience they were.

My baby was 97th percentile. Induced 37+6. Laboured for 3 days after induction and ended up emergency c section. Born 7.12oz. I’d avoid induction like the plague! Opting for elective section this time.

Thank you all for your replies!

I guess as you all say, it's up to me and what I'm comfortable with. I have my 'birth plan/preferences' appointment on Tuesday with my MW so I'm going to discuss getting booked in for a c section if it does come down to the choice of that or induction. I feel mentally that will be a lot more reassuring too as I would find an emergency c section very traumatic ❤️