Suspected big baby. Good resources for next steps?

[Lollystar15]

I am currently 39+6. I had a growth scan yesterday which has estimated baby to be 9lb 8oz. Sonographer highlighted that it was difficult to measure her tummy properly given her gestation and highlighted the possible discrepancy with her weight. Did book me in for a consultant call today which I agreed to and have just had.

She ran through all the risks around shoulder dystocia and also the outcomes of the big baby trial

She was pushing towards induction and commented she wouldn't want me to go beyond 41 weeks because of size.

Options are:

1. do nothing.

2. Induction - Either of the following would be used:
   Balloons 12-24 hours.
   Oral medication 8 tablets, 2 hours apart.

As I've had a baby before, once my waters are broken they would give me 4 hours before pushing the hormone drip, to see if my body will go into labour itself.

Available dates if I accepted.
Monday at 4pm - rejected this one

Wednesday is also an option.
As is the rest of the week.

3. C section. - said no

My current plan is to accept the sweep that will be offered on Tuesday, if my cervix is favourable. After that, if nothing happens I'll re evaluate.

In the meantime, anyone have any good resources on suspected big babies that I can read up on. Consultant has given me a couple but I'd like to weigh up all sides of the argument. Thank you.

Growth scans are so inaccurate. I was told both my babies would be huge. They forced me to agree to an induction that I didn’t want. Very luckily for me both times I went into labour naturally. Both babies were 7lb 5oz. Does your midwife feel like it’s a big baby? It sounds an odd question but experienced midwives can get a good feel for what it really a big baby and what isn’t.

In the 'big baby' trial something like 60% of the babies that were meant to be big were born average in the end. Growth scans are so inaccurate especially at this late stage. If I remember correctly I dont think levels of shoulder dystocia significantly reduced with early induction. Induction in itself is also a risk factor for shoulder dystocia.

Google for Dr Sarah Wickhams analysis on large babies and the big baby study.

Also because you asked, I would switch my phone off and wait for the baby to arrive but that's just me. Already had an 8lb and 9lb 10 at home so I'm probably less spooked by the thought of a big baby. The bigger one was actually the easier birth also.

Good luck whatever you choose x

And this is my concern! Ever since the 20 week scan they have admitted to struggling to measure her tummy properly. I have an anterior placenta and she is usually hiding right behind it on the scans. This wasn't an issue on Friday, but from what I've read growth scans get more inaccurate as gestation increases (which makes sense!).

Midwife has commented (to a student) that she wouldn't struggle to find baby as she is a big girl. I was also 38 weeks at the time so wasn't particularly surprised by the comment.

I am hoping she just arrives by herself in the next day or two as I don't have the energy to argue with them 🤣

Yeah i read up on the big baby trial after I posted this. The consultant had mentioned it during the call and said about it looking at induction between 38/39 weeks. Did ask her where the relevance was when I am 40 weeks and she didn't really have an answer aside from to ask me how tall I was (5'7). That was followed by a comment about how a smaller person would struggle to birth a 9lb baby, at which point I started to zone out slightly.

My first was 6lb 10oz but was born at 37 weeks because I had HELLP. They're trying to use the potential size disparity to feed into their argument but are ignoring the very different scenarios were are in. Currently no signs of pre-eclampsia or HELLP in this pregnancy.

I think for now, I'm just going to wait and see what happens for a little longer. I refused her offer to book the induction appointment for Wednesday and left it that if I changed my mind, I'd ring them

Thank you for your reply!

I'm 5' 4. First was 10lb 11oz, 2nd 9lb 2oz. Little bit of shoulder dystocia with first, and slight tear ( which I didn't realise at the time). V well managed with Macroberts manoeuvre. 2nd was a breeze. I was lucky to have a consultant who was quite hands off.

Midwife had suggested a sweep - consultant didn't recommend and he was right. He was the consultant of choice for the hospital staff at the time!

I also had an anterior placenta with my baby and sonographer never struggled to measure the baby. 6lb 10oz is very big at 37 weeks gestation (my dd was that weight at 40 weeks) so yours would’ve been around 9lbs if born at 40 weeks. I know a few women who had large babies 9lb+ and they were your height. They found the birth fine!

My second baby was 9Lb 13 oz when born and it was the easiest birth out of the five I’ve had!
I would go for the sweep and keep active to try and help things along.
For my 4th I was (as with the others ) two weeks overdue and I had reflexology. I don’t really believe in that sort of thing but saw it more as a nice relaxing treat. Lo and behold I went into labour the next morning. Probably coincidence but it was nice nevertheless and can’t hurt.

I have had friends who had enormous babies - but mostly born with little problem (they were all born at one of the Swedish units that allowed you to go up to 3 weeks past due date - but that was shut down now)

Friend C - baby was 11lb 2oz and a fairly quick natural birth - baby had to wear specialist shoes as had developed a club foot from being crammed in the uterus.

Friend T - baby was 12lb 12oz - straightforward birth

Friend M - baby 13lbs 4oz - had to dash out and get clothes for 3-6 months as the baby clothes were too small. M had to have treatment for gallstones.

In a similar situation, my ELCS was one of the best decisions I ever made. Would you consider it?

At 36 weeks they told me my son was 9lb13. At 38 weeks they said he was 13lb. I was so scared I went for a c section - he was born 39+3 and was 9lb6 so no where near as big as what they said. And he was actually not ‘wide/fat’ at all. He was really long and skinny!

I see their point re what she could have weighed but the growth scan i had three days before my first was born estimated she was 7lb 4oz. She very clearly wasn't and they were off by a good 10oz. That alone means I don't particular trust their scans and she was a lot easier for them to measure! Good to hear people of similar height etc had good births with 9lb+ babies! Will see what happens this week :)

That level of inaccuracy is what really puts me off trusting their scans! That's a crazy difference!

I have considered it but have decided against it. The thought of the surgery terrifies me if I am honest. As does the recovery with a 4 year old. That coupled with the fact that I don't particularly trust the scan (and each consultant has a different view on whether baby's size is an issue) means I'd rather see if i can get her out of her own accord. I acknowledge the risk of an EMCS remains present but I'm currently happy to make that decision at that point if needed.

Good luck! Baby will soon be here 😊

This is a link to the Better Birth podcast about the big baby trial - https://podcasts.apple.com/gb/podcast/s11-ep-1-the-truth-behind-the-big-baby-trial/id1526443611?i=1000708950921
I found it interesting as just over a year ago I was being told I was having a big baby… she was 7lb 3oz but very long. Luckily I’d already got a degree of scepticism so ignored them and had a natural birth.

I’d do some research, but my feelings would be to either wait or go for a c-section. The majority of people who have inductions seem to have poor outcomes.

My three pregnancies resulted in circa 9lbs, 10lbs and finally just over 11lbs. None of them spotted on US. I’m was a size 10 and apart from the last one unproblematic normal vaginal deliveries. The last had a mild shoulder dystocia.

However now post menopause with a completely buggered pelvic floor.

My dc was 11lbs 4 and back to back , my advice is get a CS

I was very against one, but it was touch and go tbh and he was extracted by ventouse just before an emergency section was ordered

I would rethink this

Thank you everyone for your advice/guidance. Just to update, I accepted the sweep on Tuesday morning. I was 1-2cm dilated so she was able to go ahead. Contractions started at 04.30 o Wednesday and she arrived, vaginally at 02.30 this morning. Weighing 9lb exactly so a little under the estimate given on 19th.

Thank you all again!

Should have added, no shoulder dystocia and a slight tear to me!

Aw that is such good news OP. Congratulations!! X

Lovely news OP congratulations!

Ignore!

The big baby trial.
big research study.
one key finding was that 60% of the babies turned out to be average size and not big, so they are over estimating