Measuring 33cm at 38+6 weeks :(

[electra]

So, just when I thought my home birth would go ahead they have started talking about induction.

I'm not happy with the situation I'm now in and just wondering what others would do. My baby has 'felt' small every time I've had a palpitation since 29 weeks. I then had three scans, the last at 34 weeks which showed the baby's growth was normal - fluid ok and placenta function. No further scans were suggested. Today, I have had an anti-natal appointment with a midwife I don't know (which is how it has been throughout my pregnancy - different people every time). Within seconds she was on the phone shrieking about not wanting to 'get called out' to a baby who has IUGR (which has never yet been suggested!) and also mentioning the fact I have bipolar disorder (how is that relevant?).

I went to the hospital where they did a CTG which was fine. The doctor came and saw me and said that the scanning department refuses to do growth scans after 38 weeks and that since that means she can't know whether the growth is ok or not I can't have a home birth because the baby might not be able to breathe when it comes out. She is even talking about induction.

I think this is very unfair because they will not be able to make an informed diagnosis and I need to be at home, away from bright lights and a bustling work environment which will stress me out and make me hyperactive when I am in labour.

I don't want to put my baby at risk of course, but I'm not convinced there is a real risk here and I'm now being told there is no way to diagnose one. I feel totally bullied and want to find a resolution that is not all about fitting me into a box because other people are not comfortable with a decision I have made carefully, and one which I feel will help me recover more quickly after I have this baby. Which I need to do because I have two older children who need me.

I was wondering whether anyone has measured small with the tape measure and then had a decent sized baby? By the way, I also do not quite trust the doctor today as she told me at the beginning of this pregnancy that I had had a miscarriage, which is now this bump!

Yes! And she was born at due date 7.4lb.

I am tall and she was hiding in my height rather than poking out. I also had slightly low fluid though.

Please get a second opinion. Ask to see the Midwife supervisor or see your GP tomorrow.

Poor you. So awful to see different people - not least becuase measuring is so inconsistent. I thought my measurements were small but ok in my last pregnancy and then the way the MW measured me in hospital I was only 33cm. My MW at home had been very relaxed - I had HG so she wasn't expecting me to be big and by her measurements I was about 36cm. DD was 7lb.

I really hope you get a scan and the kind of birth you want. Good luck.

Thanks, callmeovercautious. The problem is that having bipolar disorder seems to make everyone even more panicky. Also, the health professionals here are all too scared to contradict one another.

Thanks lal07. I have been in tears all evening because I just can't bear the thought of having to be in hospital.

I measured 30cm at 40weeks...and gave birth a few days later to a 7lb 14oz rather-larger-than-expected little girl.
She wasn't born in the UK and no-one seemed to bat an eyelid at the small bump, the hospital joked I was missing a liver or a few other internal organs! I was worried though as I kept comparing measurements to the UK charts.
I had very very tight stomach muscles in those days which I think held her in. She was also back to back so she didn't protude out at the front. I am not overly tall (5'6) and normal size 12 so I couldn't hide her any where!
Good luck, I hope everything goes to plan for you.

Measurements taken by different HCPS are not particularly useful.

This is a useful site

Thanks - surely measurements are even less accurate than scans? It is also really irritating me that they keep referring back to the fact that I've already had two babies who weighed over 8 lb - 'But you don't make small babies - you make big babies'. FFS - this baby has a different father and he is smaller than my ex-husband.

I measured small for dates with ds2 from 29 weeks. My midwives were not concerned, but when I had to go to hospital at 38 weeks cos I thought I was in labour (I wasn't) they were concerned that I was only measuring 34cms. They were worried that I didn't have enough amniotic fluid.

They did do a growth scan on me then though and estimated ds2's weight to be 6 1/2 lbs. Fluid levels were deemed to be within normal limits and the placenta seemed to be functioning ok. I had also suffered from hyperemesis for the whole pregnancy.

DS2 was born 9 days late weighing 7lb so he hadn't grown much in the last 3 weeks. I didn't have much amniotic fluid and as a result from not having much cushioning his nose, ear and foot were squished from where they had been pressed against my stomach, but he was absolutely fine. He then gained huge amounts of weight very quickly and had only just started to slow down in the last month (he is 17 weeks).

I would speak to your own midwife and get her opinion. I found the hospital were far more concerned than my own midwife because they seem to expect things to be more f a problem than they are IYSWIM.

By the way his nose, ear and toes have now straightened and look completly normal.

My hypnobirthing teacher thinks I need to buy myself some time rather than going back in today and being subjected to a lot of pressure which I will have to deal with by myself. She recommended getting a doula. I wish I had now but she thought it isn't too late.

Thanks for your replies, it is reassuring to know that some of you have measured small and had normal sized babies...also, thanks for the link northernlurker.

By the way - there is a picture of my bump on my profile page (38 weeks) - if anyone thinks it looks abnormally small feel free to say....

im 38+4 and had growth scan last week as bump is only 34cm and baby was 6lb3oz (estimasted) with plenty of fluid i was really worried but hes fine x

electra your bump looks gorgeous and doesn't look too small

I measured up small along most of the journey of my pregnancy. They clucked round, sent me for scans and monitoring etc. We concluded, I'm only 5'1, DH although tall is very slim, had very good abdominal muscles and not a huge amount of fluid. I carried low and bump stuck out! I was induced at 12 days over and had DD 6lb 11oz.
Can you see another midwife? Good luck!

Thanks Lauren and Clure. I don't think it looks too small either. Unfortunately where I live the HCPS are very inflexible.

I was the other way round - I did have an IUGR baby but measured bang on fundal height measurement for dates. I have recently had a 'normal' sized baby and measured bang on dates too.

Fundal height measurement is notoriously dodgy.

Wheelybug - how was your baby diagnosed with IUGR? I do have a problem with all my choices being taken away on the basis of a tape measurement alone... When I was scanned at 34 weeks the sonographer said that it was particularly reassuring that the abdominal circumference of the baby was absolutely fine. She measured it three times to be sure. The other parts of the baby were ok too.

The key measurement with IUGR is the abdominal circumference - this is how they diagnose IUGR rather than a small baby. DD1 measured small (3rd centile) at my 20 week scan - as a result they scanned me regularly throughout until 37 weeks when she had stopped growing completely. They would have continued to scan me beyond this date had I not had to have delivered.

With dd2, I was scanned regularly and it was the abdominal circumference they were interested in, no other measurements.

Thanks Wheelybug. I can't understand why the scanning department will not agree to look at measurements....

With ds1 I was measuring 30cms at 35 weeks so I had a scan which said all was fine. He arrived 2 1/2 weeks late (induced) and weighed 8lbs 12 1/2 oz.

i think you need to push to have a scan done. Once they know all the facts then you can all make an informed choice together.

I think that scans are less accurate the later on you get - particularly if you have started to engage. That said, they should be able to get an idea of whether the growth is as far behind as your FH measurement would suggest.

Is there a Consultant Midwife at your ante-natal unit? I would ring today, and insist on seeing her/him today or tomorrow, and then voice your concerns-insist that you have the scan, if there really is a concern for your baby's health. Obviously, if it's best for baby, you'll go for induction/a CS/whatever they suggest, but really, they've not got much reason for thinking there's a problem yet.

It is very irresponsible of the midwife to suggest that you baby may have IUGR based solely on FH measurement-especially as FH is only really a guide, and should be using measurements taken by the same person every time, otherwise they can vary wildly.

How awful. I really fear for you.

My DD was induced for suspected IUGR... the scan at 36 weeks said too small... the scan at 37 weeks said her head was too big and would get stuck. I was induced at 38 weeks and she was 6lb4oz. I didn't put up too much of a fight because I didn't know any better and had been housebound since 24 weeks with SPD... but now I feel very cross about how I was treated.

If the scans can be 20% wrong, using a bloody tape measure can't be much better. I hope you find the support you need.

Who did you see at the hospital? Can you ask around your friends etc. to see if anyone knows of a consultant at your hospital that is sympathetic towards home birth and request an appointment with them?

I had similar with both my pregnancies. With DD1 I always measured small, had a growth scan at 34 weeks (fine) was still small at term + 7 so was sent back to the hospital at which point I was induced. DD1 was 6 lb 13
DD2 also always measured small but given my history there was less concern, until term + 7 again when sent up to hospital (measuring 35cm) This time I saw a very calm and confident consultant who was adament I just carried them small and allowed me to go home and let nature take its course. (although she also said growth scans useless after38 weeks) DD2 was born a day later weighing 7 lb 13 oz

Difficult, I know, but explain your thoughts rationally and clearly, trying not to get too emotional or cross and take someone with you who knows your agenda and is on your side. If the first person you see isn't sympathetic, explain that you would like a second opinion, that you appreciate you won't be seen straight away but you are happy to wait around until the end of clinic to see someone else, then just wait smiling serenely at all the clinic staff!

Is your DP supportive in these circumstances?

Eep, I didn't mean to put 'fear for you'... I meant 'FEEL for you'. Sorry!

A midwife told me my DD2 was going to be 'very small' based on the measurements - she was born 2 days later (5 days early) - 8lbs 3oz!

Don't worry Hawkmoth - thanks for your post blowninonabreeze - I don't have a dp, so it does make it harder because I'm having to battle for what I want alone.

Today I have got my head together about it, though. And I am going to say that there will have to be more evidence of a problem before I will consider changing my plans for a home birth. They base everything on 'if this happens, this might happen' and it is not acceptable imo.

Of course, at the end of the day they are probably just trying to be sure they are not leaving themselves open to the possibility that I might sue them, which is fair enough. But I need to be viewed as an individual with individual circumstances.