I am upset by this, not sure if I should be, or where I go from here?

[mosschops30]

I have spoken to my MW since I was 30 weeks about my concern over size of baby.
She said that if I got to 40 weeks and was still measuring 40cm she would refer me for a scan. At my appointment with her on friday I was 39-40cm and am now 40wks.

So I rang a lovely MW this morning, but unfortunately she was in the wrong department, but gave me her name, pointed me in the right direction and said to phone back if I had any problems.

So I phoned the community midwives and explained that Im now 40 weeks, am concerned about baby size, and that would like a scan because if baby is big then would like early induction or ECS (explained that am part of the anaesthetic team and would like to choose who does it if I have to have a CS, which is very common within the theatre environment).

She was very short with me saying that even if I was 43cm at 40 weeks I wouldnt be referred for a scan, that my MW is very experienced, that if I want to pick my own anaes team I should go private (which is not what I meant at all).
I asked her how was this offering women a choice and listening to my concerns to which she replied that the choice was I could go consultant led instead ....thats my choice i.e. listen to your midwife or get a consultant

I was really upset, this is my 3rd baby, Im normally very small, and Id like to know if this baby is big to be able to make an informed decision as to whether I go 2 weeks over, or try and get an ECS or early induction (she told me I cant have one until Im 40+13).

Any advice would be good, please be nice, Im hormonal and may cry . I would phone the original midwife i spoke to but dont want to look like Im going behind peoples backs IYKWIM

I think you should phone the original midwife you spoke to. You can do as youplease, actually, it's their job to make ou happy, NOT the other way round.

I just feel so fobbed off her attitude was 'whatever your MW says is right and if you dont like it go consultant led'

Is it right though to speak to another MW in an unrelated department (fetal medicine)

Well, how is it wrong?

Why aren't you supposed to seek as many opinions as you feel you need?

I thought your own midwife was sympathetic.Speak to the same person, or speak to someone else referencing that conversation and midwife's name. Of course it's not going behind people's backs - its about consistency of care and information.

It may well be that what the original midwife has agreed with you is different to accepted good practice in your area, because of your particular circumstances (which others will not be aware of).

If you talk to someone different, I wouldn't mention the bit about choosing your own anaesthetic team in the first instance as it's not relevant to getting a scan, and it may have come across a bit high handed.

Good luck!

If I were you I would speak to anyone who wasn't rude and was actually helpful!

You've got enough to be getting on with without the added pressure of a moody and unhelpful midwife. Plus the nice MW said to phone back if you've got problems.

You've got a right to not be stressed out and worried about your baby.

This is your baby and the decision you make now could affect how you feel in the future. Going behind the rude midwife's back won't even figure in a few weeks.

Phone the midwife who knows you and understands and make your decision then.

What size were your other two, and did you have normal deliveries with them? Whilst I am not condoning your mw's attitude, and would trust your opinion on your size (you know your pregnant body better than anyone) I am hoping to put your mind at rest slightly re: complications. I think you must take it to a supervisor of midwives if you are really concerned but bear in mind that scans for fetal size are woefully innaccurate and I would not trust them as far as I could throw them! I'm pretty sure you would be offered induction (if anything) rather than section but that brings with it it's own problems and bear in mind that the cascade of intervention of induction is continuous monitoring, stuck on bed = less favourable position for large baby to find way out!
And just a note to Colditz, it is not our job to make you happy, it is our job to keep you and unborn baby safe (and happy we hope!)

Both previous babies were late, 4 days and 15 days, was induced with 2nd so am well aware of problems with induction, but equally would rather be induced than try and deliver a large baby and fail and end up having EMCS with people I neither like or trust professionally.

Both babies were also normal size, but this one is much bigger, I dont mind it being a 'good' size of 8lbs but not sure my usual size 8, 8 stone frame would cope with anything bigger. I have put on 3.5 stone this pregnany and it is literally all bump, from the back I look exactly the same, which doesnt exactly fill me with hope

mazzy i wasnt trying to be high handed and it wasnt said in that sort of way, I was just trying to point out that if I was unlikely to deliver this baby naturally I would rather know sooner than later so I could choose people involved to some extent

you might find this helpful- not in dealing with rude MW but with the whole big baby thing www.bigbaby.org.uk/

mosschops - I know, I am sure you weren't. but over the phone, someone who isn't aware of the context may have taken it that way and she may have thought your expectations were unrealistic or you wanted preferential treatment.

Hopefully you can get in touch with your own/original midwife who can support you with this.

And try not to get too stressed about the bump- it may be just lots of amniotic fluid!

Sorry if I'm being dim but I don't understand why they think the baby is large? Fundal height at 40 weeks would usually be 38-42cm, so yours is totally normal. You wouldn't usually get referred unless it was 43cm or more. Sorry if I'm missing something?

thanks, I think I will speak to my MW tommorrow (if Im still waiting )

My MW told me that at 40 wks you would normally be measuring slightly less as babys head descends into pelvis, so she did say I shouldnt get to 40wks and measure 40cm. The guidelines in my notes say referral is 2cm over dates, which yes I understand I am not

oh and thank you for that link, love this quote:

'heard a great analogy from an obstetrician once, that likened trying to predict the size of a baby before birth, by ultrasound, to trying to guess the weight of a man, sitting in a bath full of water, in the room next door by measuring his waist and thigh bone. When you look at it like that it really does become apparent how ludicrous these gross measures we use are!'

Scans can be very inaccurate at sizing babies. Mine was supposed to be some huge monster and I had LARGE BABY written on my notes and extra size scans etc. He came out at 7lb2oz at 39+1 so pretty average really!

Just wanted to agree about the inaccuracy of growth scans. I got sent for one and was told I was having a 10lb baby. she was 7lb 12oz so they were way off!!

oh ok, have just googled fundal height and found it usually decreases slightly at the end of pregnancy - I didn't realise that mosschops, sorry!

I still wouldn't be too concerned - lots of things can affect fundal height, like amount of fluid, position of the baby etc. Wikipedia says that "As a pregnancy approaches its end, the fundal height will become less accurate" so I guess try not to read too much into it.

My scan was 1lb out just 3 hours before DS1 was born.

Often 2nd and in particular 3rd babies do not decend into the pelvis until you are in laour, so your measurements sound fine, I know my mw's won' send anyone to see a consultant regarding a growth scan unless measuring over 3cms over. I was told this week (am 38wks) that I should be referred to consultant for a scan due to size of last baby, but it's up to the consultant to decide whether you need one or not. (DS (2nd baby) was 10.1lb born at 39wks), he was born naturally ad I am usually about a size 10 with a small frame, I really don't think you have anything to worry about, I'd be suprised if your MW can justify a growth scan.

I understand that you are worried mosschops, but from what you have said things sound fine and normal. Yes fundal height usually decreases at the end of your pregnancy as the head engages, but not always, particularly for subsequent babies. Sometimes the head will only truly engage when you are in labour. As has been said by others, ultrasound scans for estimated weight can be woefully inaccurate and cannot always be relied upon. I would encourage you to trust your midwife, if they are happy that all is well I'd just try and relax.

As for choosing your anaesthetic team, things crop up during labours that cannot be predicted in which case you will meet whoever is on duty. If you are very anxious about this perhaps an entirely different hospital would be better, it's not too late. If you have big concerns about other people's practice perhaps you should address these through the right channels. I say if what our teams are offering is good enough for everyone else, it should be good enough for us too, otherwise we should try and do something about it.

Good luck with the rest of your labour and pregnancy.

Sorry to cross with you beepbeep, took me a while to type all that!

Might not be so bad - I weigh just under 8 stone, and am five foot 3 (ridiculously small boned - my 6 year old son has chunker hands and wrists than I do!) ...HOWEVER, I had a natural delivery with both my boys and they were both ove 9 pounds (despite the midwives telling me prior to the birth that there was no way that they would be more than 7 and a half pounds).......and it's not like my husband is a giant either as he is 5 foot 10 and a slender build. Both my births were VD and I had minimal tearing (2nd degree with the first and first degree with the second) and no problems with actually getting them out. On the other hand, I've had friends much bigger than me who have had 6 pound babies and ended up with emergency c-sections and horrible tearing! So, I suppose what I'm trying to say is that size isn't always the most important factor in a nice easy birth. Having said that though, I know that prior to my first birth I was TOTALLY paranoid about the size of my bump and convinced I would never be able to push DS1 out, so I can understand why you feel anxious, and your midwife should be more understanding! Good luck!

lumpasmelly great post thanks, very reassuring I know there are lots of factors to take into account, and that growth scans are not the be all and end all, i think that maybe it would just offer some comfort

love people referencing the fountain of knowledge that is wikipedia

lily do you work in healthcare. If so Im sure youre aware of what I mean. Anyone who works in healthcare has a preference of the way things are done, or people they would prefer looking after them if they had a choice. Of course I know that if I have to have an EMCS then I will have the team that is working, but if you have the choice then you choose

Why are you so worried about size? Did you have problems delivering your previous two?

I ask because I know several women who are size 8 or less and have delivered massive babies without any complication - and all have said that it gets easier as they go along, so by the third if the other two have gone well it shouldn't be a problem.

I would never accept a EC or an induction based on a growth scan - I was told at a 33 week growth scan that ds was already 'over 7 lb' and was likely to go to 9 or 10, in fact he was born at 7lb 7 so not huge at all - if they had gone for an early induction he might well have been too small! I was also huge and 'all bump' so everyone was expecting a massive one.

I do work in healthcare Mosschops and I do understand what you are saying, however, everyone should be aiming for what is best practice. If you have a preference for the way things should be done I hope that whoever is caring for you respects your choice. If they won't then I agree, choose someone who will do it your way.

With my first the midwife wanted to refer me for a scan as she suspected a large baby. I opted against as I thought it'd just end up worrying me about how to get her out! In the end she was 7lbs and just very long.