Midwife v Scan

[skippingturtle]

Had two fundal height measurements that have been big (way beyond the top line on my graph). After both measurements I was sent for scans, both of which came back as measuring average.

A third fundal height measurement was taken today, again I'm off the graph, and have now been scheduled for a third scan.

The midwife acknowledged that the fundal height method is a bit hit and miss, but said that there was no way that the baby she could feel with her hands was the weight that the last scan had stated.

I don't know who to believe, I know scans aren't an exact science either, but the baby is due in 6 days, so I may well be expected to make a decision regarding induction very soon. Any ideas?

I've only known of one person who was told there were having a whopper by the midwife. In fact it was estimated to be sooooo big that the local papers were called when she went into labour. It turned out to be a rather modest 9lb, smaller then my second

As I understand it it's really hard for either the scan or midwife to accurately predict as you are so close to the end. If you aren't having any other complications, such as suffering due to the size of the baby, then I would hang on and let nature take it's course.

My consultant, who was in charge of obs ultrasound at the hospital, said that scans are good at predicting birthweight for babies that fall in the middle of the range, but pretty rubbish for very big and very small. My dd was on the 99.6th centile at 10lb 11oz, and delivered fine - no forceps, etc. I'm not sure what difference induction would make with 6 days to go anyway - it's head circumference that makes the difference with birth as it is, not weight. Unless you have gestational diabetes, you're not very likely to have a baby too big for you to deliver anyway. Is this your first baby?

Hello knackered76 (hope your choice of name isn't related to the size of your second baby).

As it's my first It's hard to know whether I'm uncomfortable due to the size, or just because I'm near the end. Have had a lot of muscle pain down the front of my abdomen, but I think that might be a positional thing (the scoundrel is back to back).

Part of me thinks if it's going to be huge it had better come out sooner rather than later, but I'm also keen not to be induced, as I've heard so many induction-related horror stories!

If a baby is bigger is there more likelihood of forceps etc?

x posting with Habbibu there. Yes, it's the first one, no, there's no diabetes.

My DS1 was 10lb 6oz and no forceps here. It all depends on how big your pelvis is and how streatchy your 'bits' are...

Could your muscle pain be Braxton Hicks?

The fundal height measurement is just a 'rule of thumb' I thought... And surely it depends on how much fluid and how big a placenta you've got in there...

Oh lord, the thought of stretchy bits makes my legs go a bit funny.

No, don't think it's Braxton Hicks, it's a tearing sensation that I had for several weeks, then it went away, now it's come back. It's worse when I move, particularly stretching forward, coughing etc. It's high up on my abdomen and the docs think it's to do with the baby's position, although I get the impression that's a catch-all statement for any unexplained discomfort!

Yes knitter, I asked about fluid and placenta but the midwife was adamant that even taking those things into account the size of the baby was big. It's frustrating!

Well, my baby was much bigger than those of friends who did have forceps deliveries. I don't think induction would make much difference at this stage, tbh. afaik, they are mostly just laying down fat at this stage, and that has v little to do with head circumference or shoulder size.

Big babies are magic, btw - all filled out and cuddly.

They had me worried all thru 1st preg with whopper type comments. She was 7lb 3.
Big babies always seem to birth better anyway, gravity!

I noticed you say baby is back to back - this is more of a worry than size as it will prolong labour and can be more painful.
If you can try to get baby to turn around then try try and try! (Google Postier Occiput) And if you don't progress nicely then ask for epidural sooner not later.
Do not labour on your back on the bed with a monitor on! (well, not without an epidural!) Get on all fours and ask midwives to actively help try to turn the baby during labour.
My 7lb 3 little one was a nightmare to birth because she was back to back!

Good luck, not long now. I have 3 weeks till DC2 should appear.

Yes beccas the back to back thing has come back to haunt me (at the last scan the baby was facing the right way but seems to have reverted to back to back). Will get back on to my gym ball!

Was hoping to avoid an epidural and anything instrumental, is this unrealistic with a back to back delivery?

This might be a stupid question, but what are the concerns that health care professionals have about a baby being big? Is it because delivery is more difficult? Is the baby more likely to get stuck on the way out? Just realised I never actually asked the midwife why she was concerned!

Midwives are often very very wrong about these things.
And weight is only loosely correlated with headsize, which is the difficult bit.

Is it the same midwife who's done all the fundal measurements? Any chance she's just measuring from the wrong place?

FWIW a friend of a friend was pushed into accepting an early induction on the basis of scans estimating a huuuge baby, but it was actually born weighing less that 6lbs.

THis is the site you need!

FWIW my second one felt big by mw and got sent for growth scan. Scan confirmed a big one. Born 1 days late and over 11 lbs. My third was 10lbs too. TBH big babies come out much easier than average size babies ime. Plus once they are out they feed and sleep well.

Take a look at the website and relax!

The main issue with big babies is when the shoulder can get stuck. But I am not sure how common it is. Certainly didn't happen in my case(s).

The midwife in antenatal isn't the one who is likely to deliver you, so you can ask them again at the hosp if you're still really worried. They should do more to re-assure you.

I was so adament I was having no intervention whatsoever but the back to back thing was just too much - the baby presses on some nerve on your back so you dont get any break in between contractions, its like one long continuous dreadful pain. I managed up to 6 cm ok but then it just went haywire and I didn't progress. Its the not progressing that is a worry, so as long as you keep going your cm per hour (if you can bear the VE every couple of hours!) then you should be fine and won't need the epidural and pain relief.
I just advise that if you stop progressing, its baby being back to back causing it, and nothing you can do will help - well positions may do hence get those midwives helping actively!

And I agree with cece - bigger babies sleep and feed well!!!

The size of your baby is irrelevant. It is the size of your baby and their position in relation to your pelvis. As other posters have said you may have a 10lb 8oz baby and birth it fine or have a forceps with a 6lb baby, you don't know until you get there! A significant number of shoulder dystocias happen with babies under 4kg. The midwife can tell the difference between baby and liquor , and although the fundal height may be affected by this, polyhydramnious does not seem to have been identified on your scans or on palpation.
Size is less of an issue than the posterior position of baby where they are less well flexed and it is more difficult to get into the pelvis (hence stopping at 6cm as a previous poster reported). Best things to do are forward leaning postures now and in labour, keeping up and about and perhaps try putting one foot on a low stool and rocking gently back and forth, I have seen that change a baby's position before.
Epidurals are more common for posterior labours but ironically make it less likely that the baby will turn spontaneously.
Good luck

Thank you ladies for your advice and encouragement! Perhaps we should start a sweepstake, although judging by everyone's experiences I bet the baby will be a perfectly average size after all!

cece, that website is great, thanks for that.

missus84, the same midwife did 2 of the 3 measurements, a GP did the other.

beccas, ta for the further info about your pain relief, good luck to you too!

Very happy about the comments regarding feeding, sleeping, and general cuteness, perhaps I'd like a porky little one after all!

Hi reikizen, are you a midwife? Thanks for the tips on turning the baby.

Can I ask, if the size of the baby is irrelevant why am I being sent for another scan? Sorry, that's looks really sarky , don't mean it that way at all, I'm genuinely curious, as I said, I forgot to ask the midwife why she seemed concerned.

It is irrelevant to the extent that they have no idea whether baby will fit through your pelvis even if they conclude it is big. Every labour is a trial and I have known plenty of small to medium size babies being delivered by section or forceps. They will use the scan information to decide whether to induce you early though, although of course you can decline this.
If the mw has identified a deviation from the norm (ie, large for dates baby) it must be investigated to eliminate polyhydramnious for example.
I am surprised at you having 3 scans though, what was your fundal height measurement and how many weeks are you?

Am 39 +1 today, measurement is 40.5cm.
At 37 +1 measurement was 39
At 28 +1 measurement was 28 (actually that was only just over the top line, had remembered it as rather more dramatic than that due to the midwife's reaction "are you sure your dates are right? ")

Oh god, I would not worry about that at all! 2cm bigger than your gestation I would send you for a scan and if that came back fine I'd stop worrying. If it has been different midwives I would just put it down to the differences in each practitioners method and even if it is the same one I still wouldn't worry tbh. I usually measure 2 or even 3 times if I think a woman is measuring large just to be sure. Good luck.

OK, so you were measuring 2cm over and are now measuring 1cm over. Where I work we would only refer for a scan if more than 2cm over. So 3cm over or more.

I would think scans are more accurate.

Brilliant! I'm normally very robust and no-nonsense about health issues, but I was starting to feel a bit uneasy due to the midwife seeming to think it was a cause for concern and the number of scans. At least I can't complain that I'm being neglected!

Cheers everyone for your advice, will enjoy the remaining pregnancy and won't worry about what size of parcel the stork is bringing! Now, where's that gym ball...